Mayor Lurie Launches Strong Starts, Another Major Step to Support San Francisco Kids and Families

SAN FRANCISCO – Mayor Daniel Lurie today launched Strong Starts, a new effort to support San Francisco families, mothers, and kids by supporting maternal and infant health. Strong Starts will bring together city departments in a new format to better respond to community needs and improve maternal and infant health outcomes—including reducing preterm birth rates and lowering infant and maternal mortality rates. 

The launch of Strong Starts builds on Mayor Lurie’s work to support San Francisco’s families and ensure young people are supported throughout every stage of their life. Last month, he launched his Family Opportunity Agenda to make San Francisco more affordable for families and ensure that every family has access to child care. The mayor has signed his Family Zoning plan—a generational roadmap to create more housing so that the next generation of San Franciscans can afford to raise their children in the city they love. Last fall, when a federal shutdown threatened Supplemental Nutrition Assistance Program benefits, Mayor Lurie partnered with the Board of Supervisors and philanthropic partners to ensure the 112,000 San Franciscans who rely on SNAP could still put food on the table and filled the gap in seven days. 

“If we want to be a city where every child can thrive, we must support our kids and parents at every stage of life,” said Mayor Lurie. “I am proud to announce Strong Starts—a new, citywide effort to improve maternal and infant health outcomes so that every child in San Francisco has the strongest possible start in life. Getting families off on the right start is one of the most powerful ways we can shape San Francisco’s future, and today, we’re taking the next step in our plan to make San Francisco a place where our families can thrive.”  

“We collectively recognize that the disparities in maternal and infant health in San Francisco are unacceptable; and that we have the ability to change course if we put in the investments, staffing, resources, and the political will to prioritize the issue,” said District 7 Supervisor Myrna Melgar. “This collaborative effort will finally align goals and coordination across departments; and most importantly be accountable for improving the outcomes for maternal and infant health. I am committed to seeing this work through and ensuring that it respects the needs of the communities most impacted.” 

“The maternal health data in San Francisco is unacceptable, especially for preterm births for Black mothers. These disparities are not accidental, they are the result of long-standing inequities that we must address with urgency and accountability,” said District 10 Supervisor Shamann Walton. “We must do everything possible to change these outcomes and ensure the care and support needed for healthy births in this extremely rich city. Our office will keep working on programs, securing resources, and coordinating with health providers and city leaders to change these outcomes.” 

Despite allocating more than $20 million towards maternal and infant health, the city continues to see significant disparities in outcomes: In San Francisco, Black babies are born preterm at nearly twice the citywide average and comprise 20% of infant deaths despite representing 4% of all live births according to the San Francisco Department of Public Health. 
Through Strong Starts, the city will reexamine the way it is funding and delivering services during this critical developmental window. The city will explore strategies to support mothers and infants in the following areas: 

• Improving early connections to clinical care
• Expanding access to culturally responsive prenatal and postpartum care, including supporting doula programs in partnership with City College and community organizations to strengthen the pipeline of culturally responsive care providers
• Strengthening supports for family caregiving, including building capacity for infant child care
• Providing wraparound supports to address social determinants of health, including food security and behavioral health  
• Improving data, accountability, and coordination across city government, prioritizing meaningful community engagement and oversight alongside efforts to align hospitals, health plans, and community-based organizations around shared goals 

“This initiative affirms what community organizations have known for years—culturally responsive, community-rooted care saves lives. Strong Starts is a win for the organizations that have been leading this work long before it became a citywide priority. The difference now is accountability,” said Marlee-I Mystic, SisterWeb Co-Executive Director. “By aligning departments, tracking outcomes, and creating space for community oversight, we are building a structure that can hold the city responsible for delivering equitable results. We move forward hopeful and united in our vision of healthy pregnancies, safe births, and thriving families across all of San Francisco, with no gaps based on race.” 
Strong Starts will advance a cross-departmental effort to improve outcomes for mothers and infants in the following ways: 

• Strategy and Alignment: Strong Starts will bring together city departments to align on key outcomes and leading indicators to track progress towards the goals of the initiative, ensuring alignment with community priorities and informing a holistic strategy to drive progress on agreed-upon metrics across departments. That work will include working with departments and community leaders to align programs to advance the strategy and improve outcomes. Facing a $936 million budget deficit, the city will also work to utilize state and federal funding for initiatives that serve pregnant and postpartum women and infants.
• Strong Starts Working Group: The Strong Starts Working Group will be led by the Mayor’s Office and co-chaired by the Department of Public Health (DPH), Agency for Human Rights (AHR)—which includes the Human Rights Commission (HRC) and the Department on the Status of Women (DOSW)—and the Department of Early Childhood (DEC). It will also include senior leaders from key city departments, including the Human Services Agency (HSA), the Mayor’s Office of Housing and Community Development (MOHCD), the Department of Homelessness and Supportive Housing (HSH), the Office of Economic and Workforce Development (OEWD), and the Mayor's Office for Victims’ Rights.
• Accountability: The Strong Starts Working Group will convene regularly to review program performance, while HRC’s Equity Advisory Committee will provide a venue for the community to share their lived experiences, help identify systems gaps, and bring their solutions for consideration by the working group. The group will also provide an annual update to the Board of Supervisors on progress towards goals.  

“Healthy mothers and infants are the foundation of strong families and long-term economic mobility, and Strong Starts reflects the urgency our communities have called for,” said Dr. Diana Aroche, DOSW Executive Director. “The outcomes we continue to see in San Francisco call us to act with focus and partnership, and to do better for the women and infants most impacted by disparities, and ultimately for families. As part of DOSW’s upcoming strategic plan, which sets forth the city’s Women’s Agenda, we are committed to advancing maternal health equity through coordinated efforts that drive meaningful, measurable improvements across our city.” 

“When San Francisco supports mothers and babies, we are investing in the future of our city. With Strong Starts, which is part of Mayor Lurie’s Family Opportunity Agenda, we are uniting city departments to help reduce preterm births, lower maternal and infant mortality, and tackle the inequities that still impact Black, American Indian, and Pacific Islander families,” said Ingrid Mezquita, DEC Executive Director. “By working together, we are creating a city that partners to support families when they need it most.” 

“The launch of Strong Starts reflects our collective commitment to improving birth outcomes and closing the gap in maternal and infant health disparities,” said Dan Tsai, DPH Director of Health. “By ensuring equitable care around these shared goals, we are laying the foundation for families and children to live healthy lives. This initiative will strengthen the long-term health of our communities and build a stronger, more resilient generation of San Franciscans.” 

“Maternal health is a central measure of the city’s overall wellbeing. For too long, we have seen maternal health disparities—including higher mortality and morbidity rates—align with race, regardless of economic status,” said Mawuli Tugbenyoh, AHR Executive Director. “I am proud that San Francisco is putting the necessary resources into understanding why these disparities exist and investing in solutions that will change outcomes for the better. When our city's maternal and infant health supports are responsive and quality care is guaranteed for all, the entire community benefits. The Agency for Human Rights looks forward to working with HRC’s Equity Advisory Committee as they provide space for community members to share their critically important perspective and guidance.”