Research News

Prenatal-to-3 Policy Impact Center releases third annual state policy roadmap

The Prenatal-to-3 Policy Impact Center at Vanderbilt Peabody College of education and human development recently released its third annual Prenatal-to-3 State Policy Roadmap at the Research to Policy Summit. This guide informs state policy leaders and advocates about the most effective policies and strategies for supporting the development and well-being of children in their earliest years, tracks each state’s progress toward implementing them, and advises states on how to improve their levels of support.

The prenatal to age three period is the fastest, most vulnerable period of human development and is foundational to children’s long-term health and welfare. Because children are born into differing socioeconomic and family circumstances, the policies and practices of the states in which they are born and raised can play a pivotal role in supporting their health and well-being.

“The fragile economy and continuation of the pandemic has exposed the complex social, economic, and health needs of families with young children. Parents continue to struggle to care for their little ones while staying in the workforce and dealing with rising costs of their basic needs,” said Cynthia Osborne, executive director of the Prenatal-to-3 Policy Impact Center and professor of leadership, policy and organizations at Peabody. “What we do know is that there are investments that work – and it takes a system of care to ensure healthy children are born to healthy parents, and that parents have the skills, resources, and institutional supports they need to work and care for their children.”

To support states’ decisions, the Roadmap highlights the most effective policies and strategies to achieve the Center’s eight prenatal-to-3 goals, established by decades of child development research:

Prenatal-to-3 Goals:

  • Access to needed services—families have access to necessary services through expanded eligibility, reduced administrative burden and fewer barriers to services, and identification of needs and connections to services.
  • Parents’ ability to work—parents have the skills and incentives for employment and the resources they need to balance working and parenting.
  • Sufficient household resources—parents have the financial and material resources they need to provide for their families.
  • Healthy and equitable births—children are born healthy to healthy parents, and pregnancy experiences and birth outcomes are equitable.
  • Parental health and emotional well-being—parents are mentally and physically healthy, with particular attention paid to the perinatal period.
  • Nurturing and responsive child-parent relationships—children experience warm, nurturing, stimulating interaction with their parents that promote healthy development.
  • Nurturing and responsive childcare in safe settings—when children are not with their parents, they are in high-quality, nurturing and safe environments.
  • Optimal child health and development—children’s emotional, physical and cognitive development is on track, and delays are identified and addressed early.

The Center’s policy analysts conducted comprehensive reviews of the most rigorous evidence available, including thousands of articles and hundreds of studies, to provide detailed guidance on five policies and six strategies that foster the nurturing environments infants and toddlers need, and that reduce longstanding disparities in access and outcomes among racial, ethnic and socioeconomic groups.

Effective Polices:

  • Expanded income eligibility for health insurance
  • Reduced administrative burden for the Supplemental Nutrition Assistance Program (SNAP)
  • Paid family leave of at least 6 weeks
  • State minimum wage of at least $10 an hour
  • Refundable state earned income tax credit

Effective Strategies:

  • Comprehensive screening and connection programs
  • Childcare subsidies
  • Group prenatal care
  • Evidence-based home visiting programs
  • Early head start
  • Early intervention services

The Roadmap tracks states’ achievement of the prenatal-to-3 goals based on whether they have adopted and fully implemented the five policies and whether they have made substantial progress relative to other states toward implementing the six strategies.

The combined policies and strategies create a system of care that provides broad-based economic and family supports. However, only a handful of states—California, Connecticut,  Massachusetts, New Jersey, and Washington, and the District of Columbia—have implemented all five policies. Even so, most states are making progress toward a system of prenatal-to-3 care, as many have seriously considered legislation to adopt one of the evidence-based policies, passed legislation to enhance the benefits, or will fully implement one of the policies in the next few years.