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Addressing Maternal and Child Health Disparities Through Perinatal Home Visiting.

Joshua P Mersky1, Colleen Janczewski2, Davin Hami3

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Area of Science:

  • Public Health
  • Maternal and Child Health
  • Health Disparities

Background:

  • Perinatal home visiting is a key strategy for maternal and child health in the U.S.
  • Limited understanding of home visiting program reach among disproportionately affected populations.
  • Social determinants of health significantly impact maternal and child outcomes.

Purpose of the Study:

  • To assess the extent to which Wisconsin's Family Foundations Home Visiting (FFHV) program engages priority populations.
  • To compare the characteristics of FFHV-served households with the general population regarding health risks.
  • To evaluate the reach of evidence-based home visiting services into low-opportunity communities.

Main Methods:

  • Analysis of administrative data from 6327 households in Wisconsin's FFHV program (2016-2023).
  • Calculation of proportions of households representing priority populations at risk.
  • Comparison with general population estimates and service saturation analysis in low-opportunity areas.

Main Results:

  • FFHV program successfully targets disadvantaged populations: nearly two-thirds below poverty level, over a third with substance misuse history, over half with current tobacco use.
  • Racial/ethnic disparities observed: served caregivers twice as likely Black/Hispanic, 5 times more likely American Indian/Alaska Native than White.
  • Significant reach into underserved areas: 69.1% of families in low-opportunity ZIP codes vs. 36.5% of all Wisconsin ZIP codes.

Conclusions:

  • The FFHV program effectively directs resources to populations and communities vulnerable to maternal and infant health disparities.
  • Home visiting services in Wisconsin are reaching high-risk groups and underserved areas.
  • Strategies are needed to scale up home visiting programs nationwide to address health inequalities.