over multiple years. Preventing or limiting long-term morbidity that has its origins in the prenatal or infant period is also likely to be a priority, and a variety of activities in the community could be expected to make contributions toward this end. For indicators that are adopted, communities will have to establish clear operational definitions and identify sources of relevant data. The committee proposes the following indicators.

  1. Percentage of babies born weighing less than 1,500 grams.

  2. Percentage of babies born weighing less than 1,000 grams.

    Low birth weight is a marker for increased risk of morbidity and mortality. It reflects the combined effect of a variety of factors including the mother's health and lifestyle, the infant's genetic endowment, socioeconomic circumstances, and the quality of prenatal health care services. Therefore, responsibility and accountability are diffused throughout the community. Data on birth weight would be available from birth certificates. State vital records systems should be able to provide information on the basis on a mother's place of residence rather than the location of the birth. In communities with small numbers of births, data should be aggregated over multiple years to produce a stable measurement.

  3. Of pregnant women and women who have a child less than 1 year of age and who are eligible for AFDC, WIC or related programs, percentage who are enrolled in those programs.

    Programs such as WIC and AFDC provide nutritional and income support to low income families in the community, which can benefit the health of pregnant women and their infants. These public assistance programs are a response by federal, state, and local governments to needs created by economic deprivation. Program records at the state or local level should be able to provide data on the number of enrollees and are likely to have methods of estimating the percentage of those eligible who are enrolled. Alternatively, a community survey could be used to collect information.

  4. Percentage of mothers less than 18 years of age who are enrolled in school.

    Since higher levels of education are associated with better health, communities may want to encourage adolescent mothers to complete high school. Schools can play a major role by providing child care and programs designed specifically to meet the



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