[4] Spearheaded by Hollywood producer and political activist Rob Reiner, who acted as the commission's first chairman in 1999 under former Governor Gray Davis, First 5 California was created to use tobacco tax revenues to fund health, safety and early education programs for children age prenatal to 5 years old in California.

[5][6] In the 12 years subsequent to its creation, First 5 LA had invested more than one billion dollars from tobacco tax revenues into grants and programs that benefit the children of Los Angeles County.

The mission is to increase the number of Los Angeles County children ages 0 to 5 who are physically and emotionally healthy, ready to learn, and safe from harm.

[3][8] Proposition 10 established a 50 cent-per-pack tax on tobacco products towards the healthy development of California's children from prenatal to age five.

[13] In response to these challenges, the commission developed an accelerated plan to utilize nearly $400 million in program and services for county children.

Evaluation of the Black Infant Health program has suggested that BIH clients have lower amounts of birth defects, infant mortality, and higher amounts of breast-feeding when compared to other African American mothers in LA County and the U.S.[22] Evaluation of the Healthy Birth Initiative showed more intermediary results.

Rates of gestational age, pre-term birth weight, and infant mortality were higher in HBI clients when compared to LA County statistics.

[23] First 5 LA's Early Developmental Screening Initiative has shown increased collaboration between clinicians, community groups, and patients.