Home Visiting of Mecklenburg County LANDSCAPE ANALYSIS: Opportunities for Growth, Expansion & Building Infrastructure

WHY CHARLOTTE-MECKLENBURG WOULD BENEFIT
FROM EXPANDED HOME VISITING
WHY SMART START?
Home visiting has a proven, positive impact on prenatal health and birth outcomes. It provides services to help
families thrive and give babies a healthy start. And research has shown that home-visiting programs yield a
return on investment of $1.75 to $5.70 for every dollar spent on other early childhood interventions. 4 Beyond
dollars and cents, we have an obligation to provide equitable health care in our community, which is a key
ingredient to upward economic mobility.
Maternal and infant mortality rates
Six out of 1,000 babies in the U.S. die before their first birthday,
most often due to unintentional injury. 5 And many infants are at risk
before they’ve even entered the world. 6 In North Carolina, infant
and maternal mortality rates are two to three times higher for Black
babies and pregnant women 7 . While 80% of White pregnant women
receive prenatal care within the first trimester of pregnancy, only
69% of Black pregnant women and 57% of Hispanic pregnant women
receive health care during pregnancy. 8 More alarming, little to no
data points on maternal and infant mortality rates are available for
indigenous communities in North Carolina.
Studies have found a
return on investment of
$1.80 to $5.70
for every dollar spent on
home visiting
Mecklenburg County is fortunate to have a strong
ecosystem of early-childhood service providers
and supporters. To tackle upward mobility in the
region, county leadership formed an Early-Childhood
Executive Committee (ECEC) to address inequity at its
earliest stage.
Providing access to high-quality public preschool
became a focal point, after five years of operation,
even after navigating the challenges of the Covid-19
pandemic, that same dedication and commitment led
to the next phase of work for the ECEC. In 2021, the
committee was relaunched under the leadership of
the county manager and the CEO of Smart Start of
Mecklenburg County (SSMC), this time with the goal of
improving the system of care for families from prenatal
to age 3, narrowing the work to three policy areas:
1. Healthy and equitable births
2. Optimal child health and development
3. Parental health and emotional well-being
In 2022, in the Landscape Study of Prenatal-Age 3
Services & Supports in Mecklenburg County, which
was commissioned by SSMC, stakeholders identified
the need to strengthen efforts at outreach and access
to quality services as one of their recommendations.
Increasing home-visiting services was identified as a
pathway to achieve this recommendation.
Disparities in birth outcomes
In Mecklenburg County 1 in 10 births are premature (less than
37 weeks gestational age) and low birth weight (less than 2500g).
Pregnant women of color are experiencing significant health
inequities in these birth outcomes. Of 15,061 total births in 2021,
15% of Black babies and 9% of Hispanic babies were low birthweight.
Only 5% of White babies were low birthweight. 9 Adverse health
complications such as impaired development, infections, and death
are a result of these disparities.
Child maltreatment
Child maltreatment is another area that disproportionately impacts
children of color. Although Black youth make up only 33% of
Mecklenburg County’s general population, 50% of youth entering
Youth and Family Services custody are children of color. 10 Black
families often face systemic barriers in accessing health care,
affordable housing, stable employment, and other economic drivers
of health.
Out of 15,061 total
births in 2021,
15% of Black babies and
9% of Hispanic babies were
low birthweight
Managing nearly $40 million in funds to assist early-childhood initiatives in our community, including the
nationally recognized universal preschool program, MECK Pre-K, SSMC, is currently a primary funding source for
three home-visiting models in our community:
Parents as Teachers: Nurse-Family Partnership: Child First:
Home visiting and parenting education can help eliminate racial
disparities in the health and well-being of children and families.
These programs have proven to be highly effective and
will continue to be a priority focus of SSMC’s funding.
However, these programs represent only three of 21
home-visiting models which meet U.S. Department
of Health and Human Services (HHS) criteria for an
evidenced-based delivery model for early-childhood
home visiting. Our community has both the capacity
and need to make additional home-visiting programs
available to children and families. Thanks to a
generous $342,500 American Rescue Plan Act grant
from Mecklenburg County, SSMC has embarked on a
journey to raise the profile of home visiting. Therefore,
our first step was to complete a landscape study with
the intention of evaluating and expanding home visiting
in Mecklenburg County.
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