KEY CONCLUSIONS ACROSS THE COMMITTEE’S DOMAINS OF FOCUS

The committee’s key conclusions identify issues that cut across the domains discussed in this report—education, physical health, and social-emotional health and well-being. These conclusions highlight contexts that drive opportunity gaps and areas in which there are opportunities to change policies, programs, and interventions to close the opportunity gap for young children. Supporting evidence for the committee’s key conclusions can be found in Chapter 8.

Conclusion 1: Differential experiences and access to resources in early childhood result in opportunity gaps, which can lead to long-term gaps in outcomes in education, physical health, and social-emotional development that are harmful to individuals, communities, and society.

Conclusion 2: There is substantial evidence describing effective policies and practices that can increase opportunity across multiple domains. These domains range from health, such as increasing maternal access to prenatal care, access to health care, and insurance coverage to access to antipoverty programs and to early care and education. However, differential access as a matter of policy or practice, as well as inconsistent—and in some cases, uncoordinated—implementation and inadequate funding, has allowed barriers to accessing opportunities to persist, leaving the most vulnerable populations underserved. These barriers must be addressed for these promising policies and practices to be implemented equitably and effectively.

Conclusion 3: Restrictive eligibility criteria set at the federal and state levels and differences in state and local implementation of policies lead to vastly different experiences for children and families depending on who they are and where they live. Access to resources and services has been impeded by some state and federal policies, as well as service systems that create administrative barriers to access, barriers that disproportionately affect communities of color, immigrant families, and families with low income. These differences occur across all domains examined by the committee, from school funding and access, to quality schools and teachers, to access to health care and health insurance, to the neighborhood-level resources that shape the ability of parents to support and care for their children and provide the supports needed for healthy development.

Conclusion 4: Research shows that income from full-time employment does not cover the cost of basic needs for many working families. In addition, many employers do not provide benefits such as paid leave or child care. Limited access to paid family leave creates an opportunity gap for young children by limiting parents’ and infants’ bonding time, decreasing the time available to take care of serious health issues, elevating family stress, and exposing children to financial uncertainty. Limited access to high-quality child care can create opportunity gaps by limiting parents’ employment, earnings, and job stability, ultimately leading to family economic insecurity.

Conclusion 5: Differential experiences and access to resources are associated with factors such as race/ethnicity, income, social class, gender, national origin, language background, and disability; however, the intersections of these factors with social determinants can result in interdependent systems of disadvantage that multiply negative effects. Thus, opportunity gaps for one age group can persist and compound, becoming the cause of future opportunity gaps.

Conclusion 6: Structural racism and discrimination perpetuate opportunity gaps and the achievement gap. Systematic exclusion, structural racism, racial and ethnic discrimination, poverty, unequal allocation of resources and services, labor market inequalities, biases in access to and experiences in services, and policies that create administrative burden for families all affect the ways in which families experience opportunity. While many of these structures have their origins in the past, they persist, and their effects—now compounded—continue to affect outcomes and the well-being of children and families.

RECOMMENDATIONS

The committee’s recommendations draw on evidence-based conclusions presented throughout the report to identify actions that can be taken by policy makers, practitioners, community organizations, philanthropic organizations, and other stakeholders. Additional supporting text for each recommendation can be found in Chapter 8 of this volume.

Recommendation 1: Federal entities and agencies and private philanthropic organizations that collect data and fund research related to child health and development should create and adequately support an effective equity-focused policy- and services-monitoring data infrastructure (collection of both quantitative and qualitative data, data analysis, and program evaluation) to guide federal, state, and local policy decisions aimed at closing the opportunity gap across income, race/ethnicity, disability, gender, language background, and immigrant status. This data infrastructure should also be made available for research and learning.

