Recognizing the child care link to community health and well-being

In partnership with the University of Vermont Medical Center, the OneCare Vermont accountable care organization, and others, we’re developing a first-in-the-nation project that integrates child and family health services with early care and education in the community-based child care setting. Child care is an overlooked but ideal setting for primary prevention, which leverages trusted relationships between provider and parents to support a two-generation approach to serving children and families. It frees physicians from the demands of screening and educational activities, so they can focus on treatment; and it relocates those preventative services, including nutrition and fitness education, for delivery by qualified professionals in the child care setting.  This innovation will generate new income for care providers while fostering a sustainable cycle of prevention.

“Children are the world’s most valuable resource and its best hope for the future.” – John F. Kennedy

What was President Kennedy’s lofty belief 50 years ago is now a scientifically-based reality. Research has increasingly pointed to the importance of the first years of life in setting the trajectory for lifelong well-being. This research has various applications, from “brain science” to “developmental origins of health and disease,” but a common lesson for public policy: the first five years of life are the most important for affecting lifetime cognitive, emotional, and physical well-being. Our best hope for the future is to adopt practices and policies that recognize this reality.

Today’s American childhood includes a growing component that represents a key opportunity to improve the lives of our youngest children: child care.

The child care setting: An under-utilized lever for change

An estimated 11 million children under the age of five spend an average of 36 hours per week in some form of child care in the United States. In Vermont, a state with one of the highest rates of parental employment, more than 70% of children under the age of six spend some portion of their day in child care.

Despite the data, efforts to improve child health and development have only rarely recognized this reality of children’s lives and even more rarely taken advantage of it.

The Permanent Fund for Vermont’s Children has focused its efforts on building a high-quality and accessible early care and education system—the child care system—because this is where most of our children spend much of their time and we have the greatest opportunity for creating positive, lasting change.

Connecting child care professionals to the health care community through education and training programs provides a powerful, yet previously untapped, way to support the whole child and improve the health and well-being of our communities.

Trusting relationships provide foundation of support

Child care professionals are in a unique position to support families because they see our children and parents regularly, often five days a week. This regular contact builds a positive, trusting relationship—the foundation to the child care professional’s ability to successfully help and support families.

This relationship enables the child care professional to touch two generations (the child and parents) by providing positive, nurturing experiences for the child and serving as a supportive resource (and role model) for the parent.

Child care professionals as a resource for prevention

All families experience stress, but the causes and amounts vary, as well as a family’s ability to cope with such stress. Research has shown a powerful relationship between our emotional experiences as children and our physical and mental well-being as adults. Adverse childhood experiences are common, destructive and have an effect that often lasts for a lifetime. High-quality child care professionals trained in the evidence-based Strengthening Families framework can engage parents in building protective factors that promote optimal child development and prevent abuse and neglect.

Child care professionals as a natural part of the medical home model

As we work on health care reform and integrating services, there is an incredible opportunity to tap the child care community and use resources more effectively. The high-quality child care professional is in a unique position to act as a partner in this effort, serving on the frontline—as the eyes and ears—of the health care community. The Permanent Fund is working within the child care community to influence outcomes in many areas of community health:

  • Early identification of developmental delays or mental health problems. Because of their regular, year-round contact with the children they serve, highly trained child care professionals can spot areas of developmental or health concern before the parent or health practitioner. The child care worker can refer parents to a medical professional early and assist with coordination of ongoing early intervention services.
  • Resource for integrated and efficient service delivery. High-quality child care professionals know the resources and services available in the local community and can connect parents to the supports they may need (housing and food programs, crisis management services, mental health services, etc.)
  • Providing support and knowledge of parenting and child development. High-quality child care professionals can provide support for parents through accurate information about child development and appropriate expectations for young children’s behavior. Modeling effective adult-child interactions can be a powerful form of parent support and education.
  • Improving nutrition. By providing healthy snacks and meals to the children in their care and sharing nutrition information with children and their families, child care professionals can help develop healthier food preferences in young children to counter the recent epidemic of childhood obesity and lay the cornerstone for lifelong healthy eating and exercising.
  • Functioning as part of the community family care team, child care professionals can provide support services that complement or fill gaps for other professional services being provided to the family.

President Kennedy was right: Children are the world’s most valuable resource and its best hope for the future. As a society, we need to increase our investments of time and energies in the first years of life and make smart decisions about these investments. By recognizing and leveraging the important role that the child care professional can play in community health, we have a great opportunity to create lasting change for the well-being of our children, our families and our communities.

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