Unequal From the Start

2. Unequal in 3 domains of healthy children, strong families and early learning from birth Experience and Evidence has proven the best time to intervene to optimize the development of our children and eliminate these disparities in a cost effective manner is in the first three years of life By investing in young children and their families, New York City can benefit by improving health outcomes, social and economic well being and educational success throughout the life span Unequal From the Start

3. Healthy Children Strong Families Early Learning

4. Need more concentration on 0-3 age group (hidden within the under 5 data) Need more information at the neighborhood and borough level to tease out the disparities Need more meaningful data points for important, but difficult to assess areas of infancy (i.e. adequate developmental screening and referral) Data Issues

5. Large disparities in birth outcomes Insufficient and disparate immunization information Lack of medical homes Unmet nutritional needs Incomplete knowledge about developmental screening and referral and receipt of services Disparities in Early Intervention (EI) based on neighborhood and income exist and are being addressed by the city Dearth of mental health services for children under age 3 Healthy Children

10. Over half of NYC infants and toddlers live in low- income or poor families Most parents of young children work outside the home and struggle to balance work/family demands Many families with infants and toddlers never access the services already available to them (i.e. WIC, SCHIP, Medicaid, food stamps, housing supports) One-third of NY State parents with children under 5 had to change jobs or change child care arrangements in the past year Maternal pregnancy related depression is under-diagnosed by as much as 50% in NYC Home visiting exists in NYC for approximately 4,000 high risk individuals to help support new families but is unavailable to the vast majority Strong Families

13. Most infants and toddlers are cared for in informal child care arrangements Only 7% of children under age 3 are in regulated child care NYC lacks sufficient regulated child care spots to meet need Support and education for parents and the large network of informal caregivers is lacking Regulated child care is expensive Child care standards at the city level do not meet state and best practice standards Early Learning

16. Data for 0-3 age group is insufficient across the board: infants and toddlers are overlooked Great disparities based on income and neighborhood exist from the beginning of life in health outcomes and access to resources While there are examples of a wide variety of excellent programs in NYC that exist to help infants, toddlers and their families, gaps remain in access, utilization, capacity, coordination and quality of programs General Conclusions

17. Track the health of infants and toddlers in real time for immunizations and developmental screening. Address the disparities in birth outcomes Ensure access to medical care including a medical home Make mental health services available to babies and their families and increase the supply of qualified providers who can treat infants and toddlers in the context of relationships Healthy Children: Recommendations

18. Continue the innovative anti-poverty programs that raise income, educate parents, and provide training for better employment outlined in the Mayor’s initiative to increase opportunity and reduce poverty in NYC. Screen all mothers in the primary care settings of pregnancy care (obstetrics) and well-baby care (pediatrics) for maternal depression. Develop a system of care to treat identified individuals Strong Families Recommendations

19. Reach out to the large informal child care network to aid them in their care of infants and children Continue to expand availability of proven infant and toddler programs Meet the same child care standards as New York State and best practice recommendations Early Learning Recommendations