North Carolina Has 361,000 Babies. How Are They Doing?

National early childhood organization ZERO TO THREE recently released their State of Babies Yearbook: 2021. The report compares national and state-by-state data on the well-being of infants and toddlers in three domains: good health, strong families, and positive early learning experiences.

Overall, the results show that even before the pandemic babies did not have the supports they need to thrive. Racial and economic inequities continue, with significant disparities across key indicators of the well-being for babies of color—specifically Black, Hispanic, American Indian, Alaska Native, Hawaiian/Pacific Islander, and some Asian—and babies in families living with low-income. These inequities start well before children are born and are perpetuated by racism and systemic barriers. 

ZERO TO THREE summarizes several national findings for babies—before and during the pandemic—that are worth knowing about. See below:

  • Babies are more likely than other age groups to live in or near poverty. During the pandemic, more than half of families with infants and toddlers who had low income before the crisis reported drops in income
  • Babies in families with low income often had less access to preventive medical care. In the pandemic, well-child visits and vaccinations dropped even more
  • Food insecurity before the pandemic had dropped to 14 percent of households with babies nationally, but 15 states had rates between 15 and 28 percent. In the pandemic, 45 percent of families with low income reported high food insecurity
  • Babies in families with low income were less likely to have families who felt resilient before COVID-19, and almost a third of these babies had experienced an adverse early experience. During the pandemic, families facing serious economic hardship also reported high rates of emotional distress for parents and children
  • Child care before the pandemic continued to be a high cost item for families with babies, even as quality thresholds remained low and subsidies were scarce. Between job loss and child care closures in the pandemic, non-parental child care use plummeted and had not fully rebounded, especially for families with low income, by late 2020

According to the Yearbook, North Carolina is one of 13 states that ranks in the Improving Outcomes category. See demographic data and some highlights of how NC compares to national averages below:


  • Four percent of the NC’s population are infants and toddlers, ages 0-3.
  • Forty-six percent live in households with incomes less than twice the federal poverty line (in 2019, about $51,500 a year for a family of four). NC babies of color are more likely to live in families with low income or in poverty, which in turn limits their opportunities to access quality health care and increases the likelihood that they will experience income-related health challenges, like food insecurity.
  • NC’s youngest children are diverse and are raised in a variety of family contexts and household structures. Half of NC’s babies are children of color. Seventy-eight percent live in two-parent households, six percent live in grandparent-headed households, 60 percent have mothers in the work force, and 16 percent live outside a metro area.

Good Health

  • Better than national average: The percentages of babies receiving recommended vaccinations and babies receiving preventive dental care.
  • Worse than national average: Infant mortality rate, the percentages of babies born with low birth weight, and babies experiencing food insecurity. NC Black and American Indian infants have a markedly higher risk of being born preterm and/or with low birthweight, and are more likely to die within their first year.

Strong Families

  • Better than national average: The percentages of babies living in crowded housing and parents who report living in unsafe neighborhoods.
  • Worse than national average: The percentages of babies who have had one or two or more adverse experiences and babies with time spent in out-of-home placement.

Positive Early Learning Experiences

  • Better than national average: The higher percentages of parents who read to their child every day and babies who have received a developmental screening.
  • Worse than national average: The lower percentage of infants and toddlers below 100 percent of the federal poverty line with access to Early Head Start.

Interested in learning more? Read the Yearbook‘s state report for North Carolina. Sub-reports focused on race/ethnicity, income, and material hardship are also available.