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What do babies need before age 3 to thrive — and how can state family policy help?

The “Prenatal to 3 Roadmap” lays out strategies, goals and policies states are adopting that help families with young children

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Focusing on policies that support the development and well-being of very young children is critical, a report concludes.

One way to help all Americans thrive is by focusing on policies that support the development and well-being of very young children, a report concludes.

Daiga Ellaby, Unsplash

If lawmakers want to help all Americans thrive, they should start by focusing on policies that support the development and well-being of very young children.

That’s according to this year’s Prenatal-to-3 State Policy Roadmap, released recently by Vanderbilt University’s Prenatal-to-3 Policy Impact Center. The report, now in its third year, tracks which states have implemented policies considered helpful for those formative years — a period deemed the “fastest, most vulnerable period of human development and (that) is foundational to children’s long-term health and welfare.”

The fragility of the U.S. economy, combined with the ongoing impact from COVID-19, provided a clear lens through which to see how families with young children may struggle with social, financial and health needs, the center’s executive director, Cynthia Osborne, told the Deseret News.

Which state children live in can determine the level of resources available to them, she said, describing “a patchwork of benefits and services for kids all across this country.” Increasingly, she noted, “states are adopting policies that are effective that we know lead to healthy brain development, healthy body development, that have lifelong consequences.”

States that adopt policies and strategies to help families with the very youngest children see that their lives get off to a good start, said Osborne, who is also a professor of early childhood education and policy at Vanderbilt.

Demographic characteristics

Who are America’s youngest residents and where do they live?

In 2020, the report says, 3.5 million children were born in the U.S.: 51% were white non-Hispanic, 24% Hispanic, 14.7% Black non-Hispanic and 9.4% were of other races/ethnicity. 

The number of children younger than 3 exceeded 11 million in 2020, including non-Hispanic white at 48.3%, Hispanic at 26%, non-Hispanic Black at 14% and 11.7% of other race/ethnicity.

Nearly 41% were born to unmarried mothers, while 1 in 8 were born to mothers with less than a high school diploma, the report said.

Not quite 1 in 5 children younger than 3 live in poverty, while 3 in 10 live in near-poverty. More than 1 in 12 under age 3 live in deep poverty, in households with incomes below half of the federal poverty line. 

The vast majority of American children younger than 3 — more than 9 in 10 — live in metro areas, it said.

Setting goals

The report sets goals for family well-being, including ensuring they can access needed services and that parents can work and have adequate household resources. Health is important, from parents’ physical and emotional health to ensuring healthy and equitable births and the “optimal” health and development of children. Just as important, though, is “nurturing and responsive” child-parent relationships, the authors write.

Some states have already adopted the goals, Osborne said, describing them as “backed by decades of child development research.”

Prioritizing policy

The policies deemed effective in the report for healthy early childhood development include:

  • Expanded income eligibility for health insurance. According to the report, 39 states have made health insurance available to more families, while two states are considering it.
  • Reduced administrative burden for food assistance in the Supplemental Nutrition Assistance Program. Thirty-three states — including in the last year Kentucky and Maryland — have increased the interval between recertifications to qualify for the program. 
  • Paid family leave of at least six weeks. Connecticut recently joined six states that now provide at least six weeks of paid leave. Delaware and Maryland both passed 12-week paid leave programs that will be implemented in the next few years, while paid leave in Oregon and Rhode Island will take effect in 2023. 
  • A state minimum wage of at least $10 an hour. Michigan, Ohio and South Dakota will in 2023 join the 24 states that have already increased their minimum wage to at least $10.
  • Refundable state earned income tax credit. Twenty-one states have created a refundable earned income tax credit. Hawaii will join them in 2023.

The report says most states are “making progress” in creating a system that bolsters the well-being of children from before birth to age 3 by considering, passing or implementing at least one of the policies. California, Connecticut, Massachusetts, New Jersey, Washington and the District of Columbia have implemented all five policies. Six states — Georgia, Mississippi, North Carolina, South Carolina, Texas and Wyoming — have not adopted any of them.  

The report says the policies “interact to create a system of support of varying generosity for parents and children.” And Osborne noted that state minimum wages greatly impact a family’s resources — including how likely they are to need public benefits. 

Depending on where they live, similarly constituted households could have very different resources, Osborne said. And the amount of money they earn from similar jobs could be very different, too.

The report creates a hypothetical single parent with a very young child who works full time for minimum wage and uses a subsidy to leave two children in center-based child care that costs in the 75th percentile of the state’s market rate. Then it “moves” that parent to different states. Considering the state’s minimum wage, out-of-pocket child care expenses, nutrition benefits and tax credits, it finds a District of Columbia family has resources of about $46,654, a family in Utah has $31,342 and that same family in Georgia has $22,484 a year.

Strategies for thriving

The report also lists six “effective strategies” to achieve the health of children and their families, including:

  • Comprehensive screening and connection programs.
  • Child care subsidies.
  • Group prenatal care.
  • Evidence-based home-visiting programs.
  • Early Head Start.
  • And early intervention services.

No state has adopted all six strategies, the report says, but 21 have adopted one or more of them.