Our comprehensive review and meta- analysis of these experiments find suggestive evidence of health benefits associated with investments in early life , income support , and health insurance interventions .
Housing and neighborhood trials had no effect on the outcomes included in the meta-analyses .
A positive effect of the trial on its primary socioeconomic outcome was associated with higher odds of reporting health improvements .
Early life , income , and health insurance interventions have the potential to improve health .
Policy Points Social policies might not only improve economic well-being , but also health .
Health policy experts have therefore advocated for investments in social policies both to improve population health and potentially reduce health system costs .
Since the 1960s , a large number of social policies have been experimentally evaluated in the United States .
Some of these experiments include health outcomes , providing a unique opportunity to inform evidence -based policymaking .
CONTEXT Insurers and health care providers are investing heavily in nonmedical social interventions in an effort to improve health and potentially reduce health care costs .
Effect of home visiting by nurses on maternal and child mortality: results of a 2-decade follow-up of a randomized clinical trial.
IMPORTANCE Mothers and children living in adverse context s are at risk of premature death . OBJECTIVE To determine the effect of prenatal and infant/toddler nurse home visiting on  maternal and child mortality  during a 2-decade period ( 1990 - 2011 ) . DESIGN , SETTING , AND PARTICIPANTS A r and omized clinical trial was design ed originally to assess the home visiting program 's effect on pregnancy outcomes and maternal and child health through child age 2 years . The study was conducted in a public system of obstetric and pediatric care in Memphis , Tennessee . Participants included primarily African American women and their first live-born children living in highly disadvantaged urban neighborhoods , who were assigned to 1 of 4 treatment groups : treatment 1 ( transportation for prenatal care [ n = 166 ] ) , treatment 2 ( transportation plus developmental screening for infants and toddlers [ n = 514 ] ) , treatment 3 ( transportation plus prenatal/postpartum home visiting [ n = 230 ] ) , and treatment 4 ( transportation , screening , and prenatal , postpartum , and infant/toddler home visiting [ n = 228 ] ) . Treatments 1 and 3 were included originally to increase statistical power for testing pregnancy outcomes . For determining mortality , background information was available for all 1138 mothers assigned to all 4 treatments and all but 2 live-born children in treatments 2 and 4 ( n = 704 ) . Inclusion of children in treatments 1 and 3 was not possible because background information was missing on too many children . INTERVENTIONS Nurses sought to improve the outcomes of pregnancy , children 's health and development , and mothers ' health and life-course with home visits beginning during pregnancy and continuing through child age 2 years . MAIN OUTCOMES AND MEASURES All-cause mortality in mothers and preventable-cause mortality in children ( sudden infant death syndrome , unintentional injury , and homicide ) derived from the National Death Index . RESULTS The mean ( SE ) 21-year maternal all-cause mortality rate was 3.7 % ( 0.74 % ) in the combined control group ( treatments 1 and 2 ) , 0.4 % ( 0.43 % ) in treatment 3 , and 2.2 % ( 0.97 % ) in treatment 4 . The survival contrast of treatments 1 and 2 combined with treatment 3 was significant ( P = .007 ) ; the contrast of treatments 1 and 2 combined with treatment 4 was not significant ( P = .19 ) , and the contrast of treatments 1 and 2 combined with treatments 3 and 4 combined was significant ( post hoc P = .008 ) . At child age 20 years , the preventable-cause child mortality rate was 1.6 % ( 0.57 % ) in treatment 2 and 0.0 % ( SE not calculable ) in treatment 4 ; the survival contrast was significant ( P = .04 ) . CONCLUSIONS AND RELEVANCE Prenatal and infant/toddler home visitation by nurses is a promising means of reducing all-cause mortality among mothers and preventable-cause mortality in their first-born children living in highly disadvantaged setting s. TRIAL REGISTRATION clinical trials.gov Identifier : NCT00708695
Our comprehensive review and meta- analysis of these experiments find suggestive evidence of health benefits associated with investments in early life , income support , and health insurance interventions .
Housing and neighborhood trials had no effect on the outcomes included in the meta-analyses .
A positive effect of the trial on its primary socioeconomic outcome was associated with higher odds of reporting health improvements .
Early life , income , and health insurance interventions have the potential to improve health .
Policy Points Social policies might not only improve economic well-being , but also health .
Health policy experts have therefore advocated for investments in social policies both to improve population health and potentially reduce health system costs .
Since the 1960s , a large number of social policies have been experimentally evaluated in the United States .
Some of these experiments include health outcomes , providing a unique opportunity to inform evidence -based policymaking .
CONTEXT Insurers and health care providers are investing heavily in nonmedical social interventions in an effort to improve health and potentially reduce health care costs .