Few settings offer greater opportunity for improving our nation’s health than the child care environment. The experiences of early childhood, good and bad, lay the foundation for a lifetime. Non-parental child care settings provide a unique forum for shaping those experiences. A strategic approach, based on a holistic healthy child model, can draw on the power of law and policy to support children’s mental and emotional well-being, promote social development, mitigate Adverse Childhood Experiences, and address fundamental social determinants of health.

“Our mission is to help community leaders improve America’s health,” said Center Executive Director Doug Blanke. “There’s no better place to focus than child care settings, where the right start can set the stage for a lifetime of health.”

Most young Americans spend part of their childhood in out-of-home early care and education (ECE) settings. While there is much exploration and study of quality measures for child care centers, little has been written or studied about specific quality measures for the family child care provider setting. Even with use of center-based care on the rise, many low-income and rural families seek care from home-based settings due to cost, availability, or familiarity.

The Public Health Law Center will explore what “quality” means for licensed small family home settings, with a particular focus on children and providers from socially disadvantaged and marginalized groups. Our analysis, which uses an equity lens, will begin by more clearly defining the policy domain, scoping the problem, and identifying the most promising policy interventions.

We will be using a new analytical framework, called the Five Essential Public Health Law Services, which is designed to assess the extent and quality of law-related services to support social norm change efforts.  We will review the evidence, identify existing expertise and stakeholders and gaps in the current system, and make recommendations to fill those gaps and with effective solutions.  Our existing ECE policy work and that of our partners will inform and accelerate our project.  

“We need to do more research, particularly on the experiences of child care providers, families, and children in socially-disadvantaged and marginalized communities,” said Natasha Frost, Senior Staff Attorney at the Public Health Law Center. “We need to know where we are, and where we need to go, in light of historic and institutional racism and other systemic barriers to health equity.”


March 7, 2017