Health First Indiana: Quick Facts

Health First Indiana is an initiative created by Senate Enrolled Act 4, legislation passed by the 2023 Indiana General Assembly that transforms public health. The legislation provides funding so counties can determine the health needs of their community and implement evidence-based programs focused on prevention. Health First Indiana establishes a public health infrastructure through a state and local partnership where services are delivered at the county level. Counties decide whether to opt-in to the new funding and providing the core public health services, including trauma and injury prevention, chronic disease prevention, maternal and child health and more.

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Quick Facts about Health First Indiana

$75 million in 2024, $150 million in 2025
Investment in prevention leads to healthier communities and workforce, which attracts local businesses and improves the economy
Brings together local elected officials, public health, clinical health and community partners
Partnerships allow us to identify gaps and reduce duplication to ensure the efficient delivery of services
Benefits rural communities that often have fewer resources, such as free health screenings and connection to care
More than 1.4 million services were provided in the first year of Health First Indiana

Process for Counties to Opt-in

County Commissioners vote to opt-in, County Council approves the budget
Opt-in deadline is Sept. 1
Counties have established key performance indicators and activities are reported twice a year. View each LHD’s key performance indicators and activities on the Your Community Info page.

Trauma and Injury Prevention

In Indiana, preventable injuries account for the leading cause of death in individuals aged 1-44 years, notably poisonings and motor vehicle crashes. Identifying a leading cause of injury allows effective planning and prevention of those injuries and potential deaths.

Water safety: Delaware County Health Department partnered with YMCA of Muncie to provide water safety education to the community. Overall, 102 individuals participated in the Safety Around Water (SAW) course and learned about valuable aquatic safety skills. Additionally, nine individuals completed more advanced swim lessons, and five individuals were certified as lifeguards.

Infectious Disease Prevention and Control

In Indiana, the number of congenital syphilis cases has increased by 2,300% from 2018 to 2023. Congenital syphilis is preventable, and partnerships with health systems can help reduce syphilis cases.

Partnership with health system: To reduce local syphilis rates with a focus on congenital syphilis, Wayne County Health Department (WCHD) implemented specific interventions in partnership with Reid Health's emergency department. Local syphilis rates and associated morbidity were discussed with the emergency department provider staff at their regular staff meeting. Syphilis screening has been added to the STI order set allowing for easy ordering by the ED provider when assessing STI-type complaints or reported STI exposure. Additionally, the emergency department is in the process of creating a reflex syphilis screening to all positive pregnancy tests in the emergency department. Starting in early 2025, any positive urine or qualitative serum pregnancy test with have a reflex syphilis screening test performed. Emergency department staff and providers were reminded of local health department resources and support in the care and prevention of STIs.

Infectious Disease Prevention and Control

Chronic Disease Prevention

In Indiana, the number of congenital syphilis cases has increased by 2,300% from 2018 to 2023. Congenital syphilis is preventable, and partnerships with health systems can help reduce syphilis cases.

Diabetes/hypertension: Switzerland County Health Department started outreach clinics within the county to increase access to care for the rural population. At the clinics, patients are offered a free blood pressure and glucose screening by a registered nurse. During one of the clinics, eight individuals were screened, and two individuals were identified with undiagnosed high blood pressure. At that clinic, four individuals were referred for chronic disease preventive care with a primary care physician. In the past year, nine individuals were found to have undiagnosed high blood pressure through the local health department clinic.

Tobacco and Vaping Prevention and Cessation

Youth e-cigarette use among Indiana high school students increased from 3.8% in 2012 to 19.8% in 2021. Most e-cigarettes contain highly addictive nicotine that can harm youth brain development. The first step in addressing tobacco and addictive nicotine prevention is building and maintaining a tobacco-free coalition that represents the whole community.

New community coalition: Spencer County Health Department's tobacco and vaping prevention and cessation program serves all school systems, employers, providers, nonprofits, youth and adults in Spencer County. The coalition provides key tobacco and vaping prevention education to middle and high school students. They offer the CATCH My Breath youth vaping prevention program and the INDEPTH (Intervention for Nicotine Dependence: Education, Prevention, Tobacco and Health) program. INDEPTH is an alternative to suspension and citation for students. Rather than a punitive approach, INDEPTH helps schools and communities address teen vaping in a supportive way. The coalition also provides outreach to parents and guardians through back-to-school events, health fairs and parent nights.

Maternal and Child Health

Indiana ranks 41st in infant mortality, which is the death of an infant before the first birthday. In 2021, Indiana's infant mortality rate was 6.7 deaths per 1,000 live births, compared to the national rate of 5.4. Understanding causes of infant mortality helps drive evidence-based action to prevent these deaths.

Prenatal care: Kosciusko County Health Department's Early Start Prenatal clinic provides mothers with their initial obstetric visit and then coordinates ongoing care through the local hospital's OB services. Using Health First Indiana funding, the clinic also offers vouchers to ensure women have access to follow-up prenatal care.

Lead Case Management

Children with blood lead levels of 5-9 micrograms per deciliter increased the risk of failing math and reading tests by 32%. An Indiana University study found that children who get their water from private wells before age 6 have higher blood lead levels, and as a result, have a 21% higher risk of being reported for any delinquency after age 14, and a 38% increased risk of having a record for a serious complaint. Reducing blood lead levels to less than 1 μg/dL among all U.S. children between birth and age 6 years could result in benefits of $50,000 per child annually. This would be due to improvements in high school graduation rates and reductions in crime.

Testing for children: During National Lead Poisoning Prevention Week, Greene County Health Department provided free blood lead level testing for children aged six months to six years of age. In addition, the health department provided free onsite testing with parental/guardian consent. As a result of the initiative there were 38 children tested in total with 14 indicating elevated blood lead levels about 3.5 ug/dL. Of those fourteen, two were at a level requiring further case management and are now receiving the intervention needed to bring the lead level down.