BUILDing Strong Foundations

Health Equity, the Triple Aim, and the First Two Years

11/15/2013 12:00:00 AM
Posted by: BUILD Initiative

Charles Bruner, research and evaluation partnerCharles Bruner
Research and Evaluation Partner

A Key Fundamental of Early Childhood Systems Building

The first two years of life ultimately are the most important ones to ensuring an individual’s health. During this time, the primary health care practitioner is the professional most likely to see and assess the child. She or he is best able also to identify and serve as first responder to conditions that jeopardize healthy development.

Ninety percent of infants and toddlers see a child health practitioner for a well child visit – usually seeing the practitioner several times during a year – and half of all children are served under Medicaid. However, fewer than one in five children is in a formal child care arrangement.

Therefore, the primary health practitioner needs to be the observing eyes and ears for identifying conditions in the child, the family, and the family's environment that impact healthy development. In particular, these include “social determinants” of health, including factors that can lead to toxic stress.

Connecting Early Childhood and Child Health

The BUILD Initiative has engaged both leaders in the early childhood and the child health communities to explore how states can take advantage of opportunities that exist for the primary child health practitioner to improve healthy child development – both bio-medical and social in nature. In the latter, the key is not for the child health practitioner to do it all, but to connect the child and family to other resources that provide this help.

Since many of the opportunities come through the health system, this requires early childhood systems builders to learn a new language – EPSDT, life-course development, anticipatory guidance, ACEs, medical homes, developmental surveillance, toxic stress, epigenetics, meeting the “triple aim,” and “health equity.”

Over the last four years and with support from the The Colorado Trust, the BUILD Initiative has convened four meetings of leaders in specific states to explore this role of child health practitioners in early childhood systems development. The last two, on “Medical Homes and Young Children” and on “Health Equity and Young Child Development,” have identified a variety of promising practices, particularly at the community level. Health practitioners are moving beyond their traditional medical role, including screening for developmental delays and disabilities, to effectively connect families and their children to other early childhood systems supports.

Building a Strong Network

The BUILD Initiative has drawn upon great partners in the health field in doing this work, including the National Academy for State Health Policy, the American Academy of Pediatrics, the Help Me Grow National Center, the National Center for Children in Poverty, and ZERO TO THREE.

BUILD also is seeking to expand its own learning network on child health and school readiness. Links to three of BUILD’s framing pieces, which describe BUILD’s approach, are provided below:

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1 comment(s) so far...
    • Dec 14 2013, 10:30 AM Dina Lieser
    • Docs For Tots completely agrees! he primary care venue offers unlimited potential to promote our nation's children's greatest potential- may be the greatest opportunity to promote early learning and development through promotion, prevention , co-location and linkages with key resources. Also, our nation's high quality early care venues may offer the most effective vehicles through which to promote our children's health! We know what works.....now let's do it .

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