5 Top Takeaways from the Prenatal-to-3 Policy Impact Center鈥檚 Summit
New state policy roadmap published
Top Takeaways is a series of recaps from important conversations, town halls, webinars and virtual events about early learning.
The state where you鈥檙e born has a huge impact on your health and well-being. Last month, the (PN-3) at Vanderbilt University hosted the to mark the publication of its annual .
鈥淪tate leaders need to be prepared to do big things,鈥 urged Executive Director and Founder Cynthia Osborne. The PN-3 team compared the progress of the 50 states and the District of Columbia on five policies that the evidence says are most effective at creating the conditions in which young children thrive, along with six strategies that help them get there.
States have different priorities and political contexts, and according to PN-3, 鈥渢he level of resources a family has available to meet their basic needs varies substantially, from nearly $47,000 per year in the District of Columbia, to less than $23,000 in Georgia.鈥

鈥淔ederal dollars are needed to level those differences out,鈥 鈥檚 Elliot Haspel stated. As filter through the states and then dry up, sustainable revenue sources are needed. 鈥淧oliticians aren鈥檛 taking it seriously enough,鈥 Haspel said.
Here are our 5 top takeaways:
1. Five states are five-for-five. Connecticut and Washington State joined California, Massachusetts, New Jersey and D.C. in implementing all five policies deemed most effective:
- No new states adopted and fully implemented Medicaid expansion this past year, but 11 of the 12 remaining non-expansion states introduced legislation to do so.
- 聽Participation in SNAP among those eligible has risen in recent years but still varies considerably by state.
- Only 56% of workers qualify for the federal Family and Medical Leave Act, and the policy largely benefits higher-income and white workers.
- Currently, 31 states have a minimum wage that is higher than the $7.75 federal level, with D.C., California and some cities already at or above $15.
- (EITC). According to , this is the most effective anti-poverty policy for children, compared to SNAP, Temporary Assistance for Needy Families (TANF) and state child tax credits. Currently, 21 states have a refundable state EITC of at least 10% of the federal credit.
2. PN-3 identified six strategies that states are using to boost equity:
- Specifically, the report mentions Developmental Understanding and Legal Collaboration for Everyone (; an initiative of the Center for the Study of Social Policy), and (a ZERO TO THREE initiative).
- , which, according to PN-3, 鈥渕ay allow more parents to work or complete education and training programs, and may support healthy child development when care settings are high quality and stimulate children鈥檚 early brain development.鈥
- Group prenatal care, exemplified by , a program running at approximately 350 sites across more than 40 states.
- , including traditional and virtual models, which proliferated during the pandemic.
- which can be based in a center or the home, providing nurturing and responsive relationships and improving the physical and mental health of parents.
- for infants and toddlers with disabilities or developmental delays.
3. The pandemic changed everything. Businesses, governments and families are all still managing the fallout from COVID. The child care sector, in all its various forms, is undergoing a workforce crisis that hits low-income families especially hard. Haspel noted that the price of child care is rising 鈥渇aster than inflation, even in this inflationary era鈥 and called for 鈥減ermanent, dedicated and significant funding.鈥 Hawaii state senator , noted that the unemployment rate there skyrocketed when tourism cratered. She has advocated for Medicaid expansion and a refundable, permanent state EITC as well as a Child Wellness Bill that would provide incentives for checkups. 鈥淐OVID changed work,鈥 said , state senator of the Maryland General Assembly, who shared that becoming a father reconfirmed his commitment to paid leave.
4. Change doesn鈥檛 happen overnight. The panelists described the process by which legislation is proposed and debated in the states. Once it finally passes, implementation can take years. Bipartisanship can accelerate change. , state senator of the North Carolina General Assembly, belongs to the Republican Party. 鈥淓very child,鈥 he said, 鈥渟hould have the opportunity for a healthy birth and a great life.鈥 He mentioned Medicaid expansion as a policy solution he supported, stipulating, 鈥淢edicaid should be robust but temporary.鈥
5. Business leaders should wield their influence. member Bridgette Roman quoted Nelson Mandela: 鈥淥ur children are our greatest treasure. They are our future. Those who abuse them tear at the fabric of our society and weaken our nation.鈥 , state senator of the Colorado State Legislature, concurred that the business community has an important role to play on children鈥檚 issues. , state representative of the Louisiana House of Representatives, credited for its advocacy.
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