NFP, HCZ, QED?

I was born into luck.

I had healthy, well-educated parents, married, and stable parents.  Dad had a good job, Mom was a dedicated and ardent community activist.  My mom wouldn't have even thought of drinking when she was pregnant with me.  They had the means to support having one more kid--my little sister--two years later.  I grew up near parks, not power plants.  There was no lead paint within sight or touch.  From the earliest moments, I was loved, read to, and played with--not just by my folks but by aunts and uncles, grandmothers and grandfathers. 

Am I thankful?  You bet!  To try to make such positive fetal health behaviors, early parenting, and stable life pathways more prevalent for mothers who didn't have the background of my own, enter the Nurse-Family Partnership (NFP).  I've been reading about it a lot recently. 

For someone like me who's very interested in the Harlem Children's Zone (HCZ) and programs like it, the NFP raises some big questions.

First, the NFP in a nutshell: It was a plan developed in the 70's by a developmental psychologist to make the conditions I benefited from more widespread for kids born to poor, teenage mothers in Elmira, N.Y., and later Memphis and Denver.  The backbone of the program?  Sending nurses into the homes, from early pregnancy to a couple years after birth, to talk, teach, model, counsel, what it took to be a good mother.

The results?  Less abuse and neglect, less use of public assistance by the families, and more involvement from fathers.  Many effects still showed up in kids when they were fifteen years old.  RAND found major cost-savings for the kids whose mothers were most at-risk and felt most helpless.  A flurry of similar programs emerged, and political leaders were quick to find and implement in their own cities and states. 

Teaching parenting is important.  Programs like the Harlem Children’s Zone have taken that cue, and added to it: good early parenting should lead to good pre-school, to good K-12 education, to good social-service supports.  

But there's an issue with this cradle-to-college "conveyor belt" now being replicated nationwide through the Promise Neighborhoods.  The very psychologist who developed NFP, David Olds, found that benefits to his parental supports were only for the at-risk mothers.  Secure families who got the supports didn't need them, and were a cost loss from an investment angle.  Olds's warning: making services universal may cover some families that don’t actually benefit, diluting resources that at-risk families most need.  

By keeping kids on the “conveyor belt” perpetually even if some of them could prosper by graduating out of it—cradle-to-college may threaten to “dilute” services at each level of its continuum.  Most of the families in these program's zones would probably be called "at-risk."  But maybe not all of them.  With scarce resources to fund the kind of childhood I got, that's a reality worth examining.