Priority Families
Many families could benefit from the support of a home visitor, yet limited resources restrict the number who receive services. To identify a subpopulation of high-priority families, we estimate the number and percentage of families who meet any 1 of 5 priority criteria:
- Having an infant
- Income below the federal poverty threshold
- Pregnant women and mothers under 21
- Single/never married mothers or pregnant women
- Parents with less than a high school diploma
These criteria were chosen to be useful to states, whether they aim to serve all infants or to focus on families with at least one demographic or economic characteristic associated with poor developmental outcomes. They also align with priority populations identified in many federal initiatives, including the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program. Even though actual priority criteria differ from state to state and from program to program, our national estimates show large numbers of families who are likely to benefit from home visiting.
Potential Beneficiaries of Early Childhood Home Visiting Services: By Priority Criteria
Potential beneficiaries
Number |
Percentage |
|
|---|---|---|
| Pregnant women and families with children under 6 years old not yet in kindergarten | 17,329,700 | 100 |
Priority populations among potential beneficiaries
Number |
Percentage |
|
|---|---|---|
| Families with infants under 12 months | 3,278,900 | 19 |
| Families and pregnant women with income below poverty threshold | 3,702,700 | 21 |
| Pregnant women and mothers under 21 years | 381,800 | 2 |
| Single mothers and pregnant women | 3,940,500 | 23 |
| Parents and pregnant women with less than a high school diploma | 1,000,900 | 6 |
Source: Author tabulations of American Community Survey, 2017–2021.
Note: See the methodology section for more detail on the data source and variable definitions.
Interested in State-Level Data?
We also estimate the number and percentage of families who meet any 1 of the 5 priority criteria or 2 or more criteria.
Potential Beneficiaries of Early Childhood Home Visiting Services: By Number of Priority Criteria
Potential beneficiaries
| Number | Percentage | |
|---|---|---|
| Pregnant women and families with children under 6 years old not yet in kindergarten | 17,329,700 | 100 |
High-priority families
| Number | Percentage | |
|---|---|---|
| Pregnant women and families meeting any 1 of 5 priority criteria | 8,268,700 | 48 |
| Pregnant women and families meeting 2 or more priority criteria | 3,058,100 | 18 |
Source: Author tabulations of American Community Survey, 2017–2021.
Note: See the methodology section for more detail on the data source and variable definitions.
Potential Beneficiaries of Early Childhood Home Visiting Services: By Child Characteristics
Age
Percentage |
Percentage meeting criteria |
|
|---|---|---|
| <1 year | 16 | 31 |
| 1–2 years | 34 | 29 |
| 3–5 years | 50 | 40 |
Primary language
Percentage |
Percentage meeting criteria |
|
|---|---|---|
| English | 72 | 69 |
| Spanish | 18 | 22 |
| Another language | 10 | 8 |
Health insurance status
Percentage |
Percentage meeting criteria |
|
|---|---|---|
| Public | 43 | 60 |
| Private | 53 | 35 |
| None | 4 | 5 |
Source: Author tabulations of American Community Survey, 2017–2021.
Note: Percentages may not add to 100 due to rounding. Some children with public health insurance also have private health insurance. Age, health insurance status, and primary language are based on data for children, except language for children under 4 years old is based on language of their mother or other primary caregiver. Examples of “Another language” include Arabic, German, French, and Chinese. For a full list of languages, visit the information page for the U.S. Census Bureau’s Integrated Public Use Microdata Series (IPUMS).
High-priority children meeting any one of the priority criteria differ from the broader population of all potential beneficiaries in several ways; for example, they are more likely to—
Black and Hispanic families are also more likely to meet certain priority criteria due to structural inequities and limited access to resources and opportunities. Home visiting has an opportunity to reach and support families across a range of racial and ethnic backgrounds to address some of the social determinants of health.(Source: According to the [Centers for Disease Control and Prevention](https://www.cdc.gov/socialdeterminants/about.html), social determinants of health are “conditions in the places where people live, learn, work, and play that affect a wide range of health risks and outcomes.” They include areas such as access to and the quality of healthcare, education access and quality, social and community context, economic stability, and neighborhood and built environment. Social determinants of health are impacted by complex social and economic structures (e.g., discrimination, housing access, income, transportation).)Go to footnote #>1
Potential Beneficiaries of Early Childhood Home Visiting Services: By Family Characteristics
Race
Percentage |
Percentage meeting criteria |
|
|---|---|---|
| American Indian Alaska Native | 1 | 1 |
| Asian | 7 | 4 |
| Black | 14 | 19 |
| Native Hawaiian Pacific Islander | <0.5 | <0.5 |
| White | 64 | 57 |
| One or more races | 7 | 8 |
| Another race | 7 | 9 |
Ethnicity
Percentage |
Percentage meeting criteria |
|
|---|---|---|
| Hispanic or Latino | 23 | 28 |
Education
Percentage |
Percentage meeting criteria |
|
|---|---|---|
| Less than a high school diploma | 8 | 15 |
Type
Percentage |
Percentage meeting criteria |
|
|---|---|---|
| Mother and father | 66 | 52 |
| Mother only | 20 | 35 |
| Father only | 4 | 3 |
| No parent | 3 | 3 |
| No child (pregnant woman without children) | 7 | 6 |
Source: Author tabulations of American Community Survey, 2017–2021.
Note: Percentages may not add to 100 due to rounding. Race and ethnicity are measured by family and based on race and ethnicity of mother or other primary caregiver. Type is measured by family and based on data for the youngest child; “mother only” families include children with two mothers; “father only” families include children with two fathers. Caregiver education is based on data for all parents present or the head of household if no parents are present.
Priority Families: Maternal, Infant, and Early Childhood Home Visiting Program Guidance
To maximize limited resources, the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program requires awardees to prioritize families living in at-risk communities as identified by statewide needs assessments. MIECHV also encourages awardees to recruit priority populations to serve families most in need. (Source: “Maternal, Infant, and Early Childhood Home Visiting Program,” [Social Security Act, Title V, Section 511 (42 U.S.C. § 711)](https://www.ssa.gov/OP_Home/ssact/title05/0511.htm#ft39), as amended by the [Patient Protection and Affordable Care Act, § 2951 (P.L. 111-148)](https://www.congress.gov/111/plaws/publ148/PLAW-111publ148.pdf).)Go to footnote #>2
According to MIECHV guidance, high-priority families include those with—
- Household income below the federal poverty level guidelines
- Pregnant women under 21
- History of child maltreatment or prior involvement with the child welfare system
- Household history of substance abuse or needs substance abuse treatment
- Current tobacco use in the home
- Children with low student achievement
- Children with developmental delays or disabilities
- Individuals who are serving or have served in the military