Healthy and Ready to Learn: The Importance of Health Services in Head Start


By Marco Beltran

When you think about a high-quality early childhood program, what does it look like? Does it look different for children from low-income families? Very few early childhood programs are designed to address the complex needs of their communities. Yet, Head Start, which serves pregnant women and children ages birth to 5 from low-income families, is designed to address the individual child, family, and community.

Low-income families may face a lack of safe housing, food insecurity, and unsteady employment. They may not have access to a continuous source of medical and dental care, or live in neighborhoods with community violence or substance abuse. Research tells us that poverty is closely linked to poor developmental, physical, and mental health outcomes. In fact, growing evidence shows that educational achievement disparities start to take place early in a child’s life.

Unless these disparities are addressed, children from low-income families are less likely to escape the cycle of poverty. Research also shows that young children from families with incomes at 200 percent of poverty and below are significantly behind their more advantaged peers in cognitive development as early as age 2. This developmental achievement gap continues as children enter school.

The urgency placed on programs like Head Start to address disparities in early learning and school readiness is reinforced by the changing demographics of families with young children. U.S. poverty rates are increasing for families with young children. In terms of health outcomes, a family’s income status has a direct effect on access to health care and good overall health.

Studies show that low-income children don’t always receive all of their required immunizations. This puts them at a higher risk for preventable infections and long-term illness. They have less access to a continuous source of medical and dental care. As a result, when a child gets sick, their parent or guardian is more likely to go to an emergency room where there is no continuity of care and the out of pocket fees are higher. They also tend to miss more school days because of illness, putting them further behind their more advantaged peers in terms of educational achievement.

Health disparities appear among communities of color and low-income families in terms of insurance coverage and food insecurity. In particular, asthma rates are higher in black and Hispanic children and these children tend to have poorer health outcomes related to asthma. However, Head Start has the unique opportunity to address these types of health and educational disparities for the families we serve.

Head Start was initially launched in 1965 by President Lyndon Johnson as result on the “War on Poverty.” It was designed to help preschool-aged children prepare for school by reducing the effects of poverty. It addresses the “whole” child’s social, emotional, health, and nutritional needs.

Dr. Robert Cooke was a pediatrician and expert member of the initial Head Start Steering Committee. He believed that in order for the eight-week Head Start program to be effective in preparing children for school, it must include health services as well as education and social services activities. His recommended health services included the following, many of which are still required today:

  • Ensuring needed medical assessments, dental examinations, and immunizations
  • Assisting in the provision of eyeglasses and hearing aids
  • Establishing continuity of health services, including a medical and dental home
  • Developing family awareness around community health resources
  • Establishing sound nutritional practices in the home
  • Sharing of pertinent health information to school systems
  • Screening for special needs, problems, and strengths

Almost 50 years later, the Office of Head Start has not diverged from its original purpose: “To promote school readiness by enhancing the social and cognitive development of low-income children through health, education, nutrition, social, and other services.” Building upon our history, we have a developed a health vision for Head Start that says, “Head Start will ensure that all children are healthy and ready for school.”

Marco Beltran is a Program Specialist for the Office of Head Start. This blog is crossposted from the ACF Family Room blog.

Source: Early Childhood Learning and Knowledge Center

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