- The Washington Times - Tuesday, January 12, 2010

I thought 30 years of “no man in the house” social policy showed that when fathers are ejected from poor homes, it leads to misery among men, women and children, not to mention generational poverty.

Social policy, circa 2010, therefore, should care as much about the low-income father as the low-income mother.

That’s why I see a “yellow light” with the new, voluntary “home visit” program Congress is poised to pass in its health care bill.

The federal program, modeled on the successful Nurse-Family Partnership (NFP), would send health care professionals (presumably nurses) to the homes of at-risk pregnant women and new mothers who invite them in. The goals are to improve the health and well-being of new mothers and their children.

The five-year price tag for these services is likely to be $1 billion.

The problem is that a new study about NFP shows that the program appears to benefit low-income women and their daughters more than their sons.

Cornell University professor John Eckenrode and his research colleagues looked at 310 children, now age 19, whose mothers received nurse visits in Elmira, N.Y., when the children were born. Many homes had a nurse visit regularly for two years.

A previous study on these same children at age 15 found that both boys and girls had benefited from the nurse visits to their mothers. By age 19, however, an enormous gender gap appeared.

The daughters of nurse-visited mothers were less likely to have ever been arrested (10 percent to 30 percent) compared to the daughters of women in the control group and much less likely to have been convicted of a crime (4 percent to 20 percent).

For boys, there was no difference between those whose moms had had a nurse and those who had not. In fact, in both groups, the boys’ troubles with the law started after age 12.

This was a “disappointing” finding, said David Olds, founder of the NFP and pediatrics professor at University of Colorado at Denver.

I agree. Prison inmates are overwhelmingly male, and blacks make up 38 percent of the male prison population, compared to 34 percent whites and 20 percent Hispanics, according to 2008 Bureau of Justice Statistics data.

Any home-visit program should be tweaked to ensure that the outcomes for boys are as robust as those for the girls, especially in black families.

A good starting point, says child advocacy lawyer Ronald K. Henry, is to “view both parents as targets of the program.”

“These children have fathers. These children need fathers,” he says. “These men need to be engaged and embraced in the program every bit as much as the mothers.”

Happily, one study already has shown that in one community of NFP homes, father involvement improved nearly 50 percent. So the groundwork may already be laid to include fathers in the nurse sessions.

Second, a program like this is a good place for health care workers to tout the benefits of relationship skills and marriage.

The Fragile Families and Child Wellbeing Study, which focuses on 5,000 young children of low-income, mostly unmarried parents, finds that 80 percent of parents-to-be have strong romantic connections and more than half expect to marry. Researchers call this a “magic moment” for intervention because, without support, many of these couples end up breaking up instead. The study is conducted by Princeton University’s Bendheim Thoman Center for Research on Child Wellbeing.

If Uncle Sam starts sending trusted, caring, knowledgeable nurses into “fragile family” homes, and they carry referrals for relationship-skills programs and responsible-fatherhood and jobs programs for the fathers, it might help these new parents fight harder to protect and improve their relationship and family life.

Surely that will turn out to as important as knowing how to breast-feed or burp a baby.

Cheryl Wetzstein can be reached at cwetzstein@washingtontimes.com.

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