Linking Health & Education in the Earliest Years

Population Health Hosts National Academies of Medicine Workshop About Early Childhood

Monday, September 25 2017

Exploring Early Childhood Care and Education Levers to Improve Population Health  

By the time they are three-years-old, children from low-income families have heard 30 million fewer words than their wealthier peers, putting them at a disadvantage for vocabulary development, which makes it harder for them to learn to read. Children who do not learn to read by third grade are in turn much more likely to drop out of high school. This “word gap” is just one of a myriad of ways kids are at a disadvantage without investment in their health and educational development early in life, said speakers at the National Academies of Science, Engineering and Medicine’s “Exploring Early Childhood Care and Education Levers to Improve Population Health” workshop on September 14.

The event, which was hosted by the Department of Population Health at NYU Langone Health, a sponsor of the National Academies’ Population Health Roundtable series, brought together leaders working at the intersection of health and education to discuss the current science, examples of collaborations, and different funding models and sources that have supported healthy early development—including a variety of initiatives taking place in New York City.

"Children actually spend more time in early care and education settings than they ever would with their healthcare professionals—who they might see once or twice a year," said Debbie Chang, MPH, senior vice president of policy & prevention at Nemours Children’s Health System, and a member of the workshop planning committee. Because children learn healthy behaviors early, it is important that early care and education programs become settings for promoting health, said Chang: "Supporting population health in these settings can eventually reach many, many children."

One example of a successful marriage of health and education is ParentCorps, a program based at the Department of Population Health’s Center for Early Childhood Health and Development that began as an effort focused on children’s early behavioral regulation and mental health development. ParentCorps brings together the adults who are most important in children’s lives—parents and teachers—to create “safe, nurturing, and predictable environments,” said ParentCorps’ developer Laurie Miller Brotman, PhD, Bezos Family Foundation Professor of Early Childhood Development and Professor of Population Health. According to two randomized controlled trials with more than 1,200 low-income children and families from New York City, ParentCorps in pre-kindergarten programs results in long-term impacts on child academic achievement, mental health, obesity and health behaviors. 

Laurie Miller Brotman, PhD, Bezos Family Foundation Professor of Early Childhood Development
Laurie Miller Brotman, PhD, Bezos Family Foundation Professor of Early Childhood Development

In partnership with New York City’s Division of Early Childhood Education at the Department of Education, and with funding from Thrive NYC—a mayoral initiative in support of mental health—and the New York State Office of Mental Health, ParentCorps is being scaled throughout New York City with evidence-based practices spread to all 1870 Pre-K for All programs serving more than 70,000 four-year-olds annually. Three ongoing randomized controlled trials in more than 200 Pre-K for All programs will yield critical information for policy makers about providing resources at scale to enhance family engagement and promote children’s health and well being.

Another initiative, the Video Interaction Project, developed by Alan Mendelsohn, MD, associate professor of pediatrics and population health and pediatrics at NYU Langone Health, uses pediatric check-ups to reduce gaps in development of children of low-income families by helping parents read aloud and play beginning in early infancy. At each check-up, a parenting coach creates a 5-minute video of the parent and child, which is played to help the parent identify and reinforce strengths. Randomized controlled trials have shown the video interaction is linked to enhanced socioemotional, cognitive, and language development by the children and more parental engagement with their children.

The Video Interaction Project is currently being expanded across the country, including in New York City, where it is a part of New York City Council’s City’s First Readers, which unites partners that promote early literacy and language but typically wouldn't work together, including Reach out and Read; the Brooklyn, New York, and Queens Public Libraries; Jumpstart; the Committee for Hispanic Children and Families; Parent-Child Home Program; and the United Way. It is also rolling out in Elmhurst, Queens, with support from the New York City Department of Health & Mental Hygiene.

Meanwhile, earlier this year, the New York City Department of Health launched a campaign called “Here for You” which advertised on TV, digital, social media, and public transportation services targeted at parents of children from birth to five-years-old in underserved communities. The ads inform parents of how to get free support with breastfeeding, information about parent groups in the community, referrals to early intervention services, and information on safe sleep practices. According to George Askew, MD, Deputy Commissioner of Family and Child Health in the NYC Department of Health: “Every child, woman, and family in NYC is empowered to give their full potential.”

Over the course of the day, speakers from nonprofits, health departments, and universities took participants through similar programs and policies acrossthe country. "Because it brought together researchers and practitioners from different disciplines focused on early childhood, the workshop offered unique opportunities to ask questions of one another and elicit insights and lessons learned about how the fields of health and of early childhood care and education can collaborate around shared goals," said Alina Baciu, PhD, senior program officer at the National Academies of Science, Engineering, and Medicine.

--Elaine Meyer