Late Off the Blocks: Head Start and the Formative Years

In 1995, Betty Hart, a professor of Human Development at the University of Kansas, and Todd R. Risley, a professor of Psychology at the University of Alaska, published a study examining the difference in language heard by infants of varying socio-economic backgrounds.

The study found that the average low-income child heard just over 600 words per hour, less than half the average total of working class children (1251/hour), and less than one-third that of the average child in a professional family (2153/hour). Using some rudimentary arithmetic, the researchers projected that wealthy kids heard about 30 million words by age 3, while poor kids heard only 10 million.

This divergent led to what the researchers described as an “even-widening gap” between poor and wealthy children, whereby the poor children not only “had smaller vocabularies than did children of the same age in professional families, but they were also adding words more slowly.”

More recent science also supports this conclusion. A 2013 study out of Stanford found that children in different socio-economic groups display dramatic differences in their vocabularies by 18 months.

Thus, it should come as little surprise that Head Start—the pioneering Great Society program designed to improve early learning for poor children—has had limited success in closing the achievement gap. As noted in a column by UC-Berkeley Professor David Kirp this weekend, despite recent improvements to the program, “a 2012 federal evaluation that used gold-standard methodology and concluded that children who participated in Head Start were not more successful in elementary school than others.”

Kirp goes on to argue that one of the essential flaws in Head Start is that it only applies to poor students, in part because branding Head Start as a program for the poor weakens its political power, but more importantly because it concentrates the effects of poverty rather than allowing poor students to interact with and learn from their better educated peers. This interaction has been shown to help poor students narrow the vocabulary/literacy gap with their more well to do contemporaries without hurting the more privileged group.

While socioeconomic mixing in early childhood education can help to mitigate the effects of the “word gap”, we need to do more to narrow/eliminate the gap from emerging in the first place. This means placing a greater emphasis on the formative years 0-3, as well as providing new parents with the skills and tools they need to succeed. Simply put, Head Start is getting out of the proverbial blocks too late for many students to catch up.

Creating children may come naturally to humans, but parenting those children is anything but. And yet despite the incredible importance and difficulty of parenthood, government offers little in the way of supports for soon-to-be or new parents.

One program that has been effective in not only boosting pre-natal care but in improving parenting practices, is Early Head Start (EHS). Launched in 1995, EHS is designed to assist low-income women and families on a variety of childhood development/parenting mattes. A major study of the program in 2005 found that EHS children “performed better than did control children in cognitive and language development, displayed higher emotional engagement of the parent and sustained attention with play objects, and were lower in aggressive behavior. Compared with controls, Early Head Start parents were more emotionally supportive, provided more language and learning stimulation, read to their children more, and spanked less.”

[As previously noted in this space, Early Head Start or similar programs are perfect vehicles for Social Impact Bond financing.]

This conclusion isn’t surprising given that the vast majority of parents want to do well by their kids—they simply need the tools to do so.

Indeed, the fact that many parents do not read to their children as much as would be ideal is not a “choice” in the traditional sense of the term. Not only are many parents unaware of the benefits of frequent verbal interaction with infants, but they also may lack the resources needed to simply have books/newspapers in the home to read.  For instance, parents who are given books and “prescriptions for reading” by their children’s pediatricians have been found to be four times more likely to read and share books with their children.

This fall, New York City will introduce universal pre-K for the first time. It’s a huge step for equity and opportunity for our city’s youth and it is one of many bold ideas that Mayor de Blasio is putting into motion. But even as we navigate the challenges of pre-K, we should be planning for that next great leap forward in early childhood education—to the formative years where the gap first emerges—so that when the starting gun of life goes off, all children can get out of the blocks.

Building a Better Citizen: "City Scouts" and American Infrastructure

“Whether you choose to become a teacher, a police officer, a doctor, or even the mayor of the greatest city in the world, your experiences as an Eagle Scout will prove invaluable.”