To further a research agenda addressing the opportunity gap, actions such as the following could be taken by federal entities and private philanthropic organizations:

• All federal data (and data reported to the federal government by states and local communities) could be disaggregated for groups listed in Executive Order 13985, Advancing Racial Equity and Support for Underserved Communities through the Federal Government.
• Data could be shared across agencies that are responsible for individual safety net and social insurance programs (e.g., the Department of Health and Human Services/Centers for Medicare & Medicaid Services for Medicaid, the Internal Revenue Service for the earned income tax credit/child tax credit, the Department of Labor for unemployment insurance) and linked when possible to create merged data sets. These data could be used by each agency to monitor program access, quality, and outcomes across groups known to experience gaps in opportunity through internal and external research studies.
• The Office of Management and Budget (OMB), with input from the Office of Science and Technology Policy, could direct all federal agencies to conduct audits and examine disparate treatment and administrative burden in state and local service systems responsible for serving families and children.
• OMB could direct each federal agency with significant federal expenditures on young children to create an equity research, evaluation, and technical assistance center.
• OMB could direct federal statistical agencies to assess current data collection on families and young children and make recommendations on improvements aimed at addressing opportunity and outcome gaps that can be evaluated and prioritized for investment.
• The Department of Labor could use its existing data to monitor differential trends in job quality, including wages, employer-provided benefits, schedules, and health and safety standards for all workers and working families with young children. With input from the relevant offices of the Executive Office of the President (e.g., the Council of Economic Advisers), the data could be used to formulate policy recommendations and set goals for improving job quality.
• The National Institutes of Health, National Science Foundation, and Institute of Education Sciences could prioritize studies that fill gaps in knowledge about policies, programs, and practices that reduce opportunity gaps for subgroups of young children that are underrepresented in the existing evidence base.
• The Internal Revenue Service and the Census Bureau could create a linked data system for use in analyzing all families’ access to and take-up of tax credits—the most robust antipoverty programs, including the earned income tax credit and the child tax credit—in support of the development of a systematic outreach approach to reduce the burden associated with and increase take-up.
• The Department of Education could require the What Works Clearinghouse to report the evidence for subgroups of children and results from rigorous quasi-experimental studies.
• The Interagency Forum on Child and Family Statistics could evaluate each agency’s existing systems for collecting data on young children and whether and how these systems could be linked. This assessment would lead to recommendations for improving these data systems so they could be used to evaluate and monitor developmental outcomes of young children, including disparities among groups in access, take-up, and outcomes across multiple programs.
• The philanthropic community could prioritize investments in further developing state and local data systems that include linked data on children’s health and education outcomes, as well as measures of opportunity gaps by race/ethnicity, income, nativity, language, and disability, at a minimum. To monitor child opportunity across communities and target funding to communities with lower resources, a consistent set of state/local measures from these systems could be added to the Child Opportunity Index. Investments are also needed to bolster the evaluation efforts of community-based organizations aimed at identifying, piloting, and expanding evidence-based practices that make families’ access to systems more equitable and user-friendly and their experiences within systems positive and promotive.

Monitoring and accountability are key for the successful implementation of all of the committee’s recommendations. Given the complexities surrounding the opportunity gap for young children, a system of metrics is needed to track disparities in opportunities and resources, such as access to qualified educators, rigorous and inclusive curricula, school funding, school ecologies that support learning, quality health care, and resources that promote healthy social and emotional well-being and development. In addition to tracking of these metrics, systematic cataloging of evidence-based, effective, and equitable policies and program interventions across domains in a centralized database/registry would provide a significant resource to communities, policy makers, researchers, and philanthropic organizations working to reduce disparities in opportunity for children.

Recommendation 2: The federal government and states should establish early learning opportunities—accompanied by both legal accountability guaranteeing access and inclusive, intentional quality standards that are aligned with scientific evidence—as a right afforded to all children and families who need and want services.

This recommendation is supported by a wealth of evidence demonstrating that high-quality early care and education (ECE) is a public good with social and economic returns that benefit all, one that is recognized as a fundamental right in many countries around the world. Despite this fact, ECE is available only to some and exists as a patchwork system of varying quality. As a result, many families, disproportionately those from marginalized backgrounds, are left in difficult positions, balancing the safety, care, and education of their children and their employment. To implement this recommendation, federal and state actors should consider codifying ECE as both a civil and a human right of all young children. This could be achieved at the federal level by ratifying the United Nations Convention on the Rights of the Child, which would build on existing precedent established at the federal level through, for example, the right to preschool services for young children with disabilities in the Individuals with Disabilities Education Act.

Recommendation 3: The federal government—in partnership with states—should fully implement a voluntary universal high-quality public early care and education system using a targeted universal approach (i.e., setting universal goals that are pursued using processes and strategies targeted to the needs of different groups). Such programs should be responsive to community needs, reflect the true cost of quality, and have strong monitoring and accountability systems that specifically address gaps in opportunity.

