Improving Quality of Life

Quality of life can be improved when communities offer support to families, teachers, and caregivers, to ensure the healthy physical, cognitive, social, and emotional development and school readiness of young children.

The first years of life are crucial for a child's development and set the stage for future challenges or successes.  In order to maintain a high quality of life in North Dakota, we need to invest in our children.  Children raised in loving and stable environments that provide positive stimulation, and who receive early screening and intervention for health or developmental problems, enter school ready to do their best.  The return on investment in these early years will pay back over a child’s entire lifetime.

What's happening

  • Birth weight can provide important insight into a child's long-term health and future success. Statewide, low birth-weight babies represented 7.1 percent of all live births in 2022. While the overall percentage of low-birth-weight babies in North Dakota has trended lower than the U.S. since 1990, it varies greatly by county (from 1.9% in Dickey County to 12.1% in Slope County in 2018-2022).
  • North Dakota ranks last among the 50 states for the percentage of children (3 and 4 years old) enrolled in preschool (i.e., organized child care programs offering educational experiences for children during the years preceding kindergarten – including Head Start) (29.1% in 2022), the national average was 46.7 percent.
  • The percentage of young children (under 6 years old) for whom all parents are working increased (71.2% in 2022) ranks North Dakota 16th among the 50 states.

Making connections

Low birth weight babies may have higher risks for certain health problems or suffer from social development or learning disabilities. Prevention strategies in addition to improving the health behaviors of pregnant women and screening during pregnancy include improving women's general health over the life cycle and effective interventions and changes in the social determinants of health (e.g., poverty, educationjob opportunities).

Receiving quality prenatal care continued with acquiring early learning experiences in the years preceding kindergarten, are establishing the conditions that promote successful educational achievement for children.  

An investment in our young children is an investment in the future economy and workforce of our state.


Grace Njau, Nancy Hodur, & Chelsey Hukriede: Risk Behaviors among Women with a Recent Live Birth in North Dakota: Findings from the 2017 North Dakota Pregnancy Risk Assessment Monitoring System (PRAMS)

"In North Dakota, PRAMS is especially relevant given the disparities we see in infant mortality. At 9 infant deaths per 1,000 live births, American Indian infants are more than twice as likely to die in the first year of life compared to White infants (4 per 1,000). American Indian infants are also more likely to be born premature, and to be admitted to the Neonatal Intensive Care Unit at birth. It is therefore important to identify the primary drivers of these poor birth outcomes and also to work on interventional strategies that will help reduce these disparities."

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Grace Njau: A Brief Introduction to the North Dakota Pregnancy Risk Assessment Monitoring System (PRAMS)

"The purpose of ND PRAMS is to supplement vital records data regarding maternal behaviors and experiences. As of 2017, no alternate data sources are available in ND to measure the current prevalence of the topics below – making PRAMS a valuable addition to maternal and child health data capacity in the state."

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ND Department of Health: Making change happen - Improving the health and well-being of all North Dakota infants, mothers, children, children with special health care needs and their families

"The Title V Maternal and Child Health (MCH) Block Grant Program—the Nation’s oldest federal-state partnership—aims to improve the health and well-being of women, particularly mothers, and children. Every five years, legislation requires ND to develop a comprehensive statewide needs assessment for the MCH Services Title V Block Grant Program. This needs assessment is an ongoing collaborative process, one that is critical to program planning and development and enables the state to target services and monitor the effectiveness of interventions that support improvements in the health, safety and well-being of the MCH population."

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North Dakota Compass

Center for Social Research
North Dakota State University

Compass created by:
Wilder Research

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