Mixed-race family poses for photo as parents smile at boy staring at the camera

WASHINGTON — Nov. 14, 2018 — Despite bipartisan support for federal funding, impressive research outcomes and state and local growth, evidence-based home visiting is still not reaching millions of pregnant and new mothers and families who could benefit from voluntary services in the home.

According to the 2018 Home Visiting Yearbook from the National Home Visiting Resource Center (NHVRC), about 18 million pregnant women and families (including more than 23 million children) could benefit from the information, resources and support offered by trained home visitors but were not being reached in 2017. The number of those who could benefit has held steady since 2015.

More than 300,000 families received evidence-based home visiting services in 2017 over the course of more than 3.5 million home visits. The 15 evidence-based models operating in the U.S. implemented visits in all 50 states, the District of Columbia, five territories, 25 tribal communities and 53 percent of U.S. counties last year.

Early childhood home visiting helps families meet children’s needs during the critical first five years of development. Results include improved outcomes and positive returns on investment for adults and children alike.

Tierra Heisle of Dayton, Ohio, is one mom who is grateful for home visiting. She was dealing with a high-risk pregnancy triggered by a prior medical condition and enrolled in the Nurse-Family Partnership program. “The home visiting nurse was there for everything, any and everything, personal advice, medical advice, all of it. She also helped me with looking for different schools to go to, which [one] was best for me. Now, I have my associate’s degree in health information management.”

Limited Resources Are an Obstacle to Reaching More Families

The Yearbook determined the potential need for home visiting by including all pregnant women and families with children under 6 years old and not yet in kindergarten in its estimates. That includes 16.8 million families with young children and 1.3 million pregnant women without young children, according to estimates from the American Community Survey.

Home visiting has great potential to improve the lives of all young children and families, yet limited resources restrict the number who receive services. To help states identify high-priority families, the Yearbook estimated the number and percentage of families who meet targeting criteria: families with infants, families and pregnant women with income below the poverty threshold, pregnant women and mothers under 21 years, single mothers and pregnant women, and parents and pregnant women with less than a high school education.

More than half (52 percent) of all pregnant women and families with children not yet in kindergarten meet any one of the five criteria above, and 22 percent meet two or more. On a state level, the percentage of high-priority families meeting one or more criteria ranges from 43 percent in Utah to 62 percent in Mississippi and New Mexico.

“The estimates show that all states have large numbers of families who are likely to benefit from home visiting,” says NHVRC Deputy Project Director Allison Meisch, Ph.D. “Decades of research tell us that home visiting can improve outcomes for children and help parents achieve their own education and career goals as they strive for financial self-sufficiency.”

Policymakers See Home Visiting’s Value

The Yearbook is released on the heels of recent federal support for home visiting. Congress passed and President Donald Trump signed reauthorization for the federal Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) earlier in the year.

In 2017, MIECHV helped fund services for more than 81,000 families in states, territories and tribal communities, about a quarter of the total families served by home visiting that year.

State Activity

The Yearbook drills down and provides data for U.S. states and territories, examining their efforts to deliver home visiting services. States support home visiting by combining funds from tobacco settlements and taxes, lotteries and budget line items. With limited resources, states are working to expand the reach of home visiting and serve as many families as they can in a way that makes sense on a local level.

Collection Details

NHVRC released the first Yearbook in July 2017 and later released a follow-up Data Supplement. Since the release of the inaugural Yearbook, more models and states have provided data for inclusion.

NHVRC is a source for comprehensive information about early childhood home visiting; its growing evidence base; and its potential impact on children, families and communities. The center’s goal is to support sound decisions in policy and practice to help children and families thrive.

The 2018 Home Visiting Yearbook was developed by James Bell Associates in partnership with the Urban Institute. Support was provided by the Heising-Simons Foundation and the Robert Wood Johnson Foundation.


Stacey Finkel

Adam Shapiro