Advancing Health Policy as a Lever for Improved Child Outcomes

Children’s biological and social experiences early in life influence the trajectory of their growth and development throughout the rest of their lives.  Health is one of the three areas of the Birth Through Age Eight State Policy Framework, which guides the Alliance for Early Success partnerships and investments. 

We focus on the needs of the most vulnerable children and families.  Too often, the zip code they live in determines how healthy they are: the quality of housing, the safety of neighborhoods, the availability of nutritious food, and their access to quality and affordable health care and other services.  

Experts and leaders in the field are expanding the ways we think about health.  Social determinants of health include a broad set of factors that go beyond the treatment of disease, to addressing environmental and relational factors that impact health. This requires rethinking pediatric and primary care, and how the health care system and other systems could work together. We see the intersections between this re-imagined health system, early learning, and family support as keys to reaching better outcomes, especially for the most vulnerable young children and their families.

Important advances in how we think about health, and knowledge about how early development impacts later health, are influencing policy conversations and changes in practice.  The Robert Wood Johnson Foundation sparked a national conversation in 2008 with its first Commission to Build a Healthier America report, and took the next leap with its January 2014 release of Time to Act: Investing in the Health of Our Children and Communities.

Intersections between Health, Learning and Family Support

The first of three recommendations in the RWJF Commission report is to “Make investing in America’s youngest children a high priority.”  It calls for a “significant shift in spending priorities and major new initiatives to ensure that families and communities build a strong foundation in the early years for a lifetime of good health.”  Recognizing that early childhood program quality is essential, the report calls for improved standards, as well as supports for parents and investment in research and innovation.  The Alliance strongly supports this recommendation and believes early learning strategies, combined with changes in health policies and practice, will lead to new and better ways we provide programs and services that improve outcomes for young children and families.

Alliance Efforts
In recent years, the Alliance has invested in efforts to understand the biology of adversity, toxic stress, and the buffering effect of early relationships on later growth and development.  We have supported advocacy efforts at both state and national levels to inform policies areas, including early childhood mental health and developmental screening. 

This year we are engaging in a set of activities to further explore the intersections between health and early childhood.  We conducted more than 35 key informant interviews with experts from a broad range of health-related fields.  In February we hosted a Health Policy Roundtable, bringing together key health experts with Alliance state and national partners.  Reflecting on the separate silos of health and early childhood policy, where “never the twain shall meet,” one participant referred to the roundtable as the “twains” meeting.  Topic areas included: health equity, health coverage, developmental screening and follow-up, early childhood and maternal mental health, and the importance of social capital among families and in communities.  A policy brief summarizing the key findings from the meeting and highlighting priority policy choices will be completed in May.  We have learned a lot and will use this information to help guide partnerships and investments as we go forward. 

Steffanie Clothier, Senior Policy Director, Alliance for Early Success (March 21, 2014)