My Brother’s Keeper: Early Interventions for Accelerating Health Equity

Posted on April 28, 2016 by J. Nadine Gracia, MD, MSCE, Former Deputy Assistant Secretary for Minority Health

In just a matter of weeks, proud parents, family, and friends in every corner of the nation will gather to watch their high school seniors graduate. Predictable warm weather and speeches that may run a bit too long will be of little note as an estimated3.3 million young women and men earn their diplomas and embark upon their future pursuits.

For most, it is a new beginning, full of opportunity and hope. For far too many others, including youth who don’t graduate from high school, it’s a path that is lined with barriers to opportunity which limit their educational attainment, economic opportunity, and future success.

And for children from minority and disadvantaged communities who do not graduate high school, the challenges of reaching their full potential are even steeper. They are less likely to be employed, less likely to rise above the bottom fifth in income distribution, and more likely to become involved in the criminal justice system.

These factors also influence their overall health. As Broderick Johnson, Cabinet Secretary at the White House and Chair of the My Brother’s Keeper Task Force, said during the National Minority Health Month 2016 HHS Health Equity Forum on April 7: “You can’t just talk about filling opportunity gaps, whether it is in education or in jobs, without also talking about the importance of the health and well-being, especially for our most vulnerable young people. Opportunities impact health. Health impacts opportunity.”

Improving the well-being and expected life outcomes for all young people, including boys and young men of color, is the goal of President Obama’s My Brother’s Keeper Initiative. The My Brother’s Keeper Task Force recently issued its two year progress report: Two Years of Expanding Opportunity and Creating Pathways to Success. And at HHS, we understand if we are going to meet this challenge, our work must begin early in the lives of youth.

Closing the Word Gap

By age three, children from low-income households have heard about 30 million fewer words than their peers from higher income households. Long before kindergarten starts, a disparity in language skills exists that can affect performance at school and other outcomes later in life. In 2015, HHS and the U.S. Department of Education invited government officials, researchers, advocates and community leaders for a convening at the White House on Bridging the Word Gap. Announcements at the meeting included a $2 million investment for a National Academies of Science study on supporting young dual and English language learners and the Bridging the Word Gap Challenge, an initiative of the Health Resources and Services Administration. The challenge will lead to the creation of tools to help parents and caregivers talk and engage more with young children. . HHS also funded the Bridging the Word Gap Research Network at the University of Kansas to develop and test interventions to improve early language exposure, vocabulary acquisition and language development for children from disadvantaged communities.

Early Childhood Mental Health Consultation

Promoting the social-emotional and behavioral development of children is essential to their future health and well-being. The National Center of Excellence for Infant and Early Childhood Mental Health Consultation was launched in October 2015 by the Substance Abuse and Mental Health Services Administration, Health Resources and Services Administration, and Administration for Children and Families. The Center of Excellence will develop tools, training, and technical assistance to help states and Tribal nations build strong behavioral health system systems for children. It will also ensure that more child care centers, preschools, and home visiting programs have access to consultants who can help them meet the needs of young children, especially those who struggle with developmental and behavioral challenges. The Center of Excellence, managed by the Education Development Center, Inc. in Waltham, Massachusetts and awarded $6 million over four years, is also designed to advance research, training, and policies to improve outcomes for young children.

Curbing Expulsion and Suspension

Even in preschool, expulsion and suspension of students occur at high rates. And young students are who are expelled or suspended are as much as 10 times more likely to drop out of school and experience academic failure and grade retention. These students are also more likely to be young boys of color. To curb and severely limit expulsion and suspension in early learning settings, in December 2014, HHS and the U.S. Department of Education issued the first federal policy statement on the matter. And today, the Administration for Children and Families has released a resource guide on State and Local Action to Prevent Expulsion and Suspension in Early Learning Settings, to provide states and localities with innovative approaches to address expulsions and suspensions in early childhood settings.

By curbing expulsions and suspensions, working to erase the word gap and providing more support for America’s children, we are ensuring that more youth are able to achieve their full potential, which is something of which we all can be proud. Through these efforts and many others that are advancing the goals of My Brother’s Keeper, new collaborations are underway across sectors, such as health and human services, education, justice, labor, and housing, and they are that are forging new pathways to accelerate health equity for all young people, including boys and young men of color. Find out more about what My Brother’s Keeper is doing to expand opportunity for young people here.

J. Nadine Gracia, MD, MSCE, is the Former Deputy Assistant Secretary for Minority Health and the Director of the Office of Minority Health at the U.S. Department of Health and Human Services. Dr. Gracia serves as the HHS designee on the My Brother’s Keeper Task Force.