Key Messages/Talking Points


Main Message

The mental and physical well-being of our nation’s babies and toddlers are powerful indicators of our nation’s overall health. But the State of Babies Yearbook: 2022 shows that all is not alright for the littlest among us. The 2022 Yearbook reaffirms that families with infants and toddlers continue to struggle in the absence of a strong national policy agenda for babies that prioritizes the economic security, health, and early learning needs of babies and their families. The consequences of years of inaction reverberate, and many parents and primary caregivers today still do not have what they need to ensure a strong foundation for their children – the next generation.  

The 2022 findings show the longstanding disparities in good health, strong families, and positive early learning experiences, draining our nation’s future potential and leaving families to fend for themselves. These disparities show the barriers Black and brown babies and babies in families with low income face daily due to historic and current structural inequities. It is our responsibility – and the responsibility of our country’s leaders – to enact comprehensive, permanent, and vital child- and family-focused policies. We urgently need to build and strengthen the systems our babies need to thrive. 

About State of Babies Yearbook: 2022

  • The State of Babies Yearbook, an initiative of Think Babies™, bridges the gap between science and policy with national and state-by-state data on the well-being of America’s babies. The Yearbook includes 60 indicators across policy areas essential for a strong start in life: GOOD HEALTH, STRONG FAMILIES, AND POSITIVE EARLY LEARNING EXPERIENCES. The 2022 Yearbook is augmented by RAPID-EC data collected by a special survey led by the University of Oregon during the pandemic to show how the crisis has affected and continues to affect families with infants and toddlers.   
  • Policymakers and advocates can use these data and the accompanying analysis to identify and advance policies that provide the near-term support and the long-term stability babies and families need to thrive.  
  • States are grouped into one of four tiers (for each policy area and overall) based on how they fare on selected indicators and policy domains that represent their progress towards assuring access to healthcare, paid family and medical leave, quality education, and more. The tiers from bottom to top are: Getting Started (G), Reaching Forward (GR), Improving Outcomes (GRO), and Working Efficiently (GROW). The top tier (GROW) is the top 25 percent of states while the bottom tier (G) is the lowest performing 25 percent of states.   
  • While the State of Babies Yearbook: 2022 continues to place states in tiers, we urge state policymakers and advocates to remember that the ranking is less important than the indicated disparities within your states that continue to burden babies and their families.  
  • ZERO TO THREE worked with Child Trends to select indicators of infants, toddlers, and their families’ well-being in the three areas of ZERO TO THREE’s policy framework. The data were obtained from national datasets (e.g., the Census Bureau’s American Community Survey and National Survey of Children’s Health) that provide reliable, ongoing, and comparable data for all 50 states and the District of Columbia and Puerto Rico.  For the 2022 Yearbook, we acted on our plan to achieve a more stable set of indicators by assessing the performance of the indicators (individually and collectively) in the past 3 years and refined the state ranking process. Refinement of the ranked indicators for this edition included (a) incorporating into the ranking indicators that have been added since the initial report and (b) realigning indicators within the various subdomains to ensure optimal distribution of the influence that individual indicators have on state rankings. Finally, for additional clarity, some subdomain names were modified to better describe the focus of the indicators being addressed. The resulting realignment of indicators within each domain and designation of which indicators are used to determine states’ rank. 
  • The 2022 Yearbook presents findings on the well-being of America’s babies and their families as last reported in key national datasets. Because the data reported in these sources are retrospective by one or more years, many of the findings do not yet reflect the negative consequences families have experienced since the onset of the COVID-19 pandemic.  Therefore, the Yearbook once again uses the RAPID Survey Project data to provide insights to how the pandemic affects families with infants and toddlers. 


