Lurie Launches 'Strong Starts' to Tackle San Francisco's Worst-in-State Racial Birth Disparities

San Francisco spends more than $20 million a year on maternal and infant health — yet Black babies are born preterm at nearly twice the citywide average and account for one in five infant deaths despite representing just 4% of births. On Feb. 24, Mayor Daniel Lurie stood with supervisors and community health leaders to announce Strong Starts, a new cross-departmental initiative aimed at eliminating those gaps.

• Mayor unveils Strong Starts, aligning four city departments around shared maternal-infant health goals and annual accountability reports to the Board of Supervisors

• San Francisco has the worst birth disparities by race in California, with Black mothers facing a 200% higher preterm birth risk and nearly three times the infant death rate of white mothers

• SisterWeb leaders push the city to close the gap entirely — not just shrink it — and demand public accountability for public dollars

• A former client-turned-doula-apprentice testifies to the life-changing power of culturally congruent care, illustrating the pipeline from community support to career

The basics: Strong Starts will coordinate the Department of Public Health, Human Rights Commission, Department on the Status of Women, and Department of Early Childhood around shared goals, transparent data tracking, and regular reporting. The initiative targets disparities faced by Black, American Indian, and Pacific Islander families — populations whose birth outcomes lag far behind citywide averages despite decades of investment.