Unequal From the Start

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Unequal From the Start

• Unequal in 3 domains of healthy children, strong
  families and early learning from birth
• Experience and Evidence has proven the best time
  to intervene to optimize the development of our
  children and eliminate these disparities in a
  cost effective manner is in the first three years
  of life
• By investing in young children and their
  families, New York City can benefit by improving
  health outcomes, social and economic well being
  and educational success throughout the life span

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• Healthy Children
• Strong Families
• Early Learning

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Data Issues

• Need more concentration on 0-3 age group (hidden
  within the under 5 data)
• Need more information at the neighborhood and
  borough level to tease out the disparities
• Need more meaningful data points for important,
  but difficult to assess areas of infancy (i.e.
  adequate developmental screening and referral)

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Healthy Children

• Large disparities in birth outcomes
• Insufficient and disparate immunization
  information
• Lack of medical homes
• Unmet nutritional needs
• Incomplete knowledge about developmental
  screening and referral and receipt of services
• Disparities in Early Intervention (EI) based on
  neighborhood and income exist and are being
  addressed by the city
• Dearth of mental health services for children
  under age 3

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Strong Families

• Over half of NYC infants and toddlers live in
  low- income or poor families
• Most parents of young children work outside the
  home and struggle to balance work/family demands
• Many families with infants and toddlers never
  access the services already available to them
  (i.e. WIC, SCHIP, Medicaid, food stamps, housing
  supports)
• One-third of NY State parents with children under
  5 had to change jobs or change child care
  arrangements in the past year
• Maternal pregnancy related depression is
  under-diagnosed by as much as 50 in NYC
• Home visiting exists in NYC for approximately
  4,000 high risk individuals to help support new
  families but is unavailable to the vast majority

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Early Learning

• Most infants and toddlers are cared for in
  informal child care arrangements
• Only 7 of children under age 3 are in regulated
  child care
• NYC lacks sufficient regulated child care spots
  to meet need
• Support and education for parents and the large
  network of informal caregivers is lacking
• Regulated child care is expensive
• Child care standards at the city level do not
  meet state and best practice standards

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General Conclusions

• Data for 0-3 age group is insufficient across the
  board infants and toddlers are overlooked
• Great disparities based on income and
  neighborhood exist from the beginning of life in
  health outcomes and access to resources
• While there are examples of a wide variety of
  excellent programs in NYC that exist to help
  infants, toddlers and their families, gaps remain
  in access, utilization, capacity, coordination
  and quality of programs

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Healthy Children Recommendations

• Track the health of infants and toddlers in real
  time for immunizations and developmental
  screening.
• Address the disparities in birth outcomes
• Ensure access to medical care including a medical
  home
• Make mental health services available to babies
  and their families and increase the supply of
  qualified providers who can treat infants and
  toddlers in the context of relationships

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Strong Families Recommendations

• Continue the innovative anti-poverty programs
  that raise income, educate parents, and provide
  training for better employment outlined in the
  Mayors initiative to increase opportunity and
  reduce poverty in NYC.
• Screen all mothers in the primary care settings
  of pregnancy care (obstetrics) and well-baby care
  (pediatrics) for maternal depression. Develop a
  system of care to treat identified individuals

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Early Learning Recommendations

• Reach out to the large informal child care
  network to aid them in their care of infants and
  children
• Continue to expand availability of proven infant
  and toddler programs
• Meet the same child care standards as New York
  State and best practice recommendations