The 3.4 Percent: How are Infants and Toddlers Faring in North Carolina?

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In the latest iteration of ZERO TO THREE’s State of Babies Yearbook: 2022, the Yearbook provides a snapshot of national and state-by-state data on the well-being of infants and toddlers using more than 60 indicators divided into three overarching domains:

  1. Good Health – examples of indicators used to determine the ranking: accommodations for pregnant workers, protection from job loss, babies with low birth weight, Medicaid plan covers social-emotional screening for young children, etc.
  2. Strong Familiespaid family leave, low or very low food security, family resilience, etc.
  3. Positive Early Learning Experiences – parent reads to baby every day, developmental screening received, the state reimburses center-based child care, etc.

Key Findings

With more than 10,000 babies born across the United States each day, the Yearbook finds that longstanding disparities and gaps in child and family well-being, exacerbated by the COVID-19 pandemic, continue to fail the current and future generation of babies. Lapsing of the Child Tax Credit that had lifted 3 million children out of poverty and failure to pass long-term policy agendas that support families, such as the Build Back Better Act, which included a comprehensive child care program and a national paid leave program, are complicit into millions of children and families falling back or deeper into poverty.

The Yearbook recommends improving the nation’s approach to prenatal-to-three policies, prioritizing infants and toddlers will yield a positive return on investment — 13 percent per annum in the form of better outcomes in education, earnings, and health — that will benefit the entire country.

Deep Dive into North Carolina

Where babies are born should not determine their outcomes or limit their potential, but the Yearbook continues to show that the state in which a baby is born and lives during their first three years can and does make a difference in whether they have a strong start in life.

Let’s take a deep dive into North Carolina’s indicators and see how NC ranks compared to other states in the Yearbook using the four-tier acronym GROW:

  • The“G” rating is the lowest rating indicating “Getting Started,”
  • The “R” rating indicates “Reaching Forward,”
  • The “O” stands for “Improving Outcomes,”
  • The “W” is the top rating “Working Effectively.” 

Overall, NC scored in the “R” Reaching Forward tier — better than 13 states, worse than 24 and DC, and about the same as 12. It is worth noting that in 2020 and 2021, NC ranked in the O, or Improving Outcomes, category. See the highlights of how NC compares to national averages:

GROW - getting started, reaching forward, improving outcomes, working effectively. NC ranks in the Reaching forward catergory.

North Carolina has 359,238 babies ages zero-to-three, totaling 3.4 percent of the state’s population. 

Good Health

  • NC falls in the “R” Reaching Forward, tier for the Good Health domain.
  • Better than the national average: percentages of babies receiving preventive medical care and recommended vaccinations.
  • Worse than the national average: the infant mortality rate, the percentage of babies ever breastfed.

Key Indicators of Good Health for North Carolina compared to the national average

Strong Families

  • NC falls in the “R” Reaching Forward tier of states when it comes to indicators of Strong Families.
  • Better than the national average: percentage of parents who report living in unsafe neighborhoods and the infant/toddler maltreatment rate.
  • Worse than the national average: percentages of families in poverty with a baby who receive Temporary Assistance for Needy Families, also known as TANF, babies who experience food insecurity.

Positive Early Learning Experiences

  • NC falls in the “O” Improving Outcomes tier for Positive Early Learning Experiences.
  • Better than the national average: a higher percentage of infants and toddlers who received a developmental screening.
  • Worse than the national average: a lower percentage of babies in families below 100 percent of the federal poverty line with access to Early Head Start.

For more detail on the data indicators and sources, see the full State of Babies Yearbook 2022 online. You can also view North Carolina’s full profile.

Too many babies in North Carolina are born with low birth weight. What happens next is up to us.

The Yearbook and NCECF’s Pathways to Grade-Level Reading

Many of the data indicators assessed in the 2022 Yearbook are also included in the Pathways Data Dashboard, which includes NC data on more than 60 measures of child development across the health, family, and education sectors that research shows influence third-grade reading scores. Whenever possible, the dashboard presents data at the state level, compared to national averages; at the county or school district level; by race and ethnicity; by income; by age; and over several years.

In conjunction with the data dashboard, the recently released Pathways Action Map is an interactive tool that highlights mapped initiatives that are leading efforts to impact what’s happening across the state in 44 prioritized actions that can help move the needle on third-grade reading proficiency, using a whole child, birth-to-age-eight approach to literacy and child well-being.


Pathways Action Framework