  • The data are clear: In each and every state, by nearly every measure, children living in families with low income and children of color face the biggest obstacles, created in large part by structural racism and inadequate wages. Babies of color and babies in families with low income are more likely to have experiences that produce chronic stress, which can undermine development. The effects of this stress can last a lifetime.   
  • 52 percent of the nation’s babies are children of color which includes Hispanic (26 percent), Black (14 percent), Asian (5.5 percent), American Indian/Alaska Native (1.9 percent), Native Hawaiian/Pacific Islander (.2 percent) and Multiple Races (5.2 percent) of babies. Because of historical and structural inequities resulting from systemic racism, American Indian/Alaska Native, Black and Hispanic children are more likely to be poor,  have early adverse experiences, and to live in unsafe neighborhoods or unstable housing. American Indian/Alaska Native and Black infants are more likely to be born too soon or too small, a pattern that persists even in highly ranked states. 
  • Inequities in birth outcomes remain high, reflecting disparities in access to quality care, implicit biases in medical treatment, and the cumulative effects of weathering lived experiences of racism, which is most prevalent among Black and American Indian/Alaska Native women.   
  • In 2021, caregivers with infants and toddlers continued to report higher levels of emotional distress amid the pandemic than pre-pandemic. Caregiver emotional distress coincided with an increase in their children’s emotional distress.   
  • The economic and social impacts of COVID-19 have increased the incidence of material hardship, increased the level of emotional distress, and deepened the need to support parents in nurturing the development of their young children. 
  • Access to quality early learning experiences was challenging before the pandemic. COVID-19 continues to have serious implications for babies’ early learning and development, both in the home and in increasingly stressed child care settings.  
  • While pre-pandemic data clearly showed the disparities and gaps in child and family well-being, the pandemic itself revealed the fragility and insufficiency of the many systems that should ensure stability among the nation’s families.  

Why This Matters

  • There are 11.4 million infants and toddlers in the United States, each of whom has unlimited potential. Our nation lacks key policies that would broadly support family well-being and ensure babies flourish, no matter where they live. 
  • The first three years of life shape every year that follows. Though every baby is born with unlimited potential, opportunities to grow and flourish are not shared equally, reflecting past and present systemic racism and barriers to critical resources. When babies consistently have what they need for positive cognitive, physical, and mental health – including safe, stable, nurturing relationships and environments – they are building the foundation for the rest of their lives. But when babies consistently do not get what their growing brains need to thrive, they don’t develop as they should, leading to life-long developmental, educational, social, and physical challenges. 
  • Every parent wants to give their child a strong start in life, but the State of Babies Yearbook: 2022 data reveal families with young children have long lacked the supports that would help in times of crisis or calm.  
  • As evidenced by the COVID-19 pandemic, our longstanding failure to support families with young children – particularly Black and brown families and those with low income – ensured that those who faced pre-existing disparities have faced the biggest obstacles throughout our crisis, and without policy changes that address these obstacles, we will face greater difficulties in the future. 
  • Our systems for supporting the health and well-being of our families and babies are threadbare. While the long-term ramifications of the pandemic are unclear, we know that without sound policies that invest in the potential of every baby, their social-emotional and cognitive development will continue to be jeopardized. 

What We Can Do

  • This nation cannot afford to continue failing its infants, toddlers, and families. As the State of Babies Yearbook: 2022 shows, the status quo for babies and families before the pandemic was already unacceptable, leaving them particularly vulnerable to crises big and small.  
  • To do better for our babies and our nation’s future, we need Congress and state leaders to seize the opportunity to create the forward-looking, family-centered policies that our nation has lacked. Policymakers need to make babies a priority through policies built on the science of brain development and budgets that put babies and families first.   
  • ZERO TO THREE created Think Babies to make the potential of every baby a national priority. When we Think Babies and invest in infants, toddlers, and their families, we ensure a strong future for us all.  
  • Think Babies is a call to action for policymakers to prioritize the needs of infants, toddlers and their families. Specifically, we call on federal and state policymakers to: 
    • Invest in high-quality child care  
    • Enact permanent paid family and medical leave
    • Permanently expand the Child Tax Credit 
    • Expand Early Head Start 
    • Invest in Infant and Early Childhood Mental Health
    • Transform systems for strong family support
  • Join the movement to Think Babies by signing up for our email list, visiting, and joining the conversation on social media at and @zerotothree on Twitter.    
  • Learn more about what you can do to be an advocate for babies in your state at   
Not Ranked
This indicator does not factor into the category's GROW ranking.