This phase of the NC Results First Initiative focuses on programs that are intended to support child and family health by improving the following outcomes:
Chronic disease outcomes, including obesity and type 2 diabetes
- Birth outcomes, such as reducing unnecessary cesarean section, infant mortality, low birthweight, preterm birth, small for gestational age, very low birthweight, and Neonatal Intensive Care Unit (NICU) admissions
The Department of Health and Human Services’ Division of Public Health (DPH) was selected as the partner agency, as it delivers a range of services to promote and protect child and family health. Findings from the Program Inventory and Benefit-Cost Analysis are below. In addition, for each policy area, OSBM publishes reports and briefs, which can be found using the links at the bottom of the page.
Program Inventory Findings
After defining the program scope, DHHS and OSBM collaborated to collect basic information to complete the Program Inventory. Thirty-one programs directly impact the specific outcomes listed above. Many of these programs are available across the state while others are unique services targeting the specific needs of participating communities. Several programs are tailored to reach especially high-risk or under-resourced populations.
Some of the Child and Family Health programs have been rigorously evaluated to determine their effectiveness, while some programs have very limited research. Seventeen of DPH’s programs targeting these outcomes are highest rated, meaning that multiple program evaluations found strong evidence that program participation improves outcomes. The strength of the evidence of effectiveness for four of the programs achieved the second-highest rating, while strong evaluation research is not available for eight programs.
Benefit-Cost Analysis Findings
After completing the program inventory, DHHS and OSBM conducted a benefit-cost analysis for applicable programs. Program benefits can only be monetized when rigorous program evaluations are available to measure the outcomes attributable to program participation. Of the 31 programs in the inventory, it was possible to monetize the costs and benefits for six programs with birth outcomes and two programs with chronic disease outcomes. The inability to monetize outcomes at this time does not indicate that the programs are not cost-effective; more research is needed to determine the extent to which these programs produce positive outcomes.
The estimated program benefits exceed the cost of implementation for seven programs. In many cases, program benefits may accumulate over many years. The estimated lifetime benefits of the programs, minus the cost of investing in the program, ranged from $940 per participant for Eat Smart, Move More, Weigh Less to $15,030 per participant for Healthy Beginnings. Most benefits accrue to participants through avoided out-of-pocket healthcare expenditures, increased earnings, and reduced risk of infant mortality. Taxpayers benefit from publicly-funded healthcare cost savings and reduced risk of infant mortality. State, federal, and local governments share the avoided costs. Private insurers and society as a whole benefit from reduced healthcare utilization and reduced risk of premature mortality.