Home Visiting Programs Touted by Obama Administration Improve Health and Well-Being of Both Women and Children

Programs Have Attracted Attention as Part of Health Care Reform and President’s “Common Ground” Initiative Around Abortion

Home visiting programs that would be significantly expanded under a new initiative proposed by the Obama administration have demonstrated modest but important benefits for children and significant benefits for women, according to a new policy analysis published in the Summer 2009 issue of the Guttmacher Policy Review. Home visiting programs pair new families—particularly low-income, single-parent ones—with trained professionals who provide parenting information, resources and support throughout a child’s first few years.

"Home visiting programs have gained some real and well-deserved traction, especially with the Obama administration’s request for $8.6 billion over the next 10 years," says Heather Boonstra, author of the policy analysis. "The current health care reform effort could well be the vehicle to secure funding for the program, as home visiting provisions have a good chance of being included if and when reform legislation is enacted."

The administration’s initiative would support programs that have undergone rigorous evaluation, as well as those that have demonstrated promise in improving the lives of children, women and families. A variety of home visiting programs are operating across the United States, and various models have been shown to improve both the health and well-being of children, particularly by reducing child abuse and neglect, and the sexual and reproductive health of women by promoting pregnancy planning.

"Home visiting programs fall neatly under President Obama’s emerging ‘common ground’ agenda," says Boonstra. "Interventions with a strong family planning component help vulnerable women delay subsequent pregnancies and increase birth spacing, and also help improve women’s parenting skills. That’s why expanding home visiting programs is an effort that partisans on both sides of the abortion debate should be able to get behind."

Home visiting programs are estimated to generate net benefits of $2.24 for every dollar invested, according to a 2005 RAND Corporation study. But they are expensive up front, since they involve extensive staff training, supervision and quality controls.

One clear challenge facing the home visiting initiative, therefore, will be to secure needed funding levels. Boonstra’s analysis suggests that while progressive prochoice policymakers and advocates will likely be strong supporters of these programs, antiabortion fiscal conservatives may balk at the price tag. A major question will be whether their putative concern for the well-being of mothers and children will be trumped by their opposition to new or expanded social programs. This equation, according to Boonstra, may also be a major challenge for President Obama in gaining support for other aspects of his "common ground" agenda over the longer term.

Click here for "Home Visiting for At-Risk Families: A Primer on a Major Obama Administration Initiative," by Heather D. Boonstra, in the Summer 2009 issue of the Guttmacher Policy Review.

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