Home Visits Work: Let’s Make Them Universal

Nov 14, 2016, 1:31 PM, Posted by Martha Davis

Every family deserves an equal opportunity to build a healthy, nurturing environment that helps their kids thrive. That’s where home visits come in.

Some of the most fulfilling and valuable experiences of my early career involved working as a home visitor about twenty years ago. I traveled through Philadelphia’s most underserved neighborhoods with a team from the MomMobile, a community-based organization that provides free support and education to families facing the challenges that pregnancy and parenting bring. I’ve personally witnessed the powerful impact home visits have on families, and that’s why I’m so passionate about the role they can play in building a Culture of Health.

My personal experience as a home visitor

While working as a home visitor, nearly every person I met yearned to be the best parent they could be. But many didn’t have what they needed. They lacked information about parenting skills and were often socially isolated, with few friends or family members to call for help and advice. I finally came to fully understand just how incredibly hard parenting can be years later when I personally became a parent. Support, information, and personal connections are instrumental in making those first few transitional years easier for parents and kids alike.

That’s where my job as a trained home visitor came in. Through the MomMobile, my colleagues and I supported both expecting and new parents by sharing information about nutrition, sleep habits, and health care. We connected parents to programs like WIC and Medicaid, domestic violence services, heat and housing programs and other essential resources.

While providing information about services helped immeasurably, I think the biggest benefit for families and frazzled new parents was knowing that someone was there for them. This reassurance helped alleviate their mental stress so they were better able to focus on supporting their families.

Research shows that home visits are effective in supporting all families

While my firsthand experiences as a home visitor ignited my passion for this issue, evidence on the impact of home visiting solidifies my belief in its role to positively influence the lives of all families.

Home visits play an integral role in preventing adverse childhood experiences (ACEs), which can harm developing brains and increase lifelong risk many chronic diseases and other serious problems, including exposure to violence. ACEs are disturbingly widespread—nearly 64% of adults have at least one. And they don’t just impact low-income families. In fact, the groundbreaking study that first revealed the far-reaching impact of ACEs found they were common, regardless of ethnicity or education levels.

Home visiting prevents ACEs by providing parents and caregivers with the tools, support, and knowledge they need to create a positive, trusting environment at home and establish a secure and sturdy bond with their kids. These positive early experiences can help mitigate the impact of difficulties when they do occur and help build resilience among children. Evidence demonstrates that home visiting yields positive impacts for children and families across a range of outcome areas including the following:

A safe and healthy environment during childhood forms the foundation for a lifetime of physical and mental well-being and healthy relationships.

Making home visiting universal

We know home visits are a prime example of what a Culture of Health looks like in action: Communities helping to bring families the tools they need to provide children with a healthy start to life—no matter where they live or how much money they earn.

With the strong case for home visiting, RWJF believes it should be available to everyone. Universality would remove any stigma and promote health equity, because unaddressed disparities during the earliest years can lead to intensified health problems and widening social, educational, and economic gaps.

But achieving the goal of universality requires a culture-shift—a change in mindset that acknowledges the importance of the early years and recognizes that all parents need and deserve support. Imagine if home visits were expected in the same way that we expect clean water and electricity to reach all homes in all neighborhoods. Our culture considers these basic utilities essential drivers of health and well-being, and rightfully so! Home visits could be no different.

Viewing home visits as a basic need immediately changes the narrative. Instead of asking “should we do this?” the question becomes “how should do we do this? How do we make home visiting part of our culture and how can we build an infrastructure capable of reaching everyone?”

As a starting point, involving new partners who are intimately familiar with the given needs of a community can help ensure that we’re reaching more families. Civil rights organizations and other community advocates would make ideal partners, to ensure that visitation programs are equitable and culturally sensitive.

We also know that rural areas have pressing needs and require special attention. Several indicators show that rural women and children are at higher risk for a range of adverse health outcomes than their urban counterparts. We need partners to help us devise innovative solutions for reaching these families and addressing their needs.

I am confident that we can change the way our leaders think about home visits and the importance of the early years. If we achieve universality, we will take a significant step toward building a Culture of Health for everyone in the United States.

Do you have ideas for how we can make home visiting part of our culture and build an infrastructure capable of reaching all families? Please leave your thoughts in the comments below.

Martha Davis, MSS, is a senior program officer at the Robert Wood Johnson Foundation where she focuses on the root causes of violence, including child abuse and intimate partner violence. Read her full bio.