State Policies Aligning Health and Early Childhood Learning

May 17, 2018|2:27 p.m.| ASTHO Staff

Evidence shows how early childhood education can serve as a protective factor against disease and disability as an adult. Conversely, a child’s health will impact his or her ability to learn and succeed in school and later in life. Even with these known positive connections between early learning and wellness, health and education systems sometimes fail to align and provide opportunities to maximize health and early learning outcomes for children. To address the disconnect between health and education, HHS and the U.S. Department of Education outlined a set of recommendations for states and communities to align health and early learning systems. These recommendations emphasize the need for a comprehensive, seamless, and coordinated set of systems to support children, parents, and families. The six recommendations are:

  • Build on existing structures to establish and sustain state and local coordination and alignment across health and early learning programs and systems.
  • Expand, coordinate, and streamline health and early learning enrollment processes for families eligible for multiple public benefits to minimize barriers to families accessing these services.
  • Implement innovative approaches to coordinate, co-locate, and integrate comprehensive services for young children to meet families where they are.
  • Build universal screening referral and linkages systems to ensure all children receive age-appropriate screenings to detect possible health, developmental, sensory and behavioral health needs, or delays and disabilities; assess all families for health and wellbeing (including maternal depression, family violence, and food insecurity); and perform appropriate referrals and follow-up.
  • Ensure that children’s nutrition, physical activity, and oral health needs are addressed in early learning programs and by health providers.
  • Support and engage with families consistently to improve long-term health and education outcomes.

Throughout the country, state policymakers are observing these recommendations by facilitating the alignment and collaboration of family health and early childhood learning. For example, last year the Illinois legislature instructed the state’s Kindergarten Transitions Advisory Committee to recommend legislation that addresses the value of the primary education system partnering with early childhood programs, like Head Start and home visiting (i.e., programs that provide at-risk pregnant women with resources and skills to raise children who are physically, socially, and emotionally ready to learn and thrive).

Two other areas where lawmakers are generating opportunities to align child health and early learning are adverse childhood experiences (ACEs) and two-generation approaches. ACEs (i.e., abuse, neglect, and other traumatic events that occur before the age of 18) can result in long-term negative outcomes such as increased risks for substance use disorders, depression, diabetes, and more. Policies to prevent and address ACEs benefit from a multi-systems approach and can provide opportunities for collaboration between early learning and health systems. For example, in 2011 Washington state passed a law to convene a multi-sector stakeholder group, specifically including “early learning coalitions” and “community public health and safety networks,” to inform and develop policy recommendations on ACEs. This year, lawmakers from Washington, D.C., Minnesota, Missouri, Oklahoma, and Vermont are considering similar legislation to facilitate holistic prevention and mitigation policies for ACEs that include critical stakeholders from public health, early learning, and education.

Along with ACEs, policies related to two-generation approaches (i.e., strategies that reduce poverty and improve the health, education, social, and economic well-being of both parents and children) can also be used to align health and early learning. For example, a bill in Massachusetts would establish a special commission to identify opportunities and recommend ways to align available public resources to provide two-generation approaches. In Utah, the governor signed a bill establishing a grant program for counties to implement two-generation approaches. The new law emphasizes the importance of agency partners, including public health and early childhood services, and includes these types of partnerships in the grant selection criteria.

Whether it’s through existing undertakings, such as Head Start and home visiting programs, or emerging initiatives like those to prevent ACEs or provide intergenerational support, alignment is occurring between health and early education systems. To be successful, these polices must leverage the resources and expertise of multiple systems to strengthen the capacities of families, caregivers, healthcare providers, teachers, and communities. ASTHO will continue to highlight and inform its members about proven and emerging approaches to align health policies and programs with early learning systems to create and sustain environments where infants, children, and families can thrive.