By Michael Severson, MD, FAAP
When pediatric residents from the University of Minnesota came to Brainerd to participate in my rural preceptorship, I would always make sure we took a field trip to the Brainerd Head Start Classroom for two reasons. First, because I was on the Head Start Advisory Board and could easily make the arrangements and second, because I wanted young pediatricians to observe the human fabric of these radiant, busy children’s faces woven by many threads but the single most common thread: poverty.
Poverty predicts that you are unlikely to leave the county you were born in, it predicts you are more likely to suffer from childhood obesity, heart disease, diabetes and mental health disorders, become a high school dropout or experience teen pregnancy.
Minnesota Head Start exists to help change these outcomes. Head Start oversees a program of services for pregnant women and children from birth to age 5 across 87 counties and 8 tribal nations. It assures the enrolled children will have a well child exam and perhaps find a medical home. It assures immunizations are current, that hearing and vision are normal or appropriately referred, and dental health evaluation is completed.
Head Start is a successful program and insists high-quality education and care must be available to every one of the more than 50,000 Minnesota children under the age of 5 who live in poverty.
In 2017–2018, there were 69,310 children in poverty under age 5 in Minnesota. Of those, only 46 percent of three and four-year-olds had access to Head Start. And only 9 percent of children under 3 had access to Early Head Start (EHS). EHS programs are available to families prenatally until a child turns 3 years old and is ready to transition into Head Start or another pre-K program. Most early childhood initiatives focus on preschool-age children (3-5-year-olds). Younger children (birth-3 years) who are defined as at-risk can also clearly benefit, but for many of them, Head Start at age 4 is too late. Current Minnesota funding for Early Head Start is for only 1,400 children.
For a student, Head Start could likely be the place she learns she has a last name, an address, and phone number. It could be the place one learns the pleasure of sliced apple, banana or grapes or an orange segment. Head Start is the place that improves the use of please and thank yous and sharing and perhaps how to tie your shoes.
Indeed, all of the above is remarkable but it doesn’t begin to address the Head Start mission of school readiness preparation and engaging parents’ involvement.
Head Start takes a comprehensive approach to meeting the needs of the whole child and family. This two-generation approach supports stability and long-term success for families experiencing economic hardships. Thanks to Head Start’s comprehensive services, most had access to family services including crisis intervention, job training, and parenting education.
Head Start sets academic goals and tests and evaluates outcomes. A prediction model has been developed to determine the children who are most at risk of not meeting the kindergarten benchmarks based on their fall or winter assessment scores. The prediction model considers a child’s literacy and math scores in the fall or winter given their age, gender, race, and English-language status. Teachers are given the names of children in their classrooms whose scores put them at risk of lower developmental growth so they can plan to offer more individualized supports for these children.
Pediatricians must actively support Head Start and Early Head Start. Do not let it be underfunded, it is wonderful and correct way to move children towards academic success and away from poverty.
Reopening Head Start During COVID-19
With the goal of re-opening services, the Head Start leadership association worked with the Minnesota Department of Health to develop a detailed, 44-page, “COVID -19 Preparedness Plan” offering background information, protocols and procedures to resume meeting the needs of this key segment of our community. Seeking a perspective on child health and safety, the Head Start Association approached MNAAP for a physician who could review the proposed plan and meet with program directors and health managers. Tim Zager, MD, a recently retired pediatrician from Duluth, represented MNAAP in this role during a web-based planning meeting on May 20 in preparation for establishing face-to-face summer services for 4-year- olds starting kindergarten and children with IEPS. Dr. Zager reviewed the re-opening plans, offered some suggestions, and prepared an information sheet on pediatric coronavirus infections. It is anticipated that about half the programs in Minnesota will open this summer to offer services.