When we achieve equity for infants and toddlers, we can expect that resources, opportunities, rewards and burdens are fairly distributed across groups and communities so that those with the greatest challenges are adequately supported and not further disadvantaged.[i] Even before birth, infants and toddlers are affected by social factors associated with race, age, gender and sense of place. For instance, U.S. Department of Health and Human Services found that prenatal care initiation in the first trimester was lower for mothers in rural areas than in other communities. Additionally, an analysis conducted by March of Dimes uncovered both racial and ethnic disparities in birth outcomes for pregnant women and infants in the United States based on their race and ethnicity. Community conditions set a baby’s trajectory even before conception. To create opportunity for all children from the start, county governments can help level the playing field for children and families and close opportunity gaps.
Here are a few initial steps that counties can take towards creating a more inclusive community:
- Start and sustain community dialogues about equity and bias.
- Engage a stakeholder group with a diverse spectrum of backgrounds and perspectives. Include parents in the process. In order to make realistic and sustainable progress, community members must be included.
- Build alliances across groups and allow for opportunities for feedback and reflection.
- Use local data to inform policies and practice. Indicators that may help to inform those disproportionately affected in your community may include: graduation rates; uninsured children; food security including Supplemental Nutrition Assistance Program (SNAP), Women, Infants and Children (WIC) nutrition program or free/reduced lunch data; teen pregnancy; infant mortality; low/very low birth weight; youth who have interaction with the juvenile justice system; reporting of regular reading or storytelling by a caregiver; third grade reading proficiency; exposure to adverse childhood experiences, trauma or maltreatment; child abuse and neglect rates; entry into the foster care system; cost of child care (accessibility by income and race); or kindergarten readiness measures (if available).
Counties are not only responsible for service delivery, but many times are also the catalyst for national, state and local systems change from coordinating intake and referral to a continuum of supports, building data systems that allow agencies to share information and measure progress, coordinating planning and financing to target resources most in need, fostering community and political will to enhance support for investing in infants and toddlers and creating continuous quality improvement processes to sustain improvements. These are key components of a strong prenatal to three system and can be useful in building an equitable early childhood system.
Several counties have taken steps to address implicit biases in their early childhood systems and shift investments to reduce disparities and meet the unique needs of children, families and communities. In partnership with Multnomah County, Ore., Early Learning Multnomah uses data to achieve racial equity and inform investments locally. Recently, the county established a goal to implement culturally responsive developmental screenings and referrals for Vietnamese and Bhutanese families. And, in 2005, Ramsey County, Minn., human services staff joined forces with multi-disciplinary community members, organizations and agencies to develop an Anti-Racism Initiative to identify service disparities by race and ethnicity. Since then, the county set a long-term goal of reducing disparities and client outcomes due to institutional racism by 75% by 2030 so that all individuals and families will survive and thrive. In support of that goal, the child welfare division increased their focus on children ages 0-5 and partnered with Casey Family Programs to examine five outcome measures and improve programs that focus on child safety through family engagement and family-involved safety mapping strategies. These two counties participate in the National Collaborative for Infants and Toddlers (NCIT), a project funded through the Pritzker Children’s Initiative. Twenty-nine communities across the nation are working towards a long-term goal of achieving healthy child development for young children by age 3. Each of these communities are using an outcomes framework as a roadmap for supporting infants, toddlers and their families. This framework suggests that when focusing on equity, states and communities can build and sustain locally responsive systems, programs and policies that meet their needs. Using an equity lens, counties can address health and social disparities in communities, narrow service gaps and shape equitable early childhood systems for young children and their families.