Where do babies stand across America and in NC?

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Screenshot from ZERO TO THREE’s State of Babies Yearbook 2023

The story of America’s babies has never been more important. The data presented in the fifth edition of Zero to Three’s State of Babies Yearbook: 2023 paints a clear picture: bold action is needed to address urgent needs of infants, toddlers, and their families.

Key Takeaways

All babies are born with unlimited potential. This release tells the story of the 11 million babies in the United States, who comprise 3.4 percent of the nation’s population. As we look at the data provided in the State of Babies Yearbook: 2023, nationally, we see that:

  • The number of infants and toddlers continues to decline. There are about 900,000 fewer babies than 5 years ago.
  • The data tells us that diversity remains the hallmark of America’s babies, a source of strength and renewal. America’s babies and parents are more diverse than at any other point in our nation’s history, reflecting the characteristics of our society overall. More than half, 52% of infants and toddlers born today are of color.
  • Poverty and disparities in access to resources along racial and ethnic lines continue to be defining features of a baby’s experience. Two million infants and toddlers in America live in poverty, and poverty and low income remain the most striking demographic of babies in the United States.
  • The state where a baby is born and spends their first years also is a significant indicator as to whether a baby will have a strong start in life.

The State of Babies Yearbook: 2023 is a blueprint for transformation to put our nation back on the path towards a comprehensive infant-toddler policy agenda, long called for by ZERO TO THREE and our partners.

Five Urgent Priorities For Action:

  1. Maternal and Infant Health
  2. Infant and Early Childhood Mental Health
  3. Child Care and Early Childhood Education
  4. Unstable Housing
  5. Economic Insecurity and Poverty

Impact areas examined include good health, strong families, and positive early learning experiences. States are ranked on a G-R-O-W spectrum with G standing for “Getting Started” or the baseline, R standing for “Reaching Forward,” O for “Improving Outcomes,” and W for “Work Effectively” as the top rating a state can receive for the conditions they offer babies and families of young children. 

Screenshot from ZERO TO THREE’s State of Babies Yearbook 2023

The State of Babies in NC

All children born in the US should have the conditions necessary to thrive. However, the state where a child is born and lives during their first three years makes a big difference in their chance for a strong start in life. Where you’re born, the color of your skin, or your family’s income should not make a difference in your chance for a strong start in life.

Let’s take a look at how NC stacks up—and where significant disparities exist in the opportunities available to do more for our babies. 

North Carolina is home to 347,349 babies, representing 3.3% of the state’s population. As many as 43.7% babies live in households with incomes less than twice the federal poverty line (in 2021, about $55,000 for a family of four), placing them at economic disadvantage. The state’s youngest children are diverse and are raised in a variety of family contexts and household structures:

  • 8.5% of babies live in rural areas
  • 40.3% of babies live in families with low incomes
  • 52.32% of babies are children of color

Good Health in NC

Supporting the physical and mental health of babies’ and new parents builds the foundation for infants’ lifelong cognitive, emotional, physical, and social well-being. Brain development occurs rapidly in babies, during the first few years of life. In these early years, the brain works with other organs and organ systems to set the stage for subsequent development and health outcomes. Equitable access to good nutrition during the prenatal period and first years of life is imperative to ensure that babies receive the nourishment and care they need for a strong start in life. Strengthening equitable access to integrated, affordable maternal, pediatric, and family health care is also essential to meeting babies’ and families’ health and developmental needs.

North Carolina falls in the Reaching Forward (R) tier for the Good Health domain. 

A state’s ranking is based on indicators of maternal and child health, including health care coverage, prenatal care, birth outcomes, and receipt of recommended preventive care as well as nutrition and mental health. North Carolina performs better than national averages on key indicators, such as the percentage of babies receiving preventive dental care and babies receiving recommended vaccinations. The state is performing worse than national averages on indicators such as the percentage of women receiving late or no prenatal care and the infant mortality rate. 

However, in terms of assessing good health policy in North Carolina, it appears that this reflection is prior to the new budget passing, which is designed to enact Medicaid expansion in the state. See the following screenshot examining good health policy in North Carolina: 

Screenshot from ZERO TO THREE’s State of Babies Yearbook 2023

Visit the State of Babies Yearbook 2023 to learn more about the Key Good Health Indicators for North Carolina. 

Strong Families in NC

Much of our lives is rooted in our earliest experiences with our families. Young children develop in the context of their families, where stability, safety, and supportive relationships nurture their growth. All families may benefit from parenting supports, but families with low income and in historically marginalized communities of color face additional challenges that impact their babies’ immediate and future well-being. Many policies can be designed to address these disparities by race, ethnicity, and income, including the provision of safe and stable housing, home visiting services, family-friendly employer policies, economic support for families with low income, and tax credits that benefit families with young children.

North Carolina falls in the Reaching Forward (R) tier of states when it comes to indicators of Strong Families. 

The state’s ranking in this category reflects indicators on which it is performing better than the national average, such as the percentage of babies living in crowded housing and babies living in unsafe neighborhoods, as reported by parents. North Carolina is doing worse than the national average on indicators such as the percentage of babies who have had two or more adverse experiences and babies experiencing food insecurity.

See the following screenshot exploring strong family policy in North Carolina:

Screenshot from ZERO TO THREE’s State of Babies Yearbook 2023

Visit the State of Babies Yearbook 2023 to learn more about the Key Strong Family Indicators for North Carolina. 

Positive Early Learning Experiences in North Carolina

Infants and toddlers learn through interactions with the significant adults in their lives, active exploration of enriching environments, and community experiences. The quality of babies’ early learning experiences at home and in other care settings can impact their cognitive and social-emotional development, as well as early literacy. High-quality early childhood care and learning can strengthen parents’ interactions with their children in the home learning environment, while also supporting parents’ ability to go to work or attend school. Equitable access to high-quality care across factors like race, ethnicity, and income, ensures all infants and toddlers have the opportunity for optimal development. However, disparities in access to high-quality care remain across many states and communities in the United States.

North Carolina scores in the Improving Outcomes (O) tier for Positive Early Learning Experiences. 

The state’s ranking in this area reflects indicators on which it is performing better than the national average, such as the percentage of infants and toddlers who received a developmental screening in the past year. On the other hand, North Carolina is doing worse than the national average on indicators, such as the percentage of babies in families below 100 percent of the federal poverty line with access to Early Head Start. Beginning with the 2022 profile, infant care costs as a percentage of the state’s median income for single and married parents are not factored into the ranking.

See the following screenshot exploring positive early learning experiences policy in North Carolina:

Screenshot from ZERO TO THREE’s State of Babies Yearbook 2023

Visit the State of Babies Yearbook 2023 to learn more about the Key Positive Early Learning Experiences Policy Indicators for North Carolina. 

Keep in Touch with NCEF and Support Our Work

ALL babies deserve equal opportunity to thrive and to step onto a life path paved with promise. Let us all feel and be more empowered as advocates, as changemakers, and as baby champions. Together, we can shape a reality where every baby is embraced by possibility, every family is thriving and our country’s tomorrows are infinitely brighter.

Please be sure to subscribe to our biweekly newsletter to keep up with our work helping the lives of North Carolina families, from their earliest days. 

The NC Early Childhood Foundation is driven by a bold – and achievable – vision: Each North Carolina child has a strong foundation for life-long health, education, and well-being supported by a comprehensive, equitable birth-to-eight ecosystem. We build understanding, lead collaboration, and advance policies to ensure each North Carolina child is on track for lifelong success by the end of third grade.