Such a unified system would:

• ensure that children and families from communities listed in Executive Order 13985, Advancing Racial Equity and Support for Underserved Communities through the Federal Government, are prioritized;
• allocate greater resources to historically marginalized communities to compensate for historical and current inequities in resources, experiences, and opportunities;
• allocate greater resources for parts of the early care and education system that have traditionally received fewer resources;
• require evidence-based program standards that improve population outcomes and explicitly remedy opportunity gaps;
• build a corps of diverse, competent, well-trained, well-supported, and appropriately compensated early childhood educators and program leaders, across all age groups and program settings; and
• require disaggregated data collection that can be linked with other relevant data sources, as well as continuous quality improvement aimed at bridging opportunity and outcome gaps.

Underinvestment in high-quality ECE disproportionately affects children from low-income families, children of color, children who speak languages other than English at home, and children with disabilities. This underinvestment, the result of a complex array of factors, persists despite the well-documented benefits—individual and societal—of high-quality ECE.

Quality frameworks adopted by the field may not, in many instances, include indicators that have a particularly salient effect on opportunity gaps and the experiences of children from historically marginalized communities, such as issues related to bias, language of instruction, and inclusion of children with disabilities. Underfunded and fragmented programs, underpaid workers, inconsistent access to high-quality programming, and inadequate quality frameworks contribute to opportunity gaps. Wide-scale implementation of such a system should take into account the challenges that can occur during scale-up, such as insufficient capacity to implement programs, lack of sustained funding, a mismatch between demand for and supply of programs, and barriers to access for targeted populations. A systematic approach to scaling up should be used to ensure that goals are clear and measurable, that progress is assessed regularly, and that challenges and opportunities are identified as they occur to inform iterative improvements in implementation.

Recommendation 4: The federal government, states, local communities, and districts should adequately and equitably support elementary school education and out-of-school programs. Elementary school education should operate under a common quality framework, with quality benchmarks aligned with those in the early care and education (ECE) system and based on evidence-based policies and practices.

Such a system would:

• address structural drivers of education opportunity, including segregation in learning settings by language, disability, race, and income; and
• be adequately funded to support the implementation of high-quality benchmarks aligned with those in the ECE system, including
  • high-quality instruction and asset-driven pedagogies, assessments, and curricula;
  • social-emotional and mental health supports and policies to explicitly reduce exclusionary and harsh discipline and eliminate disparities in such practices;
  • full inclusion of children with disabilities in general education settings, with high-quality and individualized services and supports;
  • bilingual learning opportunities for children who are English learners and dual language learners;
  • structurally sound, safe, healthy, and engaging learning environments;
  • a well-qualified, fairly compensated, and supported workforce;
  • data-driven continuous quality improvement efforts targeted at identifying and addressing opportunity and outcome gaps;
  • authentic and meaningful family engagement and partnerships;
  • strong partnerships with ECE systems that promote seamless transitions from ECE to the early grades; and
  • community partnerships and engagement to promote holistic family wellness.

Increasing funding for education, particularly for low-income students, has significant effects (e.g., improving achievement and graduation rates, employment, and wages, and reducing poverty rates). Thus, resource allocation would need to prioritize underserved populations, including high-poverty and minoritized communities and children with unique needs, such as English learners and students with disabilities. Increased resources could be used in a targeted way to meet quality benchmarks, close opportunity gaps, and meet the holistic and academic needs of students. ECE and the early grades would also need to be aligned so that what was attained in the early years would be built upon and expanded in the later grades rather than repeated or dropped altogether. Families and communities must be a part of these systems to ensure that children are immersed in the environments and conditions they need to thrive across settings.

Recommendation 5: The Department of Education should fully integrate Individuals with Disabilities Education Act programming with general early childhood and K–12 education. As part of achieving this goal, the Department of Education, states, and districts should undertake specific reforms explicitly addressing opportunity gaps identified in this report, including:

• uneven access to early intervention and preschool special education;
• uneven quality and dosage of early intervention and preschool special education;
• inclusion of children with disabilities across age groups, especially preschoolers, who are the most likely to be served in separate settings;
• nonbiased, accurate identification, specifically addressing over- and underidentification of specific groups of children, such as children of color, English learners, and others; and
• prohibition of harsh forms of discipline, including suspensions, expulsions, all forms of corporal punishment, seclusion, and inappropriate restraint for all students with disabilities, with special attention to students of color, who are disproportionately subject to these practices.