--Michael R. Bloomberg, 108^th Mayor of the City of New York

This week, the Center for an Urban Future released a tremendous report on the sorry state of infrastructure in New York City. While acknowledging the tremendous strides the City has taken in the past three decades (thanks to enormous public investment), CUF concluded, “too much of the city’s essential infrastructure remains stuck in the 20th Century—a problem for a city positioning itself to compete with other global cities in today’s 21st Century economy.”

The truth of this statement was once again tragically made clear he following day, when two buildings in East Harlem exploded. The expected cause: a gas leak from a cast iron pipe buried beneath Manhattan streets for over 125 years.

While the precise cause is not yet known, it is potentially the latest (and deadliest) example of our continued abandonment of infrastructure. In January, a 140-year-old water mane burst on 5^th Avenue, disrupting subway lines and leaving a crater in the middle of one of the world’s most famous boulevards. Even before Sandy, the Straphangers Campaign found that over one-third of preventable delays on the NYC Subway was caused by the malfunction of 70-year-old signals.

If we know that infrastructure is a growing concern—one that affects us on a daily life in potentially catastrophic ways—what keeps us from investing the way we should? Many reasons, but the one that I want to focus on today is the public’s lack of understanding of how our infrastructure works and, in turn, how that ignorance contributes to a citizenry ill-prepared to grapple with aging tunnels, switches, and streets.

In The Works: Anatomy of a City, Kate Ascher describes in vivid, colorful detail the wonders of New York City’s transportation, communication, utilities, and sanitation infrastructure. While I can cop to being an infrastructure nerd, the truth is that everyone who I’ve watched open the book on my coffee table is floored by what is beneath our streets and anxious to learn more.

Of course, we shouldn’t wait till our citizens are adults to have them understand the intricacies of our infrastructure. Instead, by cultivating knowledge and interest early, we can develop citizens already well-versed in how their City functions, and, we hope, ready to do what it takes to keep the trains running, the water flowing, and the for generations.

Enter City Scouts: a co-ed program designed to get urban kids involved in their communities. City Scouts would not focus on outdoor survival skills like traditional Boy/Girl scouts, but would instead dive headfirst into the nitty gritty of the urban environment, albeit the same emphasis on community service and personal growth.

"Badges" would be earned less by proving life skills in the wilderness and more by projects associated with the City (think: FDNY, NYPD, Nursing, Water Tunnels, MTA, Parks, etc.). 

Once troops are up and running in every borough (requiring significant philanthropic support—I’m looking at you, Mayor Mike and David Rubenstein!), City Scout troops would develop partnerships with nearby Boy/Girl Scouts so that that kids from different backgrounds could come together to share their skills/worlds with each other.

The long-term goals of the program are as follows:

1)    To instill a love of the City and an understanding of what makes it run so that the next generation of New Yorkers is full of citizens who understand the invisible backbone of Gotham—the magic of the Water Tunnels, the miracle of the subways, the mystery of the communications network.

2)    To inspire a generation of Americans to view service to their communities as an essential component of good citizenship.

3)    To bring kids together from all different types of backgrounds so that they can learn from each other’s skills and forge bonds that will, over time, prevent the parochial politics that has long infected generations that have come before them.

City Year provides a clear example of the pent-up demand of America’s youth for an opportunity to serve their communities and their nation by living and working in our urban cores.

City Scouts is a natural extension of the same idea—an opportunity for America’s youth—the leaders of tomorrow—to understand and appreciate what makes their neighborhoods work and answer the call to serve.

As the late Senator Lloyd Bentsen, Jr. (D-TX) once said, “I have never forgotten my days as an Eagle Scout. I didn't know it at the time, but what really came out of my Scouting was learning how to lead and serve the community. It has come in handy in my career in government.”

E-Cigs and the Never-Say-Die Attitude of a Deadly Industry

“The fragile, developing self-image of the young person needs all the support and enhancement it can get. Smoking may appear to enhance that self-image in a variety of ways.”

