Early Childhood Education and Health

1
Early Childhood Education and Health

• Judith S. Palfrey, MD
• Harvard University
• Santiago, Chile
• July, 2006

2
Sharing Our Experiences

• What we have learned from the US experience

3
Sharing Our Experiences

• What we have learned from the US experience

What is the Chilean experience especially NOW!!
4
Propositions

• To improve the well-being of our children, we
  need to integrate educational, medical and public
  health approaches
• We need to address social, economic and cultural
  inequities
• We have models for doing this
• What stands in our way are
• - Inadequate political will
• - Incompletely developed social strategies

5
Early Childhood and Health

• Background
• Early Childhood
• Integration with Health Services
• Long Term Payoff

6
21st Century Community Factors that Affect Child
Health and Development

• Poverty
• Ethnicity
• Geography
• Environment
• Family configuration
• Parental occupation
• Stress
• Isolation

7
Worldwide Child Mortality
8
Millennial Morbidities

• Related as much to lifestyle as to viruses and
  bacteria
• Injuries and violence
• Nutrition related concerns (overweight and
  obesity)
• Environmental concerns (asthma)
• Behavioral issues (autism, ADHD, mental health)
• Habits (smoking, alcohol, drugs, sexuality)

9
Poor Children Poorer Health
10
Percentage of Children in Poverty by Family
Type, Race, and Ethnicity in the US, 2002
11
Poor Health

• Violence
• Child Abuse
• Homelessness
• Hunger
• Depression
• Suicide
• Drug/alcohol
• HIV/AIDS

12

• But
• We
• Also
• Know
• That
• COMMUNITIES MATTER

13
Percentage of 6th-12th graders with high risk
behaviors, by number of assetsfrom Benson,
Leffert, Scales, Blyth (n99,462)
Source Benson et al.
14
Early Childhood

• Period of rapid growth
• Foundation for all later health
• Foundation for all later learning
• Biologic and social processes linked
• Critical role(s) of caring adults and community

15
Early Childhood

• Period of rapid growth
• Foundation for all later health
• Foundation for all later learning
• Biologic and social processes linked
• Critical role(s) of caring adults and community

16
Monitoring Growth
17
Longterm Importance

• Lifelong consequences
• Diabetes
• Heart Disease
• High Blood Pressure
• Mental and Emotional Concerns

15
32
18
Longterm Importance
19
Early Childhood

• Period of rapid growth
• Foundation for all later health
• Foundation for all later learning
• Biologic and social processes linked
• Critical role(s) of caring adults and community

20
Brain Growth/Organization

Birth
One Month
Three Months
Six Months
Harlow, Lorenz, Hubel and Wiessel, Richmond and
Caldwell, Abecederian, Piagetians, Bowlby,
Ainsworth, etc.,
21
Critical Role of Stimulation

Harlow, Lorenz, Hubel and Wiessel, Richmond and
Caldwell, Abecederian, Piagetians, Bowlby,
Ainsworth, etc.,
22
Early Childhood

• Period of rapid growth
• Foundation for all later health
• Foundation for all later learning
• Biologic and social processes linked
• Critical role(s) of caring adults and community

23
Integration of Health Services with Early
Childhood

• Access to Primary Care
• Well Child Visits ( for Immunizations)
• Injury Prevention
• Detection of Sensory Defects
• Dental Screening
• Speech/Language Assessments
• Behavioral Screening (ADHD, autism, withdrawal)
• Rapid Intervention

24
Successful Models

• Head Start
• Perry Preschool Project
• AbeCeDarian
• Brookline Early Education Project

25
BEEP Program

• Home Visits/Center Visits
• Language based curriculum
• Parents as first and best teachers
• Diagnostic Program
• Health screenings
• Developmental monitoring

26
2nd Grade Findings

• Impact on behavior
• Impact on reading
• Differential effects

27
BEEP 2nd Grade OutcomeReading Difficulty
Families Highly Educated
28
BEEP 2nd Grade OutcomeReading Difficulty
Families Highly Educated
29
BEEP 2nd Grade OutcomeReading Difficulty
Families Highly Educated
30
BEEP 2nd Grade OutcomeReading Difficulty
Families Highly Educated
31
BEEP 2nd Grade OutcomeReading Difficulty
Families Not Highly Educated
32
BEEP 2nd Grade OutcomeReading Difficulty
Families Not Highly Educated
33
BEEPers at Age 25

• Objective
• To assess the health status and general
  well-being of young adults (age 25) who were
  enrolled as infants and children in the BEEP
  program in comparison with matched controls

34
BEEPers at Age 25 Outcomes

• Improved Educational Outcomes
• Improved Job Placement
• Improved Health Outcomes
• Improved Health Care Utilization
• Improved Mental Health Outcomes

35
(No Transcript)
36
Propositions

• To improve the well-being of our children, we
  need to integrate educational, medical and public
  health approaches
• We need to address social, economic and cultural
  inequities
• We have models for doing this
• What stands in our way are
• - Inadequate political will
• - Incompletely developed social strategies

37
Richmond Model
Knowledge Base
Social Strategy
Political Will
38
Lack of Political Will

• Public. Other Peoples Problem
• Public Health equated with Poverty
• Problems that appear too difficult
• Successes not celebrated or remembered
• The Dangerfield Dilemma
• After all its not rocket science

39
Early Childhood/Chile 2006

• There is strong Political Will
• The problem is seen as OUR problem
• A goal has been articulated
• And the work is going forward

40
Social Strategy

• Defining Constraints
• Defining Contributions
• Designating Clear Goals
• Identifying Players
• Articulating Responsibilities
• Evaluating Results
• Institutionalizing Success

41
Components for Success

• Health services including nutritional and oral
  health services
• Early childhood education
• Social services
• Parental involvement

42
Components for Success (cont.)

• Volunteer recruitment
• Local governance to implement maximum feasible
  participation of the poor.
• Training, technical assistance, evaluation, and
  research in collaboration with local institutions
  of higher education

43
(No Transcript)
44
(No Transcript)