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Rural Health Information Hub

Early Childhood Education

Early childhood education programs aim to lay a foundation of health by building the social and emotional skills of young children. Educational attainment is a very important social determinant of health (SDOH), and these programs can have profound long-term impacts on the health and well-being of children and families. In particular, the first 5 years of a child's life are a critical time for social, cognitive, emotional, and physical development. Educational experiences that occur during these foundational years can help set children up to live healthier lives.

Several factors can impact early childhood development and educational attainment, including:

Programs that focus on providing early childhood education and positive developmental experiences have been shown to improve overall educational attainment, increase potential future earnings, reduce crime rates, and improve health outcomes. Specifically, the Community Preventive Services Task Force recommends the implementation of educational interventions, such as center-based early childhood education (ECE) and Head Start programs, to reduce health inequities and to support children who live in communities with an uneven distribution of SDOH, including low-income populations. ECE programs work with children ages 3 to 4 to improve cognitive and social development. ECE programs help to improve literacy, numeracy, and motor skills. When catered to low-income or racial and ethnic minority populations, ECE programs may reduce educational achievement gaps and improve health.

Head Start and Early Head Start are federally-funded early childhood education programs that promote school readiness in low-income children age 5 and under through a variety of services, depending on the needs of the community. Head Start programs support child growth and development through instruction, play time, health screening, and health services. Head Start also uses a multigenerational approach to engage families by providing training opportunities for parents, and by connecting families with social services that address SDOH.

Early childhood programs such as Head Start play an important role in meeting the educational, health, and economic needs of rural communities by providing child care and social services. A 2018 report by the Center for American Progress found that Head Start has a positive impact on rural communities, with program centers available in 86% of America's rural counties. For one quarter of the counties surveyed in the study, Head Start programs were the only, or one of few, child care centers. Access to Head Start and other child care opportunities impact families' ability to retain jobs and earn a stable income.

Some states have decided to implement universal pre-kindergarten (pre-K) as a state-level policy in which pre-K is offered to all 4-year-old children regardless of family income. Universal pre-K programs typically reach a wider array of students compared to programs like Head Start, and have been shown to improve cognitive outcomes for disadvantaged children. The Community Preventive Services Task Force recommends full-day kindergarten programs to improve academic achievement and health among low-income and racial and ethnic minority children.

Examples of Rural Early Childhood Education Programs Addressing SDOH:

  • The Rural Alaska Community Action Program (RurAL CAP) administers 24 Head Start programs in Alaska, 23 of which are designated as rural. In addition, RurAL CAP runs 7 Early Head Start programs. Through Head Start and other early childhood educational opportunities, RurAL CAP engages young children and their families in a variety of programs aimed at building relationships, resiliency, and connections to their culture. RurAL CAP tailors the evidence-based early education curriculum of Head Start with local traditions. For example, the Elder Mentor program has tribal elder volunteers go to classrooms and Head Start centers to focus on skill-building with individual students. The elders provide mentoring and tutoring services, and develop lasting relationships with students. The elders teach tribal language and traditional skills, including subsistence hunting and fishing, to help children connect with and learn about their culture.
  • In parts of rural Colorado and several other rural communities, mobile preschools are being used to provide early childhood education. These programs deliver education to hard-to-reach populations using vehicles, often buses, which are transformed into mobile classrooms. Programs like Gus the Bus and Magic Bus are licensed preschools delivering educational programs to youth in rural areas. These mobile preschools are able to travel to different communities, including mobile home parks, to provide several hours of education. These types of programs can help prepare children for kindergarten and elementary school, and help improve the accessibility and affordability of early childhood education.
  • The Community Healthy Partnership of Illinois offers Migrant and Seasonal Head Start programs for migrant and seasonal farmworkers and their children, starting from birth through age 5. The Community Health Partnership of Illinois also runs the Illinois Migrant Education program which serves older children in Illinois, between the ages of 3 and 21. These programs provide educational services, as well as dental and health services to youth, with the goal of improving educational attainment and health outcomes.
  • Fostering Futures is a state-wide project in Wisconsin designed for Menominee Indians that trains Head Start and Early Head Start staff, as well as other educators and healthcare providers, on how to deliver trauma-informed care (TIC). The goal of the program is to use TIC in early educational settings and other youth settings to help overcome the effects of adverse childhood experiences and to build positive early childhood experiences.

Implementation Considerations

Access to affordable and high quality early childhood programs is important for rural communities. Many early childhood education programs show promise for addressing SDOH and improving health and well-being. High quality programs are more likely to make a long-term impact on children and families. Ensuring that programs meet important requirements and standards can help promote the quality of the program. Early childhood programs should also be tailored based on the community, culture, and needs of the students.

Research on center-based early childhood education demonstrates several implementation considerations for programs. Many early childhood programs have high rates of staff turnover and it can be difficult to find qualified and adequately trained staff. For example, Head Start programs require that teachers have at least an associate's degree in early childhood education. Other center-based early childhood education programs may have different educational requirements. The training resources available to teachers may not be sufficient in every rural community. For programs that follow a set curriculum, staff training is very important to ensuring success and retention. In addition, funding and budget considerations are important for program implementation and success. Recruiting and retaining qualified staff may require substantial resources. Space, food, and other resources may require significant continued investments.

In addition, there are several challenges to consider for implementing Head Start in rural areas. While the Head Start curriculum may be standard for most programs, rural communities may want to adapt programming to fit the unique needs of their students and families. Many rural residents lack access to reliable transportation which can pose challenges to getting children to child care, including Head Start, on a daily basis. Some programs may look to partner with other organizations who can help provide transportation for families. In addition, Head Start grantees have specific requirements around meeting health and dental needs of children enrolled in the programs. Partnering with health clinics, mobile healthcare units, and other local healthcare providers may help ensure that these requirements are met.

Program Clearinghouse Examples

Resources to Learn More

Confronting Social Determinants of Child Health
Website
Includes information and resources about early childhood development, promoting children's access to healthcare, and strategies for protecting children while parents are at work.
Organization(s): Farmworker Justice, Migrant Clinicians Network

Insights on Access to Quality Child Care for Families Living in Rural Areas
Document
Describes the availability of early child care and education programs for families living in rural areas.
Author(s): Henley, J.R. & Adams, G.
Organization(s): Urban Institute
Date: 10/2018