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infants and toddlers
A child plays with a doll while her father speaks to a home visitor. Evidence-based home visiting programs have been proven to improve outcomes for families. Credit: Jackie Mader/The Hechinger Report

In California, almost 27 percent of eligible families with children under the age of 18 do not receive food stamps, compared with just 2 percent of such families in Tennessee.

In Mississippi, more than 76 percent of children under the age of 3 do not receive a critical screening for developmental delays, nearly twice the percentage of children who go without in Minnesota.

And in Texas, nearly half of low-income women lack health insurance, compared with fewer than 6 percent in Vermont.

These are some of the findings of a new report released by the Prenatal-to-3 Policy Impact Center at The University of Texas at Austin’s LBJ School of Public Affairs. Researchers looked at the myriad ways in which life differs for mothers, infants and toddlers in America and the disparities families face when it comes to challenges like food insecurity, poverty and housing.

In Texas, nearly half of low-income women are uninsured, compared with fewer than 6 percent in Vermont.

They found children have drastically different experiences in the early years based on the state in which they live, in part due to wide variations in policies and strategies that are in place in each state to support families. These disparities, which often disproportionately affect children of color, are especially concerning because they impact children during a critical period of brain development.

“When their environment is full of warm and stimulating interactions, that promotes very healthy brain development,” said Cynthia Osborne, director of the Prenatal-to-3 Policy Impact Center. “Similarly, if their environment is full of adversity or a lack of stability or violence, that actually negatively impacts their brain development. It affects their physiological systems, their stress systems.”

“We know it gets under their skin, so to speak, and it stays with them throughout their lives,” she added.

Related: When it comes to keeping kids safe and fed, some American counties rank alongside Iraq, Bangladesh

The authors of the report single out five research-based policies that state legislatures or agencies can adopt to support the prenatal to age 3 period. These include making it easier for families to apply for food benefits through the Supplemental Nutrition Assistance Program (SNAP) and raising the minimum wage to $10 or more. Currently, only two states, California and New Jersey, along with the District of Columbia, are fully implementing all five. Seven states haven’t fully implemented any.

“When we don’t really pay attention to our infants and toddlers, we may be setting them on a trajectory that has huge social consequences and financial consequences for both the child who will become the adult, and for society.”

Cynthia Osborne, director of the Prenatal-to-3 Policy Impact Center

The report also identifies six research-based strategies, or initiatives that aren’t tied to legislative or regulatory action, that create healthy, nurturing environments for infants and toddlers. States can launch evidence-based home visiting programs for families and early intervention programs that provide services for children with delays or disabilities, for example. Programs like these are proven to “reduce long-standing disparities in outcomes among racial and ethnic groups and socioeconomic statuses,” the report says.

The disparities are poised to worsen as the pandemic continues. Many of the programs that have been proven most beneficial at improving outcomes for young children and their parents, like home visiting initiatives and group prenatal care, have been discontinued or moved online because of coronavirus and the economic fallout from the disease.

Related: Early intervention services by screen can only go so far

But Osborne said there are ways for state officials to move forward in supporting families. “The place to begin is to make sure that the families who are eligible for the policies or programs that you already have and are funding, are actually receiving [those services],” Osborne said. Simply moving more applications online, as some states have done during the pandemic, can help. Reducing fees to apply for food and other benefits can also make important interventions more accessible to families.

Disparities could also improve across racial and ethnic groups if states address their “vast differences” in terms of how families qualify for certain benefits and what they receive from those benefits.

Related: Home visiting is proven to help mom and babies — so why aren’t we investing in it more?

The consequences of not addressing the well-being of families and young children could be enormous, Osborne said. “When we don’t really pay attention to our infants and toddlers, we may be setting them on a trajectory that has huge social consequences and financial consequences for both the child who will become the adult, and for society,” she said. “[That] is a lot more costly in terms of health costs, incarceration costs, other sorts of costs that society will have to bear.”

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  1. “It has been said that if child abuse and neglect were to disappear today, the Diagnostic and Statistical Manual would shrink to the size of a pamphlet in two generations, and the prisons would empty. Or, as Bernie Siegel, MD, puts it, quite simply, after half a century of practising medicine, ‘I have become convinced that our number-one public health problem is our childhood’.” (Childhood Disrupted, pg.228).
    Unhindered abuse and neglect typically launches a helpless child towards an adolescence and adulthood in which their brain uncontrollably releases potentially damaging levels of inflammation-promoting stress hormones and chemicals, even in non-stressful daily routines.

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