Number 4) Home Nurses Visitation Program

Sometimes when we make policy decisions, we have to take our best guess about what types of programs work and what don't. For instance, a lot of people had very high hopes for abstinence education programs, and even those of us who were dubious about the idea couldn't be sure whether the programs would be effective until they had been tried and data had been gathered to determine if they would work. (The verdict is now in, though. They don't.)

However, this is not always the case. Sometimes we are blessed with the opportunity to support programs that have a long track record and have proven statistically effective in achieving valuable social goals. For example, the Home Nurses program, which sends nurses to the homes of low income mothers to be to offer instruction and support in infant care. Programs of this type have been running in trial versions since the late 1970's and have consistently shown real benefits.

But that description is too cold. What we are talking about here is children who would otherwise be abused are not being abused. Children who would otherwise receive poor nutrition are well fed. Children who would be born premature, are born healthy. Teenagers who benefited from the program as children are less likely to be arrested themselves or for their parents to be in jail

The Home Nurses programs work with the most underprivildged families in some of the poorest neighborhoods in the country. Here's a description pulled from a heartbreaking article on the nurses and mothers participating in the program in New Orleans. A home nurse, Luwana, is trying to help a mother called Alexis learn how to care for her 13 day old baby:

No matter how chaotic the scene - no matter that Alexis' sister has taken a break from hacking chicken parts by the kitchen sink to attend to the ex-inmate's sexual needs in the next room - Luwana's first task is to create an aura of momentousness around the new baby. As she moves through a household, giving advice about routine-building, breast-feeding, and storing the shotguns out of reach, she attempts to win over not just a young mother but a typically unwieldy cast of supporting players, from the baby's father to the great-grandmother getting high in a tent behind the house. What Luwana tells each family may seem, on the face of it, fiction: that in this infant enormous possibilities inhere. But such fictions can be strategic...

Obama's budget creates a national Nurse Home Visitation program to help turn this fiction into a reality for thousands of the neediest infants in America.

Money well spent.