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October 7, 1998

Reconfiguring Child Health Services in the Inner City

Author Affiliations

From the Department of Clinical Outcomes Management, Shriners Hospitals for Children, and the Departments of Pediatrics, Epidemiology, and Biostatistics and College of Public Health, University of South Florida, School of Medicine, Tampa (Dr Wood); and Center for Healthier Communities, Families and Children, Department of Pediatrics, School of Medicine, and Department of Community Health Sciences, School of Public Health, University of California, Los Angeles (Dr Halfon).

JAMA. 1998;280(13):1182-1183. doi:10.1001/jama.280.13.1182

In this issue of THE JOURNAL, Hoekstra et al1 demonstrate how 2 public agencies, through innovation and collaboration, were able to dramatically increase immunization rates among thousands of young children in the inner city of Chicago, Ill. The Chicago Department of Public Health contracted with the Chicago Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), which has 47 offices that follow 70% of inner-city families during the first year of an infant's life, to have WIC staff review the parents' immunization record for each child, to educate the parents concerning when immunizations were due, and to make referrals to accessible immunization services, some of which were at the WIC offices. Parents of children found to be delayed in their immunizations or who did not bring in their infant's immunization card were provided only 1 month's supply of WIC food vouchers instead of the usual 3 months' supply that was given if the child's immunizations were up-to-date. In just 15 months, immunization rates for thousands of WIC children, which had been stubbornly low for more than a decade, increased dramatically from 56% to 89%, a stunning accomplishment. Moreover, the intervention did not result in any measurable negative impact on WIC program participation.