Examining the Causal Impact of Prenatal Home Visiting on Birth Outcomes: A Propensity Score Analysis

Objectives: In Ohio, African American babies die at 2.5–3 times the rate of White babies. Preterm birth and low birth weight are the leading causes of infant mortality. Home visiting is an evidence-based strategy for serving low-income pregnant women; however, there are relatively few rigorous studies examining its effect on birth outcomes. Methods: This study uses a propensity score technique to estimate the causal effect of participation in home visiting on prematurity and low birth weight among a low-income, predominantly African American sample (N = 26,814). Results: We found that participation in home visiting significantly reduced the odds of experiencing both adverse birth events, with a larger program effect for the low birth weight outcome. Conclusions for Practice: Results suggest that selective prevention strategies must be accompanied by universal attempts to improve the health and life circumstances of low income and minority women.