The best early sign of good child outcomes is reading skills at the end of third grade. Currently, approximately 50% of Wayne County children are not reading at grade level at the end of third grade. That puts 50% of our children at risk not only to drop out of school but also to engage in crime, substance abuse, irresponsible pregnancy, suffer with mental health disorders and to be much less likely to become contributing members of our community.
We know that child health, including mental health, is all about having parents who understand how to raise successful children. Our community must address forces that affect child outcomes and the community needs to do whatever it can to improve these outcomes. What do we know?
- Children are healthier when their mothers are healthy, older, have at least two years of college education, do not live in poverty, and have significant other/family supportMultiple organizations are meeting monthly (Community Access to Child Health grant) to improve our community-wide approach to prenatal care.
- Child outcomes are better when parents, grandparents, aunts, uncles, and other family members spend quality time with the children that involves lots of face-to-face talking and playThe old-fashioned way of child rearing has proven to be best: talking, reading, singing, playing games on the floor, as opposed to the new-fangled technology approach using TV, cell phones, and tablets
- At-risk low-income children have better outcomes when they live in neighborhoods and attend schools that allow them to interact with children from middle class families. These benefits work both ways: children from middle class families are also more successful when they attend more diverse schools.Our school board is looking at redistricting now – changes to school districts could give more low-income children the chance to attend school with children from families with higher incomes. Wayne Forward is addressing all aspects of poverty in our community.
As a community, we must address each of these items in some organized fashion if we expect child outcomes to improve. If not, the children who experience bad outcomes will continue to fuel epidemics of poverty, crime, and substance abuse.
It is possible to devise an 11-step plan to assure community support for the adolescents who make up our future:
- Screen all adolescents on-site in the schools for mental health/substance abuse problems and refer at-risk students for necessary support servicesOur public schools and the Wayne Initiative for School Health are addressing these issues.
- Provide comprehensive family life/human sexuality education for all adolescents who attend school in our county and provide support for students at-risk to experience unplanned pregnancyOur school board is revising this curriculum; the program should be “opt out” only for students whose parents object to the content; if the program is “opt in,” many low-income students whose parents are not attentive to their educational programs will be left out.
- Link students at-risk for academic failure to vocational education programs in the schools and the community college so that these students do not lose hope and join the ranks of the unemployed/homelessOur public schools and community college are improving vocational programs for young people in our community.
- Assure that all students complete the educational programs they are intellectually capable of completing despite their inability to pay for their educational experiences, and so that all our children can enter our workforce as competent, happy young adultsCommunities in Schools provides graduation coaches for at-risk students in our public schools.
- Assure that all adolescents have access to comprehensive health services so that we address the epidemic of obesity/type 2 diabetes that contributes significantly to poor young adult health and poor pregnancy outcomesParents must adopt healthy lifestyles if children are to have a chance for good health. There are resources in the community through the Family Y, Goldsboro Parks and Recreation, and UNC Wayne Hospital for families who desire education in the areas of nutrition and fitness.
- Identify pregnant women as soon as possible so that they receive optimal prenatal careOur obstetrician/gynecologists work very well with our health department and primary care health professionals to assure early access to prenatal services for pregnant women.
- Incorporate parenting skills education, with an emphasis on early brain development, into prenatal care programsThe US has no early childhood policy when it comes to assuring that parents know what to do to assure optimal kindergarten readiness. WAGES (Wayne Action Group for Economic Solvency) Early Head Start/Head Start, WCPFC (Wayne County Partnership for Children), United Way of Wayne County, Wayne County Public Library, and Goldsboro Pediatrics are working together to improve early brain and language development of preschool babies and children.
- Provide home visiting “parenting coaches” for at-risk parentsWAGES, the Partnership for Children, and the Wayne County Health Department provide parenting support for parents of babies/preschool children.
- Assure that mothers who have recently delivered babies have access to comprehensive health care, including mental health and substance abuse servicesMany at-risk young women would benefit from state government efforts to raise the income eligibility levels for Medicaid. Such state action could assure that many more at-risk young women could enroll in comprehensive mental health and physical health programs.
- Enroll all babies in comprehensive pediatric care where the health professionals assist parents in preventing health problems, including vaccine-preventable infections, and emphasize healthy parenting that includes maximal face-to-face conversation with babies from the moment of birth, so that babies are most likely to experience optimal early brain development and are ready to learn to read when they enter kindergartenGoldsboro Pediatrics works collaboratively with multiple community organizations to promote face-to-face talking as the best way to improve early brain and language development, and ultimately improve kindergarten-readiness.
- Link high-risk parents with quality child day care and preschool programs through the WAGES Early Head Start/Head Start Programs, and the Wayne County Partnership for Children, and assure that we have enough government-subsidized child day care and preschool slots for all our at-risk childrenOur legislature has the capacity to fund enough PreK slots so that no at-risk child is left out.
As ambitious as some of these goals sound, they are all easily achieved with resources we currently enjoy. These investments in our parents and children will pay off for generations by building a strong foundation for Wayne County’s future.
Article by David Hill, MD and David T Tayloe, Jr, MD,