Home Visits to Low-Income Mothers Have Lasting Health and Life Effects

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After participating in a program of home visits by nurses, a cohort of low-income, unmarried, pregnant or postpartum women living in an urban environment reduced their average number of pregnancies and their dependence on entitlement programs while increasing their degree of participation in the work force and the intervals between their pregnancies. According to a recent article in the Journal of the American Medical Association, there is increasing evidence that home visitation can produce enduring positive effects on life and health outcomes.

The randomized study involved pregnant or postpartum women who were younger than 18, had not previously given birth, and most of whom were black. Participants received 7 prenatal and 26 postpartum home visits by nurses. According to the authors, "The nurses followed detailed visit-by-visit guidelines to help women improve their health-related behaviors, care of their children, and life-course development (pregnancy planning, educational achievement, and participation in the workforce) … in the context of helping women set goals for themselves at a crucial stage in their own personal development."

The authors found that more than 4 years after the intervention began, women who had received these home nursing visits

• Were more likely to have fewer subsequent pregnancies, and the intervals between those pregnancies were longer;
• Used Aid for Families with Dependent Children (cash assistance) and food stamps for fewer months;
• Were more likely to be living with a partner, with the father of the child, or with a partner who was employed for longer duration; and
• Had fewer therapeutic abortions, neonatal intensive care admissions, and special care nursery admissions.

The authors observed that the home visits had lasting effects on both health and life outcomes. At the same time, they acknowledge that these effects were smaller in magnitude than those found in similar studies with different population samples. Nonetheless, the authors reported that their results were consistent with the outcomes of other studies using the same methodology.

Kitzman H, et al. 2000. Enduring effects of nurse home visitation on maternal life course: A 3-year follow-up of a randomized trial. JAMA 283.25:1983-1989.

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MCH Alert. 2001. Arlington, VA: National Center for Education in Maternal and Child Health. http://www.ncemch.org/alert.