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Home visits make families healthier

Photo: St. Louis County

Public health nurses have been visiting clients in their homes for as long as our profession has existed. And there's a simple reason why: home visits work.

When a public health nurse makes repeated visits with new families, the results include: better parent-child bonds; better parenting skills; a reduction in child abuse, neglect and maltreatment, and domestic violence; improvements in school readiness; fewer child emergency room visits, a reduction in the number of months a family needs financial assistance; increased employment; and fewer subsequent pregnancies. In fact, studies have shown that for every dollar spent through home visiting programs, we ultimately save somewhere between $2.88 to $5.70 in other public costs such as social services and criminal justice. That's a good return on investment!

St. Louis County Public Health now offers four home visiting programs: Nurse Family Partnership, Healthy Families America, Superior Babies and Universal Home Visiting. The programs differ some in terms of who they serve and eligibility requirements, but they share common goals: healthier pregnancies, healthier babies and healthier families.

Our home visiting programs are all voluntary. We don't force people to participate. Through them, a public health nurse meets with pregnant and new moms (and dads, whenever possible) on a regular basis. By building a relationship with the parent(s), our nurses are able to make a real difference. We look at these relationships as partnerships. The parent has control and we walk with them, listening, encouraging and helping them to help themselves. Along the way, we're able to watch for signs of substance abuse, domestic violence, anxiety and stress and other negative factors that can impact the health of children and families.

A common misperception is that public health nurses focus only on improving physical health and well-being. But we do much more than that. As more and more research points to the strong connection between physical, mental and emotional well-being, we have evolved the work we do, and it's strongly evidenced in these programs.

Most people are aware of how rapidly a baby's brain grows and develops during the child's first few years. However, many programs aimed at helping children to grow up healthy, don't begin until preschool or school age. By then, the child has already gone through critical years of physical and emotional development. A child's ability to have empathy for others and to establish trusting relationships is developed during early childhood. So when we work with mothers, we are doing more than encouraging hands on activities with their child and helping them form a stronger bond. We are improving the child's chances of being developmentally ready for school, of being able to form stronger relationships and of living a healthier, stable life.

There's a growing focus nationwide on the long term effects of what's known as Adverse Childhood Experiences (ACEs). These are traumatic events including child abuse and neglect, growing up with a parent or family member with chemical addiction or mental health issues, witnessing domestic violence, parental separation or divorce, or having a family member in prison. The more ACEs a child has, the more likely he or she will have behavior, health and social problems, and even early death. Approximately two-thirds of the people we are visiting have extensive trauma.

Beyond the benefits for the child, our home visiting programs also benefit parents by helping them to be better parents and to reach personal goals, such as furthering their education and gaining employment. This leads to community-wide benefits, ranging from reduced social service costs to improved community health.

And that's what Public Health is all about: promoting healthy behaviors and preventing disease and injury for families, communities and large populations. You can learn more about our Public Health Home Visiting programs by calling (218) 725-5210 or visiting stlouiscountymn.gov/publichealth.

Amy Westbrook is the St. Louis County Public Health division director.

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