Recently, we released the final part of the five-part Pathways to Grade-Level Reading Policy and Practice Action Toolkit to provide guidance for how policymakers, advocates, community non-profits, the business community, and other stakeholders can support the well-being of all North Carolina children with strategic, early-life investments.
The introduction to the toolkit reminds us that Medicaid is a powerful tool in child and family wellbeing because it touches a huge number of families: Nearly half of children under age three in the United States get their health insurance through Medicaid and the Children’s Health Insurance Program (CHIP). The importance of Medicaid for strengthening the health and wellbeing of children in low-income households cannot be understated: At least three-fourths of children under age 6 in low-income households rely on Medicaid or CHIP for health coverage. Of the general population of children in North Carolina, approximately 33% of African-American and 20% of White children had Medicaid coverage.
The toolkit also included five 2-page action briefs that highlight policy actions aimed at helping to ensure that parents and their young children can be resilient and thrive, even in the face of adversity. Take a look at each action brief.
ACTION: Use Data to Track Community Needs and Service Provision. Early childhood data systems help program leaders and policymakers better understand the needs of the families they serve. Data can illuminate answers to questions around access, program effectiveness and quality, and young children’s needs, ultimately serving to inform the allocation of federal, state, and private funds. For young children in North Carolina, this data gap is particularly apparent with regards to social and emotional health (SEH). Measuring what matters is frequently the first step in shifting the needle because data can empower policymakers to make informed decisions that support all aspects of children’s wellbeing, including their mental and behavioral health. Population-level data on children’s SEH would enable informed discussions about the allocation of resources. Read this action brief >>>
ACTION: Screen Children and Families for Social Determinants of Health and Connect them to Appropriate Services. The social determinants or drivers of health are the conditions in which people are born, grow, live, work, and age. The conditions of children’s neighborhoods, homes, and child care have a strong influence on their health, development, and school success. Because differential access to the social determinants of health is the primary driver of racial, ethnic, and socioeconomic health disparities, screening for them and directly connecting families and children in need to services is a crucial step in working towards health equity. Given the complex and multilayered nature of the social determinants of health, collaboration across sectors, such as transportation, education, housing, and healthcare, and across various organization types, such as government agencies, private industry, and community-based organizations, are needed to create positive change. Read this action brief >>>
ACTION: Invest in Two-Generation Interventions. Two generation approaches are centered around the principle that outcomes for children are closely related to the well-being of their families and caregivers. Two-generation approaches can be particularly beneficial for families that face systemic barriers, particularly members of communities of color who face disproportionately high rates of poverty. There is strong evidence that parents’ wellbeing, from mental health to economic security, strongly influences children’s development by providing the foundational developmental environment—both physical and emotional. Similarly, healthy child development supports parents’ economic and mental health because needing to take time off to care for sick children can cost parents’ their jobs and can take a toll on their wellbeing. Read this action brief >>>
ACTION: Expand Maternal Depression Screening and Treatment. track North Carolina’s rates of maternal postpartum depression screening at well-baby visits and the amount and effectiveness of maternal depression and evidence-based two generation (mother and child) treatment services. Determine the extent of racial, ethnic, and geographic disparities in screening and service delivery to mothers with depression, and then expand access to screening and treatment services based on the results. Maternal depression is an especially salient issue for women with four SES risk factors (low monthly income, less than a college education, unmarried, unemployed, who are 11 times more likely than women with no SES risk factors to have clinically elevated depression scores. Routine postpartum pediatric, obstetric, and gynecological visits are the healthcare system contacts that are most likely to catch early stages of postpartum depression. Read this action brief >>>
ACTION: Include At-Risk Children in Early Intervention. Early intervention is a system of services designed to support families with young children who have, or are at-risk for, disabilities. Early intervention providers include early childhood special educators, physical therapists, occupational therapists, speech and language pathologists, and health professionals that work in partnership with parents and caregivers to understand and provide services that build on children’s strengths, so they can reach their highest possible potential. Unfortunately, most states, including North Carolina, provide limited support for proactive and preventative early interventions, forcing many families and children to wait until developmental challenges are causing serious impairment before they become eligible for support. Early intervention harnesses the tremendous knowledge that we have on the individual, family, community, and society level factors that can harm children’s development and limit their future social and economic opportunities. Using this knowledge to identify infants and children who may need more support than their parents and caregivers can provide enables us to reduce the likelihood of adverse outcomes. Read this action brief >>>
Local and Statewide Initiatives Leading the Way
Organizations and initiatives around North Carolina are working hard to implement many of these actions and policy recommendations through innovative programs. Several are profiled in these briefs, including Family Connects, which provides universal newborn nurse home visiting program that combines engagement and alignment of community service providers with short-term nurse home visiting; and REACH, which provides case management services with the goal of addressing the social-emotional, behavioral, developmental, and academic needs of children. Learn more about these and other initiatives in the toolkit.
Background on Pathways
Eight years ago a broad tent of stakeholders from across North Carolina started meeting and developed NC’s Pathways to Grade-Level Reading (Pathways). Pathways stakeholders identified 44 Pathways Actions that provide evidence-based guidance for how policymakers, advocates, community non-profits, the business community, and other stakeholders can support the wellbeing of all NC children. It is these actions that we now advance through this five-part Pathways to Grade Level Reading Policy & Practice Actions Toolkit. Each part of the toolkit will provide evidence-informed guidance and recommended practices and also highlight organizations and initiatives across the state that are already taking action to move the needle.
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The NC Early Childhood Foundation is driven by a bold – and achievable – vision: Each North Carolina child has a strong foundation for life-long health, education, and well-being supported by a comprehensive, equitable birth-to-eight ecosystem. We build understanding, lead collaboration, and advance policies to ensure each North Carolina child is on track for lifelong success by the end of third grade.