“Investing in Early Care and Education is a Powerful Public Health Initiative”

1. “Investing in Early Care and Education is a Powerful Public Health Initiative”

2. At Birth 6 Years Old 14 Years Old Rethinking the Brain, Families and Work Institute, Rima Shore, 1997.

3. World Health Organization Definition of Health “A state of complete physical, mental, and social well-being and not merely the absence of infirmity.” Tempkin, O. (1953). What is health? Looking back and ahead. In Gladston, I. (Ed), Epidemiology of Health. New York:New York Academy of Medicine, Health Education Council

4. The American Journal of Health Promotion (AJHP) offers the following definition of health promotion and optimal health[i]: “Health promotion is the science and art of helping people change their lifestyle to move toward a state of optimal health. Optimal health is defined as a balance of physical, emotional, social, spiritual, and intellectual health. Lifestyle change can be facilitated through a combination of efforts to enhance awareness, change behavior and create environments that support good health practices. Of the three, supportive environments will probably have the greatest impact in producing lasting change”. • [i] This definition of optimal health was conceived by the American Journal of Health Promotion. http://www.healthpromotionjournal.com/index.html.

5. Adverse childhood experiences predict health-risk behaviors and disease conditions Disease conditions Heart disease Diabetes Stroke Cancer Suicide Skeletal fractures Chronic bronchitis/ emphysema STDs Hepatitis Health-risk behaviors Smoking Severe obesity Physical inactivity Depression Alcoholism Illicit/injected drug use Sexual promiscuity Adverse childhood experiences Source: Felitti, VJ et al. Am J Prevent Med 1998; 14(4):245-58.

6. The Influence of Adverse Childhood Experiences Throughout Life Death Birth Early Death Disease, Disability Adoption of Health-risk Behaviors Social, Emotional, & Cognitive Impairment Adverse Childhood Experiences

7. Chicago Child-Parent Centers Study • More likely to have health insurance • More likely to report lower rates of depression • Lower rates of child maltreatment • Lower rates of teen pregnancy • Lower rates of felony arrests and incarceration

8. The Abecedarian Study • Lower rates of teen pregnancy • Lower rates of marijuana use • Lower rates of cigarette smoking

9. Brookline Early Education Project • More likely to have health insurance • More likely to have a regular source of health care • More likely to visit a doctor or dentist annually • More likely to report a health rating of good or excellent • More likely to report lower rates of depression

10. High/Scope Perry Preschool Study • Less likely to use/abuse illicit drugs • Less likely to become smokers • Less likely to engage in risky behaviors • Less likely to engage in violent behavior • More likely to be employed and earn higher wages

11. OUTCOMES AND BENEFITS BASED ON QUALITY BASED ON QUALITY BASED ON QUALITY ….and quality

16. Immediate Health Benefits • Screenings- hearing/vision/developmental • Immunizations • Referral to services • Nutrition • Mental Health Consultation • Parent Coaching

17. Participation in quality early care and education has a documented impact on nine out of ten leading health indicators, as defined by Healthy People 2010: Physical activityOverweight and obesityTobacco useSubstance abuseResponsible sexual behaviorMental healthInjury and violenceImmunizationAccess to health care*No evidence linking participation in early care and education in to changes in environmental quality

18. THE DATA IS IN! • Economic returns • Health Returns • Justice Returns SO--------From Policy to Practice

19. POLICY RECOMMENDATIONS • Full Day Quality Pre-K for all 3 and 4 year olds • Enhance and sustain health promotion opportunities in early learning settings • Implement QRIS system • Invest in Early Childhood Work Force

20. A Vision for a Coordinated Early Childhood System Needed Information, Resources & Services Pediatric Practitioners Medical Home/ Access to Care Family Resource Center Child Care Centers Early Childhood Education/ Child Care Health Centers Home VisitingPrograms Families Economic Assistance (TANF, WIC, Foodstamps) Social & Emotional Development/Mental Health Others Head Start CBO’s Family Support Early Intervention/Regional Centers Subsidized Child Care Parenting Education

21. Service Organization for Early Brain and Child DevelopmentNeal Halfon, MD, UCLA Center for Healthier Children, Families and Communities Programs influencing Early Brain, Child Development & School Readiness Pre/perinatal support Kindergarten Parenting and Family Literacy Programs Child care centers Nursery Schools Family Child Care Pediatric services Family Resource Programs Child Care Resource Programs Recreation & Arts Programs E.I. programs Children’s Library Programs

22. Home-visiting network Specialized services Home-based satellites Family Day Care Libraries Recreation Programs Service Organization forEarly Child Development and ParentingNeal Halfon, MD, UCLA Center for Healthier Children, Families and Communities Parent Support Pre/Postnatal Health Care Pediatric Care Family Resouce Center Early Headstart & Headstart Information & referral services Family Events Toy and resource libraries Play-based problem solving WIC Programs

23. Parenting Support Early Intervention Early Child Mental Health Services Home-visiting network Early HeadStart & HeadStart Child Care Resource & Referral Agency Developmental Services Lactation Support Service Organization forEarly Child Development and ParentingNeal Halfon, MD, UCLA Center for Healthier Children, Families and Communities Preventive Care Acute Care Pediatric Office Developmental Services Chronic Care

24. Clinical/Individual Includes: Doctors Schools Child Care POLICY COMMUNITY NEIGHBORHOOD SERVICES FAMILY CHILD Child Health