Smart Investment: Early Childhood Development

For David Morgan, president and CEO of TEAM Inc., not only is the research clear but the results are undeniable—focusing community support through the lens of early childhood development means children are primed for successful futures.

"We know that third grade reading performance is one of the primary factors determining whether a child graduates from high school and that not graduating is the fastest route to poverty," Morgan says. "That's why we say ready by five and fine by nine."

Individuals, families, and the community benefit from programs such as the Nurturing Families Network from the VNA of South Central Connecticut and the Maternal, Infant, and Early Childhood Home Visitation (MIECHV), which use research and a holistic approach to address the barriers that impact early childhood development.

Each program relies on regular home visits to assess individual families and provide practical support to help parents and guardians. A two-generational approach engages families to put them on a path to self-sufficiency and stability.

MIECHV's home visitors educate parents so they understand the rapid growth taking place in their young children. Interactions are dynamic. When home visitors step back from demonstrating simple, nurturing activities, mom and child are able to perform the activity together, building gross and fine motor skills while promoting brain development in the child.

Morgan comments, "I'm a father with three kids. I'm still learning and navigating how I can be the best parent I can be and one of the best things that any parent can learn is how every experience cultivates a child's chance for success."

He points to income disparity as a barrier to positive early childhood development. "The vast majority of low income parents have been faced with incredible disadvantages or lack of choices. These are people trying to move forward in a positive way and want the best for their children. Our work is all about the child and supporting his or her success."

According to the 2016 United Way report describing the challenges facing the Asset Limited, Income Constrained, Employed demographic (ALICE), child care is the single largest expense for an ALICE family of four at 28 percent of the household survival budget.

Therefore, parents are taught more than just what their children need in terms of stimulation and socialization. The Nurturing Families Network provides answers to questions such as how to utilize benefits including the Supplemental Nutrition Assistance Program (SNAP) and Women, Infants, and Children (WIC) food assistance program, or that public libraries offer play groups, workshops, and even job search tools, computers and Internet access.

These resources are vital because, as the 2016 Valley Community Index reports, a living wage needed to cover basic costs, including childcare, is $40,000 per year but 45% of Valley workers earn less than a living wage salary.

It is common for one or both Valley low-income parents to work multiple jobs, which can affect their schedules and ability to perform such fundamental chores as transporting their children. Those tasks can quickly snowball into bigger issues, such as when reliance on public transportation in the Valley or a bus system limits daycare options when the bus route does not reach all centers. Or, parents who work nights have fewer regulated care options. Only two home-based providers offer services between 11 p.m. and 6 a.m.

Pamela Lorenzo, program manager for the Nurturing Families Network at the Visiting Nurse Association (VNA) of South Central Connecticut and chair of the Valley Early Childhood Regional Council (VECRC), explains that lack of affordable childcare is another significant risk factor. "It is very, very expensive to run a facility or home-based daycare. We're seeing centers closing in the Valley because parents cannot afford to send their children to daycare, and keep their children home as a result."

The federal government recommends that families spend seven percent of household income on childcare. In the Valley, the average cost of one regulated childcare slot, or space for one child at one center, is between 11 and 15 percent of median income and up to 40 percent of an annual budget for a low-income household.

Valley childcare providers can meet 40 percent of the need for regulated care and education; in 2014, there were 2,968 regulated slots for 7,361 children ages 0-4.

Both programs can help parents identify viable childcare options and facilitate the child's transition from preschool to kindergarten with meaningful collaborations with the school districts. Assessments are comprehensive, evaluating family dynamics and needs because a child's outcome is directly and indirectly impacted by the adults around him or her.

The various forms of support from MIECHV build a level of trust that is expanded through twice-monthly gatherings of parents and caregivers, where speakers elevate everyone's ability to live a better life. The Connecticut Food Bank's mobile pantry and grow truck teaches new and creative ways to prepare low-cost, health meals and hygienists emphasize what preventative oral health means for young children.

Morgan says one of the benefits of these meetings is organic. "Parents create a network that reduces their sense of isolation. They may not have extended family during this time of need so connecting with other parents gives them a sense of belonging and really good things come out of that."

Nurturing Families Network's home-based services are provided from pre-natal to six years. Lorenzo says, "Children prepare for school through parent education, mental health screenings, developmental screenings, and case management."

As a result of these efforts, children are entering kindergarten not only ready to learn but equipped to handle almost anything. Morgan notes, "The home visits are a great way to engage and partner with hard to reach families. By reducing their stresses and providing screening, we can minimize or avoid the issues that would have been present if the child appeared in kindergarten without any support up to that point."

While not a single solution, these programs play a critical role as one service element in a system of early childhood development opportunities.

Lorenzo believes the work done so far has made a real difference, "We have 23 years of data showing that children are better off thanks to the information their parents get from the home visits. Families would have fallen through the cracks because of many barriers, including language. The Valley is a wonderful melting pot and perfectly illustrates that as diverse as our culture is, we all want the same thing for our children. We want them to be smart, healthy, and successful."

As the hub of the Valley's healthcare system, Griffin Hospital's leadership realized long ago that there are many spokes that reach out to where, from a population health and wellness standpoint, the rubber meets the road.

The hospital has a long and proud history of helping organize and coordinate community health needs, and providing support for the Valley's most vulnerable residents.

Supporting the 2016 Valley Community Index as the lead sponsor, Griffin Hospital played a major part in bringing this report to life and will use it as a tool to improve the health of the Valley moving forward.

"Having a consistent source of local data across the various categories featured in the report (Education, Health, Economics, Early Childhood, etc.) is invaluable," says Patrick Charmel, Griffin Hospital President & CEO. "When combined with demographic trends, this means we can plan, as a community, to meet current and future needs of the Valley. This common ground will eliminate the need to debate the merits of varying data sources before moving forward with actionable items."

In addition, Griffin Hospital's staff also participated in the planning stages, providing input into data collection and overall structure of the index, as well as leadership in the development of the Community Health in the Valley section. This section details Valley residents' causes of death, chronic diseases, mental health, and access to care. It is believed that many of these statistics will improve with a continued approach to prevention and wellness initiatives, something Griffin Hospital has been addressing for some time.

The Affordable Care Act requires nonprofits hospitals, like Griffin, to perform a Community Health Needs Assessment (CHNA) and to adopt a Community Health Improvement Plan (CHIP), which is an implementation strategy designed to meet the health needs of the community. The most recent Naugatuck Valley CHIP, shared by the Naugatuck Valley Health District and Griffin Hospital, was developed out of the Community Health in the Valley section in the 2016 Valley Community Index, which served as the organizations' 2016-2018 CHNA.

The CHNA, in turn, served as the launch pad for the next CHIP, which lays out a strategy to categorically address the six focus areas, and includes an overview of the baseline data, short- and long-term indicators, objectives, and strategies to address community needs.

"Griffin is at the forefront of population health management among hospitals, so we have been an early adopter of efforts to effect change in social determinants of health to improve overall health outcomes," Charmel says. "In addition to providing specific insights into many areas traditionally associated with social determinants of health, such as housing, education, and other socio-economic factors, the Index synthesizes this information across a broad spectrum of factors affecting well-being. The result is a very compelling picture of just how interdependent we all are, as individuals, municipalities, and organizations in the Valley. Only by working together can we maximize positive impact to change our community for the better in the years to come."