The maximum federal share of funding for the Individuals with Disabilities Education Act (IDEA) determined by Congress is 40% of the national average per pupil expenditure. Today, Congress funds about 18% of what it costs to educate children with disabilities. Indeed, the inadequate funding of these services has resulted in states restricting eligibility criteria, lowering the dosage of services, or stretching wait times for the evaluation and service delivery process to the upper limits of what is allowable by law.

IDEA policy reforms, through reauthorization, regulation, technical assistance, and monitoring and accountability systems, must intentionally address gaps in access, particularly for children of color; accuracy in identification; inclusion in general ECE settings; and the harsh discipline to which children with disabilities are disproportionately subject.

Recommendation 6: The Department of Health and Human Services (HHS) should create, lead, and be accountable for coordinating an interagency group focused on children’s mental health and social-emotional well-being that includes the several HHS operating divisions, including the Administration for Children and Families, the Health Resources and Services Administration, the Substance Abuse and Mental Health Services Administration, the Centers for Disease Control and Prevention, and the Centers for Medicare & Medicaid Services, among others, as well as the Department of Education, the Department of Justice, the Department of Housing and Urban Development, and other relevant agencies, for the purpose of designing, implementing, and evaluating a comprehensive system of primary psychosocial care for young children and their families.

Such a comprehensive system of primary psychosocial care for young children and their families would include:

• universal support across the lifespan from the prenatal period through third grade, consisting of regular screening and identification of needs in mental health and social-emotional development for both families and children, followed by facilitated access to community resources that address those needs;
• sufficient community capacity to address young children’s needs through a comprehensive array of well-funded, evidence-based intervention programs and resources;
• an integrated data system, much like a child’s electronic medical record, that charts a child’s needs and interventions across the life course, to facilitate cross-agency communication and program and policy evaluation, and serve as a resource for future providers; and
• an evaluation plan and support for research to understand systemic and structural drivers (e.g., racism) that create or worsen physical and mental health challenges among young children from historically marginalized communities.

For families with children, no universal system provides care to support the social and emotional development, mental health, and well-being of their child from birth until age 5 when they enter the K–12 system with continuity of supports and services through the early school-age years. Families from minoritized groups (both parents and children) are disproportionately exposed to hardships and stress across the life course, including stress related to racism and discrimination; are less likely to have their mental health needs met; and are more likely to have treatment prematurely terminated. In addition, children from minoritized groups are less likely to have access to mental health services in schools and in the child welfare system. For many families, especially those experiencing poverty, health issues, and precarious jobs, uncoordinated public systems that provide support for the well-being of children create barriers to access and burden these families as they attempt to access services and supports. A centralized system for identifying and cataloging effective, evidence-based intervention programs, policies, and resources should be part of the development of this system of primary psychosocial care to assist communities in selecting appropriate evidence-based interventions that can then be evaluated and used to understand drivers of challenges that affect specific communities.

Recommendation 7: The Department of Labor and the Department of Health and Human Services, in partnership with other relevant federal agencies, should review, update, and enforce existing labor standards and employment policies to address disparities that disproportionately affect working families with young children.

To implement this recommendation, the federal government could:

• build on the current job protections offered under the unpaid Family Medical Leave Act to create a paid social insurance program, administered by the Social Security Administration, to support parents needing time away from work to care for infants and newly adopted children and attend to their own and their family members’ serious health issues;
• address documented issues in access to paid family and medical leave for low-income families and families from marginalized communities by implementing progressive wage replacement rates, making coverage more inclusive by eliminating firm-size requirements, and using existing hours and duration criteria for Social Security Disability Insurance or Medicare Hospital Insurance;
• develop recommendations on the definition of good-quality jobs for families with children, an effort that should include setting standards for family-sustaining wages and family-friendly employer practices;
• update existing labor standards and policies, raise the minimum wage floor, make work schedules more predictable, budget more resources for enforcement, and incentivize employers to provide training and career ladders; and
• partner with philanthropic organizations to conduct research on job quality standards and metrics to guide policy and employer-based interventions.

