As a pediatrician who has devoted a career of more than five decades to promoting children’s optimal health, development, and well-being, I am excited that U.S. Rep. DeLauro’s bold, relentless, and persistent push for expansion of the child tax credit is finally receiving the bipartisan attention that it deserves. The prestigious National Academies of Sciences, Engineering, and Medicine concluded that the expansion of the credit could reduce childhood poverty by half, leading to better outcomes.
While much attention and debate will focus on the proposal’s fiscal analysis and implications, the National Academies’ report also references a more nuanced strategy that, if undertaken, will make a great difference in advancing children’s well-being. Strengthening families to ensure the best outcomes for children, especially those living in poverty, demands that we bring to scale and impact efforts across multiple sectors including family support (e.g., home visiting), early care and education (high quality child care and preschool), housing (i.e., stability and security), workforce development, and mental health supports (e.g., addiction prevention and treatment), to name just a few.
The key to this approach is to engage all sectors and their services in a comprehensive, integrated systems approach, characterized by “all sectors in” and “cross-sector collaboration.” While this may seem opaque and daunting, it is actually the approach taken by most developed nations and being increasingly employed by our federal agencies in their child- and family-oriented initiatives. Examples include, but are not limited to, the Maternal and Child Health Bureau’s Early Child Comprehensive Systems initiative and the U.S. Department of Education’s Promise Neighborhoods effort.
Similarly, many states are now in the process of engaging multiple agencies across diverse sectors in developing comprehensive, integrated approaches to promoting all children’s optimal health, development, and well-being. Through our work in the Help Me Grow National Center, we are privileged to currently support 30 states in their efforts to ensure that all children, especially those most vulnerable due to such adverse social and environmental factors as poverty, have access to developmental promotion, early detection, referral and linkage to community-based programs and services. Such integration of efforts does not significantly increase costs and has both demonstrable benefits for families and their children, as well as cost savings and returns on investments. In Connecticut, the Office of Health Strategy’s State Innovation Model for health care transformation recognizes the imperative of cross-sector engagement in the development of Health Enhancement Communities as critical supports for children and their families.
We have the skills, knowledge, and even resources to strengthen families and advance the heavy lifting of children out of poverty by promoting their optimal health, development, and well-being. The real question is, do we have the will?
Paul H. Dworkin, MD, is Executive Vice President for Community Child Health at Connecticut Children’s and is also the Founding Director of the Help Me Grow National Center.