Opinion: As a pediatrician and mom, Michigan needs home visiting program
One would think that when I became a parent, I would have been fairly prepared for what was coming my way. After all, in addition to being a board-certified pediatrician, I am receiving additional training as a fellow in developmental-behavioral pediatrics – meaning I have survived four years of medical school, three years of a pediatric residency, and have voluntarily signed up for an additional three years of training in child development and behavior.
It would be a reasonable assumption that I would have navigated the newborn period with ease, but that could not be further from the truth. Reflecting back to those early weeks with my son still makes my heart fall into my stomach. Despite my extensive education, tremendous help from my husband, and the ample support I had from nearby friends and family, I was in a constant state of panic and worry.
Three days after I was discharged from the hospital, and roughly six weeks before I was scheduled for a postpartum check up with my obstetrician, I had a visit from a home-visiting nurse. It was one visit, a couple of hours long, and it is no exaggeration to say that this single visit substantially changed the course of my postpartum recovery and the next few months with my son. I don’t remember the woman’s name, but I will never forget her face or the kind and patient advice she offered. My son is now almost 2 years old and his father and I still reflect on that visit and how grateful we feel for having been offered the opportunity.
My home visitor was affiliated with the hospital where I delivered. However, home visiting programs exist throughout the state. They are designed to help women have healthy pregnancies and to support families through the early years of raising a child. Home visitors can educate and coach families on issues related to parenting, children’s health and development, and community resources that are available in their area.
The service is free, voluntary, and acts to fulfill a simple goal: build a safe, healthy, and stimulating environment for Michigan children and their parents. Programs are evidence-based and have been linked to promising outcomes for the children and families who participate, including improved parenting capacity, increased school readiness and completion of high school, decreased smoking rates for parents, reduced rates of child abuse, and improved access to prenatal and postpartum care.
Home visiting programs in Michigan served nearly 27,000 families in 2019 – an impressive figure. However, when you consider the overall need for these programs, Michigan is falling short.
For example, in 2020, 2,631 families were enrolled in home visiting programs in Wayne County, but there were an estimated 20,422 families eligible and in need of home visiting services. That means that only 13 percent of eligible Wayne County families were utilizing the program to support their parenting needs. Many other counties throughout the state, particularly those that encompass a large rural area and/or have lower median household incomes, see a need that far outstrips current enrollment. Therefore, it is essential to expand access to evidence-based home visiting services statewide.
In order to maintain and expand home visiting services, Michigan policymakers need to support state general fund dollars of approximately $16 million for evidence-based home visiting programs, as well as the governor’s recommendation to invest an additional $7.4 million in expansion of home visiting and related infrastructure needs. This funding supports eight evidence-based models that deliver services to families across the state in partnership with six state agencies.
Finally, there are significant, and widening, health disparities facing people of color and individuals with low incomes. Home visiting programs can also help ameliorate some of the significant disparities in maternal health outcomes, preterm birth rates, low birth weights, and overall infant mortality/morbidity. Therefore, the state needs to implement policies and procedures that allow for flexibility across programs to support an equitable approach to serve families in ways that address racial, health and geographic disparities.
This is clearly a policy issue that can and should transcend party and county lines. While the governor and the Legislature are continuing to negotiate the 2022 state budget, the initial budget bills passed by the House and Senate included Gov. Gretchen Whitmer’s recommended funding for home visiting.
Parents and medical professionals – and in my case, both – agree that expanding the state’s home visiting program will have many positive benefits on our kids, our families and our state as a whole. I hope all policymakers will continue to make this investment a priority as budget discussions continue.
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