2022 Prenatal-to-3 State Policy Roadmap

The Prenatal-to-3 State Policy Roadmap provides guidance to state leaders on the most effective investments states can make to ensure all children thrive from the start. Grounded in the science of the developing child and based on comprehensive reviews of the most rigorous evidence available, the Roadmap provides detailed information on five effective policies and six effective strategies that foster the nurturing environments infants and toddlers need, and that reduce longstanding disparities in access and outcomes among racial and ethnic groups and socioeconomic statuses. The Prenatal-to-3 State Policy Roadmap is an annual guide for each state to:
  • Assess the wellbeing of its infants and toddlers and prioritize state PN-3 policy goals;
  • Identify the evidence-based policy solutions proven to impact PN-3 policy goals;
  • Monitor states’ adoption and implementation of the 11 effective Roadmap policies and strategies;
  • Track the impact that policy changes have on improving the wellbeing of children and families and reducing disparities between racial and ethnic groups.
In this Roadmap, we provide a summary of the progress that states have made over the last year toward full and equitable implementation of the 11 effective policies and strategies. The Roadmap also includes demographic characteristics of infants and toddlers across the U.S., and for each state, as well as a set of 20 outcome measures that illustrate how the wellbeing of children and families varies across states. Additional details, including extensive information on the impact that each solution has on the eight PN-3 policy goals, the choices that states can make to effectively implement them, the progress states have made in the past year toward implementation, and how states compare to each other in their generosity and reach of the policies and strategies is provided in a profile for each policy and strategy.



Expanded Income Eligibility for Health Insurance

The United States Roadmap summary presents an overview of the prenatal-to-3 state policy goals and states’ progress over the last year on the 11 Roadmap policies and strategies.


Demographic Characteristics

The characteristics of families vary considerably by state. Find summary data on the current demographic composition and characteristics of the United States’ prenatal-to-3 population. State-specific demographic characteristics are also available within each state Roadmap.


State-Level Outcomes

Use the pull-down menu to browse state-level data on 20 outcome measures to track the overall health and wellbeing of infants and toddlers and their parents. Each outcome is aligned with a PN-3 policy goal and illustrates states’ success in meeting that goal or indicates where a state is lagging.

Effective state policies
Effective policies impact PN-3 goals and research supports clear state legislative or regulatory action. State progress toward implementing the five effective policies is measured based on the implementation of specific policy actions.

Expanded Income Eligibility for Health Insurance

Medicaid expansion helps families access needed care and services, increases financial wellbeing, improves healthy and equitable birth outcomes, and keeps children safe.


Reduced Administrative Burden for SNAP

Reduced administrative burden through a bundle of policies increases SNAP participation rates among eligible households, which lowers food insecurity among children and families.


Paid family leave

Paid family leave programs providing a minimum of 6 weeks increase access to paid time off from work, reduce racial disparities in leave-taking, boost mothers’ labor force participation, improve maternal mental health, and foster better child-parent relationships and child health.


State minimum wage

A state minimum wage of at least $10.00 increases household earnings and reduces child poverty, particularly in families of color, improves birth outcomes and children’s health and development.


State Earned Income Tax Credit

A refundable state EITC of at least 10% of the federal credit promotes healthier and equitable birth outcomes, increases parents’ workforce participation, and improves economic security, with the greatest effects for single mothers and their children.

Effective state strategies
Effective strategies impact PN-3 goals, but the research does not yet provide precise guidance for state legislative or regulatory action. Progress toward state implementation of strategies is measured relative to other states, rather than against an absolute standard.

Comprehensive Screening and Connection Programs

Comprehensive screening and connection programs increase families’ connections to needed services, and may enhance optimal child health and development with positive impacts on emergency department visits and vaccination rates.


Child Care Subsidies

Child care subsidies increase access to needed services including the use single, formal care arrangements, support maternal employment, and increase earnings.


Group Prenatal Care

Participation in group prenatal care improves the likelihood that mothers receive adequate prenatal care, and may impact mothers’ physical and emotional health and breastfeeding initiation.


Community-Based Doulas

Participation in group prenatal care improves the likelihood that mothers receive adequate prenatal care, and may impact mothers’ physical and emotional health and breastfeeding initiation.


Evidence-Based Home Visiting Programs

Participation in evidence-based home visiting programs leads to small but positive impacts on parenting skills; these effects exist within the context of many more null findings. Impacts are inconclusive across program models on other important child and family outcomes, including birth outcomes, child maltreatment, and child health.


Early Head Start

Early Head Start improves numerous aspects of child-parent relationships, promotes access to good-quality care, positively impacts parent health and emotional wellbeing, and improves children’s language and vocabulary skills and problem behaviors.


Early Intervention Services

Early Intervention services improve children’s cognitive, motor, behavioral, and language development, and boosts maternal self-confidence and role satisfaction.