Scale Evidence-Based Home Visiting Programs to Reduce Poverty and Improve Health

The Problem

Childhood poverty is costly for children, families, and the entire country. Evidence-based home visiting programs are effective, but they are not reaching enough families.

The long-term effects of childhood poverty include the following:

• premature, low-weight births

• higher rates of abuse, exposure to violent crime, poor nutrition, and other trauma

• poor mental health and behavioral and emotional problems

• lower reading and math test scores, lower school attendance, and higher dropout rates

• higher rates of teen births and juvenile arrests

• in adulthood, lower education, poorer health, and job instability

The Solution

Early childhood provides a brief window of opportunity to intervene and minimize—or even prevent—some of the effects of childhood poverty.

• Home visiting benefits children by reducing early mortality, improving academic achievement, improving health, reducing criminal and antisocial behavior, and lowering rates of teenage pregnancy.

• Home visiting benefits mothers by helping them become confident, informed parents, and it reduces criminal behaviors, substance abuse, the need for welfare assistance, and reports of child abuse and neglect.

• Home visiting saves money by reducing the demand for public assistance and improving life outcomes for children. One dollar invested in an evidence-based home visiting program can return a net benefit of $5.70, with the majority accruing to the government in savings on social programs.

What Philanthropy Can Do

Philanthropy can support efforts to identify communities that would benefit most from expanded access to these critical programs. Philanthropy can also supplement funding to implement and test communitywide approaches so all families can experience the benefits. It can continue to fund research on program effectiveness and help identify new funding strategies by convening key stakeholders.

What Government Can Do

Congress can expand the Maternal, Infant, and Early Childhood Home Visiting program, which provides grants to states for evidence-based home visiting services. State agencies could allow Medicaid to cover home visiting costs. State and federal agencies can use value-based health care financing reforms, which focus on quality of care instead of quantity, to explore new funding streams for home visiting services. Finally, by establishing career pathways and professional development opportunities, government can help build the home visiting workforce.

What Does "Mobility" From Poverty Mean?

The US Partnership on Mobility from Poverty’s definition of mobility has three core principles: economic success, power and autonomy, and being valued in community. These principles drive five mutually reinforcing strategies:

• Change the narrative
• Create access to good jobs
• Ensure zip code is not destiny
• Provide support that empowers
• Transform data use

Evidence-based home visiting programs are part of the strategy to provide support that empowers.

How Evidence-Based Home Visiting Programs Can Improve Mobility

• Economic success: By intervening early, home visiting can support the brain development and executive functioning that children need to thrive in school and the workforce.

• Power and autonomy: Home visiting helps parents develop a sense of control, knowledge about available resources, and confidence.

• Being valued in community: Home visiting programs can strengthen parent-child bonds. Families will experience less social isolation and have greater social capital.

This brief summarizes the paper Scale Evidence-Based Home Visiting Programs to Reduce Poverty and Improve Health. The paper lists sources for the research summarized here.