Research shows that many working families do not earn enough from full-time employment to cover basic needs, and that many employers do not provide benefits such as paid sick or medical leave, parental leave, or child care. Lack of access to paid leave creates an opportunity gap for young children by limiting bonding time for parents and infants, decreasing the time available to attend to serious health issues, elevating family stress, and exposing children to financial uncertainty. Overall, this body of research suggests that paid family and medical leave is an effective policy that improves the social-emotional well-being of parents and the health of their young children. Moreover, making the program nearly universal would lower per-worker costs. The policy could be further improved by reducing racial/ethnic and income disparities in take-up of leave through less restrictive eligibility criteria, higher wage replacement rates, targeted outreach, and improved administrative systems.

Recommendation 8: The federal government, in partnership with state and local governments, philanthropy, and relevant public and private organizations, should support policies and interventions targeting social determinants of health that create and perpetuate opportunity gaps at the community level.

To further the development of targeted policies and interventions for addressing the opportunity gap at the community level, the following actions should be taken by federal, state, and local entities and private philanthropic organizations:

• Federal and state governments should expand existing safety net programs that have been shown to address poverty and food insecurity as social determinants of health, including the Special Supplemental Nutrition Program for Women, Infants, and Children, the Supplemental Nutrition Assistance Program, and the earned income tax credit, as well as the 2021 expanded child tax credit. Eligibility applications for these programs could be unified and streamlined to reduce administrative hurdles to take-up.
• As with other programs such as child care subsidies, to reduce disruptions in insurance and health care access, the federal government should ensure continuous coverage with Medicaid for a minimum 12-month period even if families experience temporary changes in income during the year that make them ineligible, and Medicaid should be provided to women for at least 12 months postpartum.
• Federal, state, and local governments should increase the supply of affordable high-quality housing, which would include access to green spaces, playgrounds, and parks.
• Local governments should engage in urban planning improvements to enhance traffic safety and eliminate road hazards (e.g., legislate speed limits), especially in marginalized communities.
• Governments at the federal, state, and local levels and philanthropy should prioritize support for communities with a level of high need and low resources, as measured by the Child Opportunity Index, program administrative data, and historical budget data.
• Early learning, education, and health care systems should act as anchor institutions and be coordinated through shared data systems and integrated service delivery to promote family wellness and community development by offering onsite or providing connections to health, mental health, after-school, nutritional support, and economic wellness services. The federal government should build on and expand existing programming that can facilitate this anchor organization approach, such as full-service community schools, Head Start, and federally qualified health centers.
• Community organizations, philanthropy, and local governments should support evidence-based programs for young people, such as those that include tutoring or mentoring; sports; and early childhood mental health programs, including parent–child interaction and cognitive-behavioral therapeutic approaches.

For children living in poverty and those from other marginalized populations, inequities in experiences and access to resources that support healthy developmental outcomes can vary greatly, leading to persisting opportunity gaps for young children. State and local governments have opportunities to examine existing policies that have demonstrated promising outcomes for young children and to leverage resources and partnerships with the private sector to invest in interventions with the potential to promote healthy development and close opportunity gaps for young children.

Recommendation 9: Early learning and K–12 education systems, health care systems, and employers should test and institute policies and protocols for identifying and addressing manifestations of institutional racism to reduce inequities in access to resources and quality services in education, health care, and public health.

To identify and address manifestations of institutional racism that create and perpetuate the opportunity gap, the following specific actions should be taken to reduce inequities in access to resources and quality services in education, health care, and public health:

• Systems leaders and administrators across all levels of government (federal, state, local) should work to address institutional racism and increase culturally and linguistically appropriate health care, public health, ECE, and early grade education.
• Policy makers should take into account historical inequities in resource distribution and current manifestations of racism and marginalization in developing policy and making budgetary decisions.
• Federal research agencies (e.g., the National Institutes of Health, the National Science Foundation) and philanthropic organizations should support and prioritize historically marginalized communities and groups to improve their access to professional development programs, apprenticeships, and scholarships, and to diversify the pipeline of health care professionals, public health practitioners, teachers, early educators, and early childhood researchers.
• National professional organizations and accreditors should improve curriculum training and require minimum competencies in antiracist approaches; social determinants of health inequities; and culturally competent, trauma-informed, and resilience-building health care, ECE, and early grade education.

A consistent finding across issue areas (e.g., early education, health, social-emotional development) is that opportunity is associated with race, and that race intersects with multiple other identities to result in compounded gaps in opportunity and outcomes. These gaps are the products of centuries of systemic racism across a number of domains of life. Any attempt to bridge unequal opportunity must be addressed by understanding and remedying historical inequities and their manifestations today.