Persistent and unacceptable disparities in infant mortality and perinatal outcomes affect the health of families in every state in the nation. For the past 30 years, the federal Healthy Start program has provided integral maternal and child health services in communities disproportionately impacted by negative birth outcomes. Now, NICHQ is working with all 101 Healthy Start community sites to harness lessons learned, implement innovative approaches to improvement, and ultimately start to close the disparity gap in maternal and infant health.