Imperative #1

Mission

Imperative #1 Promote the health, development, and well being of all Detroit children

Summary: The period from the time a woman gets pregnant to age eight is a critical time in a child's life Their experiences and development during this window lay the foundation for future success so it's particularly important for young children and their families to have access to the information, services, and resources they need for a healthy start. Our health care and social service systems are crucial entry points for families to tap into the web of services and resources that exist to help kids thrive, but families' disconnect from them and the lack of coordination between them means Detroit children experience health and developmental problems at higher rates than they should.

Detroit's Context

Prioritizing the first 1,000 days is particularly important for those children who are most at risk for falling behind before entering kindergarten. These include, children from low-income families, children with developmental delays or disabilities, children of parents with low educational attainment, children in non-English speaking homes, and children experiencing severely adverse or traumatic situations (1). Detroit has a relatively high share of children facing these challenges that could benefit from connecting to the Early Childhood Health resources that exist in the city. For example in 2010 a state-led home visiting needs assessment found that Wayne County as a whole, and Detroit specifically exceeded state averages on twelve indicators of risk ranging from infant mortality to unemployment. (4). For children to thrive it is essential that their families have access to the myriad of resources that are available to them. To increase participation we must go to families and provide meaningful and needed service that can help connect them to the public health and social services systems in the city.

Policy Alignment

Locally, Starfish Family Services partnership with the NFP is already engaged in work that directly supports improved health and wellness in the first 1,000 days. Expanding and scaling this work could help to maximize the impact of statewide programs that are already in place. Additionally, for home visiting programming to be fully effective this will need to be accompanied with advances on HSH policy priorities 1.1-1.3. which emphasizes the importance of screening for mental health issues and providing access to fresh foods. Home visitation programs will directly align and should partner with mental health and developmental delay screening efforts. Additionally, professional health care consultants could also drive increased awareness of the nutritional needs of children in this state. However, to achieve maximum impacts on these policy areas, policymakers must also invest in expanded nutrition, through levers such as school lunch programs and snap benefits, and mental health resources so that these services can work in concert to fully promote early childhood health. .

Leading Practices

1. Support the first 1,000 days by prioritizing healthy pregnancies, breastfeeding, term births, food access, and good nutrition to ensure babies are born healthy and are on track developmentally.
2. Set up a comprehensive screening system that identifies health and developmental challenges in both children and caregivers, then connects them to services that can help.

Case Studies and Evaluations (Research): 

• Oklahoma- Parent Pro: parentPRO promotes Oklahoma families with young children by linking you with programs that best fit your family. Many of Oklahoma’s parenting programs can be provided in the convenience of your home. No need to find childcare or transport the family to the clinic. Professionals help reduce the stress that comes with being a parent by modeling skills, providing information, and connecting to resources. (smart Start Oklahoma; Potts foundation) Oklahoma’s two most populated counties—which include 2/3 of the state’s citizens, Tulsa and Oklahoma Counties—are receiving MIECHV (Maternal, Infant, and Early Childhood Home Visiting) funds to hire community connectors to link families with needed services.
• Memphis-Nurse family partnership. A national non-profit that has even recently expanded into Detroit through a partnership with Starfish Family Services, the program pairs first-time low-income mothers with a nurse to meet regularly and discuss childcare and connect the family to any and all services they may need. Strong evidence supporting this program's effectiveness can be found in multiple randomized control trials on the impact of the program in Memphis. One study, in particular, followed up with randomized control trial subjects 18 years later to find that the program "significantly improved the cognitive functioning and academic performance of 18-year old youth born to high-risk mothers with limited psychological resources to cope with poverty.” (3).
• New York- Healthy Families For New York (HFNY) which is based on the Healthy Families for America (HFA) framework is a strengths-based intensive, home visitation program that specifically focuses on preventing child abuse and supporting child health and development. A 2009 evaluation of HFNY’s work conducted by researchers at the University of Michigan that followed children up to 7 years old in a randomized control trial, found that families who participated in the program showed lower instances of child abuse, a larger share of children that participated in Gifted and talented programs at schools, and a lower share of children in special education (7).
• Nationally-Home visit programs following the Model of Parents as Teachers (PAT) a model that currently operates in Detroit, has shown through Dozens of studies that the program successfully improves Early Childhood outcomes. The program's support through evaluation qualifies it as an Evidence-based home visitation program according to Federal Guidelines. (1)
   

What We Do

Who's On Deck:

A 2011 statewide home visitation needs assessment found that approximately 8,500 of families in Wayne County received home visits from a total of 8 county providers, all of which work in Detroit and 2 additional statewide providers. (4). These homevisit programs are focused specifically on impacting maternal and infant health outcomes. The majority of these families participate in the statewide MIHP (about 6,000) while others participate in programs such as Early Head Start, Healthy Start, and collaboration between Starfish Family Services and the national NFP. (5). These community programs tend to be more involved and often include more meetings and support. (1). In Detroit’s broader healthcare system major players include the city’s major health system such as the Detroit Medical Center, Henry Ford Health system, St. John Providence Health System, and Oakwood Health Care Systems. These partners are already working as part of The Detroit Regional Infant Mortality Reduction Task Force to find collaborative solutions to impact infant mortality (6). These organizations are also major players in the Woman-Inspired Network which works to address issues that particularly affect the health of Woman and mothers in the city (6).