February 1, 2006
Michael Weitzman, Brett Brown, Martha Zaslow
B. Brown, M. Zaslow, and M. Weitzman, Studying and Tracking Early Child Development from a Health Perspective: A Review of Available Data Sources, The Commonwealth Fund, February 2006
Over the last several decades, there has been a substantial increase in interest among the pediatric health policy and practitioner communities in moving beyond narrow medical models of health to promote more broadly the development of very young children including their social, emotional, intellectual, and physical well-being. In this report, we review existing national data sources in terms of their capacity to inform child health policy and practice in their efforts to promote early child development. The body of the report provides an overview of existing areas of strength, identifies gaps, and makes recommendations for future data development. Some 26 national surveys and administrative data sources are assessed for their collective ability to support research and for their adequacy as sources of descriptive social indicator data.
Equally important, and perhaps even more useful for those who wish to analyze existing public data, we provide an appendix summarizing the content of the 26 surveys and administrative databases. There is a one-page summary for each data source using a standardized checklist of measures in the areas of health, health care receipt, socioemotional and intellectual development, family functioning and parent health; community characteristics; and child care and family demographics.
Recommendations for future data development include the following:
- Protect and expand sources of federally collected state- and local-level data covering early child health and development. Increasingly, policy decisions affecting early child well-being are being made at these levels, and policymakers deserve high quality indicator data as the basis for their policy decisions. At present only the National Survey of Children's Health, and to a lesser extent the survey of Children with Special Health Care Needs, provide such data for the states.
- Expand the regular collection of data on the characteristics of the neighborhoods and communities where young children live. At present there are virtually no estimates collected on a regular basis (outside of the decennial census) that allow us to track elements of the local environment known to shape early child well-being.
- Add developmental screening assessments for children under age six to the National Health and Nutrition Examination Survey (NHANES). This will create a unique source of data to support research linking health status to early socioemotional and intellectual development.
- Include more detailed information on the content of developmental screening and well-child visits in future longitudinal surveys, to support research capable of linking specific early health care practices to better intellectual, socioemotional, and physical developmental outcomes at older ages. Existing longitudinal surveys lack such measures, though they have been fielded in cross-sectional surveys, notably the National Survey of Early Child Health (NSECH).
- Include a rich set of age-appropriate intellectual and socioemotional development measures in the National Children's Study, an extremely ambitious federally sponsored longitudinal study that intends to follow 100,000 children from birth through age 21 (still in the design phase). The planned study will also contain very detailed information on health and health care receipt.