HOLD FOR RELEASE: WEDNESDAY, AUG. 27, 1997, 3 P.M. CST
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ITHACA, N.Y. -- The benefits of nurse home visits to low-income,
unmarried women during pregnancy and the early years of their children's
lives endure for many years after the program of home visitation ends,
according to two newly published University of Colorado Health Sciences
Center/Cornell University studies appearing in this week's issue of the
Journal of the American Medical Association (Aug. 27, 1997).
These benefits include less use of welfare, fewer childhood
injuries, less child abuse and fewer arrests among the women. The results
come from both a 15-year follow-up study conducted in Elmira, N.Y., and
from a replication study in Memphis, Tenn.
The Elmira study looked at how 324 at-risk women and their
first-born children were faring 15 years after they participated in the
Prenatal/Early Infancy Project, a nurse home visit program. "We knew
from earlier studies of the project that the home visits resulted in fewer
and less closely spaced pregnancies, fewer cases of child abuse and
neglect, fewer emergency room visits and more maternal labor-force
participation during the child's first four years of life," said John
Eckenrode, professor of human development at Cornell and a co-author of the
new Elmira study.
"This follow-up study, however, now shows that the nurse home visit
program has enduring and positive effects on both the mothers' and
children's lives years later."
The Prenatal/Early Infancy Project was launched in 1977 in Elmira
by David Olds (Cornell Ph.D. 1976) and Charles Henderson, senior research
associate in human development at Cornell, co-authors on both new papers.
Four hundred women, many unmarried and low-income, and all
pregnant with their first babies, participated in the initial study; about
half received nurse home visits (an average of nine visits during pregnancy
and 23 during the child's first two years) and were compared with a control
group of mothers. During the visits, the nurses discussed nutrition,
prenatal care, developmental stages and needs of children, and other
health, behavioral and psycho-social conditions that could affect maternal
and child well-being.
"What is particularly encouraging about these new results,"
Henderson said, "is that not only are there clear benefits of the program
for those families most in need but also that the savings in government
spending seen for the first four years after birth of the child continue to
accumulate over the succeeding decade."
The research team for the Elmira follow-up study includes Olds, now
professor of pediatrics, psychiatry and preventive medicine at the
University of Colorado Health Sciences Center, Eckenrode, Henderson, Jane
Powers (Cornell Ph.D. 1985) and Pamela Morris of Cornell, as well as
Harriet Kitzman and Robert Cole (Cornell Ph.D. 1976) at the University of
Rochester. The intervention program continues in Elmira under the
direction of John Shannon at Comprehensive Interdisciplinary Developmental
Services.
Specifically, the research team found that, among women who were
low-income and unmarried, those who were provided a nurse home visitor had:
-- 46 percent fewer verified reports of child abuse or neglect;
-- 31 percent fewer subsequent births;
-- more than two years' greater interval between the birth of their
first and second child;
-- 30 months less use of Aid to Families with Dependent Children;
-- 44 percent fewer behavioral problems arising from alcohol and
drug abuse;
-- 69 percent fewer maternal arrests.
The researchers suspect that these pervasive, long-term differences
between home-visited women and the control group are due to the combined
influences of improved prenatal health, reduced caregiving problems early
in the life cycle, improved family planning and economic
self-sufficiency, all working in synergistic ways that improve the
life-course of the low-income mothers and their children.
The findings from the Prenatal/Early Infancy Project have been so
positive that the program has been widely emulated around the country and
has resulted in the U.S. Advisory Board on Child Abuse and Neglect
recommendation that home-visitation services be made available to all
parents of newborns as a means of preventing child abuse and neglect.
Although such a program is costly, the economic analysis of the
first four years of Prenatal/Early Infancy Project, published in Medical
Care (Vol. 31, No. 2, 1993), showed that the program paid for itself by the
time children reach age 4. That's because, in the nurse-visited
group, far fewer government services were needed, since there were fewer
additional pregnancies and fewer cases of child abuse and neglect, welfare
services were relied upon less, and fewer emergency room visits were
required.
The Memphis study replicated the research with 1,100 young women in
an urban area with a large population of African Americans. The pattern of
benefits seen among program participants in Memphis is similar to that
observed in semi-rural Elmira (where the sample was primarily white)
through the child's second year of life. The program reduced low-income
women's pregnancy-induced hypertension, reduced the rates of subsequent
pregnancies and reduced children's injuries.
The Elmira follow-up study was supported by the Prevention Research
Branch of the National Institute of Mental Health.
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