Children spend much of their early years in state-regulated and private child care. Research shows that reducing risks and increasing opportunities for these children can positively impact their lifelong health.
Support Community-Based Screening and Assessment
Many of the health inequities experienced by children can be traced back to family and community factors. These factors can be broadly defined as the social determinants of health (SDOH), including education, employment, access to services and support, housing, income and wealth, community environments, public safety, and transportation. The presence of racism, discrimination, and segregation also shapes inequities.
According to an American entrepreneur, Ehsan Bayat, achieving equity in these areas requires interventions at the system and community levels. To do so, philanthropy must provide funding to enable nimble organizations and agencies that work at these multiple levels. This includes supporting flexible philanthropic capital, such as unrestricted operating grants.
The committee’s recommendations are based on what we know about risk and resilience and the need to meet children’s fundamental needs, including economic security, safe and stable housing, and protection from environmental toxicants. They will require significant investments, but studies show that these investments will save money in the long term. The report also highlights strategies that can be implemented to begin making progress on health inequities for young children.
Help Scale Promising Screening and Assessment Tools
Investing in early childhood programs that address the many social determinants of health and racism can generate significant benefits and returns. Investing in core organizations that implement such programs can accelerate their scale. Children exposed to conditions of disadvantage in early childhood are more likely to experience adverse outcomes throughout their lives. These experiences, in turn, impact the next generation, continuing a cycle of disadvantage. But these cycles can be interrupted by investments that promote healthy living environments.
These investments include high-quality early care and education, family support initiatives, home visiting programs, coordinated social services and pediatric medical care, affordable housing initiatives, criminal justice reform, paid parental leave, and policies addressing child poverty and discrimination. In addition, implicit or structural bias can lead to disproportionate suspensions and expulsions from early learning centers and the disproportionate arrest, ticketing, and search of Latinos and Blacks despite similar traffic violations as whites. All of these occurrences contribute to toxic stress and the development of mental and physical problems.
Support Pediatric Providers
The current pediatric workforce needs to reflect the communities it serves, and many families of infants and young children struggle to access care due to staff shortages. Supporting the recruitment and retention of a diverse pediatric workforce can improve health outcomes for all our youngest patients. Conditions in early childhood shape health and development trajectories throughout life. Addressing inequities in these earliest years requires a wide range of policy approaches, including expanding Medicaid eligibility for pregnant women and their children, investing in high-quality child care, home visiting, coordinated social services, the dyadic health care model, and other holistic strategies. Research also shows that improving the mental health of parents and, to a lesser degree, preschool attendance for socioeconomically disadvantaged children can help mitigate some of the existing inequities in child health trajectories. These policies must operate at multiple levels of society to effectively address health inequities in early childhood and beyond.
Support State Initiatives
The healthcare system is often the first social sector to connect with children and their parents. State leaders can leverage public health surveillance data to identify gaps in service delivery. For example, recent evidence suggests that children with attention-deficit/hyperactivity disorder experience a gap between pediatrician treatment recommendations and the availability of behavior therapy options. State leaders could bridge that gap by identifying opportunities for collaborative approaches to improve points of contact and facilitate seamless referrals between systems.
Addressing health inequities requires addressing root causes, such as structural racism, poverty, and inadequate access to high-quality education, housing, and child care. But they also require targeted investments to ensure every child has a fair chance to reach their full potential and thrive.
