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Making Counties the Best Places for Babies to Grow

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Joan Lombardi believes leadership at the county and city level can help knit services together to assure access to quality services and support for all families

Dr. Joan Lombardi is a global leader on early childhood issues. She currently serves as senior advisor to the Bernard van Leer Foundation on global child development strategies and as an advisor to a range of foundations on domestic early childhood issues.

She has witnessed an increase in community-wide early childhood initiatives and believes that leadership at the county and city level can help knit services together to assure access to quality services and support for all families.


What do you think counties need to have in place to ensure healthy infants and toddlers, supported families, and quality childcare and early learning?

If we turn to those communities that are moving toward putting these supports in place, we see a pattern in their process. First, leadership matters, so in other words it makes a big difference if the county executive or other prominent member in the community such as someone from the business sector steps forward to lead a process to improve conditions and outcomes for young children and families. 

Once you have an engaged cross-sector group in a community, they often start by discussing what specific outcomes they want for children and then go on to map assets and issues facing families.  This often leads to a specific plan to improve policies in core areas — health, family support and child care.


What should counties consider if they wish to impact health, family support and access to affordable, quality childcare?

First, we must assure that all families have access to quality health care — that is where it all begins for pregnant women and babies. What many communities are trying to do is put in place a set of connections and supports that can link families to core services and connect them to the social networks of support so critical to all of us. Breaking the sense of isolation for families, the sense that they have to go it alone all the time, is essential, particularly for families with young children. And of course, one of the biggest issues families face is quality child care. Communities and states are trying to find additional revenue to invest in the development of hubs of support for existing child care providers as well as building more supply.  A community is just not viable anymore without an adequate child care system.


What are some of the challenges communities face implementing policies and practices that ensure support for early childhood development?

Without a doubt, the biggest issue is finding additional resources for improving and expanding services, especially at a time when resources may be tightening at the federal level.  Communities around the country are exploring new revenue sources, including local levies particularly targeted to helping families with young children. For example, King County, Washington initiated a county-wide levy, Best Starts for Kids, to invest in early intervention and prevention for children and families. King County voters approved the initiative in November 2015, resulting in a six-year levy, which raises about $65 million per year.


More and more policymakers across the political spectrum are realizing that money spent early in life pays off later in better health, learning and behavior.

Along with resources, counties are challenged to work across sectors to address the holistic needs of children. They need to promote better partnerships between pediatricians and child care providers, hospitals and other community services, and early childhood teachers and elementary teachers. This is the only way we can meet the comprehensive needs of children and assure continuity so important to assuring impacts.


Communities often struggle to collect data. What recommendations do you have for counties that want to implement strategies and track progress, but aren’t sure where to start?

Developing a “data dashboard” or key facts about the children and families in the community is a core building block of community efforts to understand how to improve the wellbeing of children. As you know, one of the challenges is that there is limited population-level data on young children between the time they are born and when they enter school. This makes it difficult to know what issues children are facing — particularly children under 3 — and what services families need. Every community should put together a cross-sector group, particularly across health and education, to pull together all the facts they have and to plan to develop more integrated data systems.


Are there data indicators and/or metrics counties should track?

They need data on the status of prenatal care and birth; if children are developmentally on track throughout the early years; if families have the supports they need; the demographics of the community by age of child, and those are just the basics. Data should be disaggregated by income and ethnic characteristics, so we can uncover disparities and work toward more equity.


Are there considerations for rural counties you might suggest?

We need to pay much more attention to the needs of rural areas in the country. I would start with the local public school, which is often such an important resource and gathering place for children and families in rural areas.  To address 0-3, if we start with the families in the school and connect with child care providers and health providers in the surrounding community, you begin to build a hub of support. And again, don’t assume you know what is needed, go out and ask the families, it is their community


What do you think are the opportunities counties have in the coming years to impact early childhood development?

In so many ways this is up to each one of us. To those working in counties, you have the opportunity to look closer at the status of young children and families in your communities, to take all the evidence that has piled up in the past several years and put it to work, to develop a plan. In the early days of the country, people used to talk about coming together to help “build the barn.” It is that same spirit that we have to capture to revitalize the country.  But it will take everyone coming together, from the federal and state level as well as from the community level, from the local business person to the church elder, from the librarian to the county commissioner, supervisor or county executive.  We know what to do, we just have to pick up the pace, increase investments and create a quilt of support for young children and families county by county.


Joan Lombardi Ph.D. served in the U.S. Department of Health and Human Services as the first deputy assistant secretary for early childhood development (2009–2011) and as the deputy assistant secretary for policy and external affairs in HHS’s Administration for Children and Families and the first commissioner of the Child Care Bureau (l993-1998).  She is the author of numerous publications including Time to Care: Redesigning Child Care to Promote Education, Support Families and Build Communities and co-author of Beacon of Hope: The Promise of Early Head Start for America’s Youngest Children. 


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