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Why Early Childhood is Critical to Health Equity

Every child deserves a strong, healthy start in life, no matter who they are or where they live. A shows that addressing the barriers to health equity, such as poverty and structural racism, early in life is crucial—and possible.



This report, produced in partnership with the University of California, San Francisco, examines some of the barriers to health equity that begin early in life, and promising strategies for overcoming them.

Key findings include:

  • Poverty limits children’s and families’ options for healthy living conditions. Poverty can limit where children live, and can lead to exposure to unhealthy conditions in the home, such as lead or mold—and in the community, such as air pollution or lack of healthy food options.
  • Structural racism also limits families’ options for healthy living conditions. Race-based unfair treatment built into institutions, policies, and practices—such as residential segregation in impoverished neighborhoods; discrimination in bank lending to residents of largely minority neighborhoods; and discriminatory policing and sentencing practices—constrain parents’ ability to provide healthy living conditions for their children.

  • Sustained poverty and racism can create chronic stress in children and parents. So-called toxic stress can derail healthy physical, cognitive, and social emotional development.

  • Early care and education can help narrow the inequitable gaps. More than 40 years of research links short- and long-term health and health-related outcomes with a range of early-care and education programs.

  • Supporting children requires supporting families. Improving health equity in early childhood requires reducing poverty in households with children, which may require different strategies than those that focus on services for children alone.

There is no single solution, but a range of promising approaches. Approaches like highly effective early care and education, home visiting, coordination across social services and medical care, and broader supportive economic policies can all help support lifelong health, starting early in life.