2023 Prenatal-to-3 State Policy Roadmap
The Prenatal-to-3 State Policy Roadmap guides state leaders on the most effective investments to ensure all children thrive from the start. Grounded in the science of the developing child and based on the most rigorous evidence available, the Roadmap details the state actions that foster the nurturing environments infants and toddlers need, and that reduce longstanding racial, ethnic, and socioeconomic disparities in access and outcomes.
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 12 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 addition to each state’s Roadmap summary, we provide an overall summary of the progress that states have made over the last year toward full and equitable implementation of the 12 effective policies and strategies.
- We define policies as an approach for which the research demonstrates impacts on PN-3 policy goals and supports clear state legislative or regulatory action. We measure progress toward implementing the effective policies, therefore, based on the implementation of specific policy actions.
- We define strategies as an approach for which the research demonstrates impacts on PN-3 policy goals but does not yet provide precise guidance for state legislative or regulatory action. We measure progress toward implementing the effective strategies relative to other states, rather than against an absolute standard.
The Roadmap also includes demographic characteristics of infants and toddlers across the US 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.
TABLE OF CONTENTS
United States Roadmap Summary
An overview of the prenatal-to-3 state policy goals and states' progress over the last year on the 12 Roadmap policies and strategies.
Demographic Characteristics
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
State-level data on 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
Policies for which the research provides precise guidance for state action. Progress 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.
Paid Family Leave
Paid family leave programs of at least 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
Strategies for which the research does not yet provide precise guidance for state action. Progress is measured relative to other states, rather than against an absolute standard.
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.
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 of single, formal care arrangements, support maternal employment, and increase earnings.
Group Prenatal Care
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
Community-based doulas increase attendance at health appointments, improve healthy birth outcomes, increase breastfeeding initiation, and improve child-parent relationships.
Evidence-Based Home Visiting Programs
Evidence-based home visiting programs lead 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, as well as boosts maternal self-confidence and role satisfaction.
