CHILD AND FAMILY OUTCOMES
Based on the science of the developing child, we have identified 18 outcome measures to track the overall health and wellbeing of infants and toddlers and their parents. Each outcome is aligned with one of eight prenatal-to-3 (PN-3) policy goals that combine to create the environments in which children can thrive from the start.
Learn more about how your state performs on indicators of child and family wellbeing below. Select a state in the dropdown menu to see all indicators of wellbeing for your state. To explore more about a specific outcome, expand the accordion for that outcome below to learn more about state variation and differences by race and ethnicity.
Prenatal-to-3 Outcomes to Measure Impact
For additional information on the prenatal-to-3 policy goals, see the Prenatal-to-3 State Policy Clearinghouse.
Health Insurance
Adequate Prenatal Care
Developmental Screenings
Parental Employment
Child Poverty
Crowded Housing
Food Insecurity
Preterm Births
Infant Mortality
Maternal Mental Health
Parenting Support
Daily Reading
Daily Nurturing Behaviors
Parenting Stress
Access to EHS
Breastfeeding
Immunization
Child Maltreatment
FREQUENTLY ASKED QUESTIONS
How can state leaders use child and family outcome measures to inform policy?
State leaders can use this outcome information to understand their states’ success in meeting each PN-3 policy goal, and to prioritize the policy goals in which their state is lagging. The Roadmap provides clear guidance to state leaders on which effective policies or strategies they can implement to improve outcomes related to their priority PN-3 policy goals.
Importantly, the “best” state does not necessarily indicate a target for all other states to strive toward; even in the states with the best outcomes, many children and families are struggling. For example, Oregon reports the lowest, or best, percentage of children who did not receive a developmental screening, but in that state still 40% of children are not screened for potential delays that can identify the need for intervention. Massachusetts has the best rate of children receiving all of their required immunizations, but nearly 13% of infants and toddlers are not up to date on their immunizations.
The daily reading outcome measure provides another example of an outcome on which all states can improve; West Virginia families report that nearly 72% of parents do not read to their infants and toddlers daily, which is the highest, or worst, percentage in the country. Maine families report the best rate of daily reading, but 42% of young children are not read to daily in the state.
To see which policies are effective at improving each prenatal-to-3 policy goals, check out the Roadmap summary.
What can these measures tell state leaders about equity in access and outcomes?
Although reviewing the aggregate health and wellbeing of children and families is important, states also must pay attention to disparities in outcomes by race, ethnicity, and socioeconomic status. Long-standing patterns of racism, reinforced through state policy choices, have continuously resulted in racial and ethnic disparities in access and outcomes. Eliminating these disparities must be a goal for all states.
Yet, small sample sizes often prohibit the measurement of state-level racial and ethnic disparities in outcomes, unless many years of data are pooled into one sample. Pooling data across years, however, limits a state’s ability to track progress toward their goals over time. Nonetheless, states should continue to collect and analyze disaggregated data to inform, as much as is possible, more equitable policy choices
Why did the Prenatal-to-3 Policy Impact Center select these outcome measures?
Although the 18 outcome measures included in the Roadmap are certainly not the only, or even the best indicators of child and family wellbeing, they were chosen for three primary reasons. First, these measures are available for all states and the District of Columbia, which allows for national comparisons. Second, rigorous research shows that most of the outcome measures can be positively impacted by the policies and strategies included in the Roadmap. And, finally, nearly all of the outcome measures are predictive of subsequent health and wellbeing of children and families, and thus important to target in the earliest years.
Can the outcome measures be used to track states’ progress toward policy goals?
The most recently available data in the national datasets are typically a year or two old before they are released for public use, which makes it difficult for states to measure the impact of recent policy changes on changes in outcomes. Indicators of wellbeing may vary year to year, however, this variation may be driven by small sample sizes, rather than meaningful changes in outcomes; examining outcomes over longer periods of time can allow for a clearer understanding of real changes. Nevertheless, the data provide an important portrait of child and family wellbeing.
For additional information on each goal, see the Prenatal-to-3 Policy Clearinghouse.