-- Claude Teague, Senior Researcher, R.J. Reynolds Tobacco, 1973

“The use of e-cigarettes does not discourage, and may encourage, conventional cigarette use among U.S. adolescents.” That was the conclusion of a new study published in the Journal of the American Medical Association last week, highlighting the continued challenge facing public health officials in determining appropriate regulation of a booming new market that simultaneously promises a less harmful alternative to conventional cigarettes, but may well be an end-around the anti-tobacco efforts that have driven youth smoking rates down since the 1990s (see chart from the CDC). Indeed, since 1997, smoking among 8^th, 10^th, and 12^th graders in the U.S. has declined by nearly two-thirds.

Within the public health community, the conclusions reached in the JAMA study are far from consensus. As Thomas J. Glynn, a researcher at the American Cancer Society, told the New York Times, “The data in this study do not allow many of the broad conclusions that it draws.” Furthermore, the study fond that youth who used e-cigarettes were more likely to plan to quit smoking.

While a consensus remains elusive about the effects of e-cigarettes on youth and the population writ large, the plans of the tobacco industry could not be clearer. The tobacco industry has invested heavily in e-cigarettes (see list below) and it is actively working to develop a more addictive cigarette. 

·      Lorillard (LO) (Blue eCigs/SKYCIG)

·      Altria Group (MO) (Markten ecig)

·      British American Tobacco (BTI) (Vype ecig)

·      Reynolds American (RAI) (VUSE ecig)

As RJR researchers noted above 40 years ago, “Realistically, if our Company is to survive and prosper, over the long term we must get our share of the youth market…[T]his will require new brands tailored to the youth market.” This statement is as true today as it was then. As the Surgeon General reported earlier this year in a landmark report, 87 percent of smokers use their first cigarette by 18 years of age, with 98 percent starting by age 26.

It comes as no surprise, then, that the tobacco industry views e-cigarettes, like Joe Camel before them, as a gateway to hook youth on nicotine.

According to the CDC, nearly 7 percent of American youth in grades 6 through 12 tried an e-cigarette in 2012, more than double the rate in 2011. This shouldn’t be a surprise, given that e-cigarette marketing is transparently directed toward kids, both in terms of cost (e-cigs cost significantly less on average than conventional packs) and flavoring. Indeed, as USA Today noted, while the FDA banned flavored tobacco cigarettes, there are no such restrictions on cigars or e-cigarettes. This regulatory loophole has led to flavors like Fruit Loops and cookies and cream.

The tobacco industry is once again leaving no stone unturned to get at this potentially lucrative market. In January, a group of tobacco companies sued the City of New York in federal court to halt new regulations slated to go into effect this month. The companies allege that the City’s ban on coupons and otherwise promotionally priced tobacco products are an unconstitutional restriction of free speech (in addition to being preempted by both federal and New York State law).

If you are rolling your eyes at the idea that barring coupons from being used to circumvent national efforts to boost the price of cigarettes in order to (a) pay for a portion of the health costs imposed by the industry’s product and (b) dissuade children from picking up the deadly habit, implicates the First Amendment, you aren’t alone.

Last week, the Campaign for Tobacco Free Kids filed an amicus brief on behalf of the City, highlighting the inverse relationship between cigarette price and cigarette use. In particular, the Campaign noted how Philip Morris’ 1993 “Marlboro Fridays” program (and the corresponding cuts in prices by competitors) led to an immediate and sharp increase in youth tobacco consumption.

So what are public health officials to do while we await better data about the effect of e-cigs? I think they need to do three things, keeping in mind our first principles:

1.     The government should fund independent research into the effects of e-cigarettes on users and others who breathe in supposedly harmless “water vapor”. Until the “vapor” is found to be safe, e-cigarette use should be banned in public accommodations to reduce the chances of second-hand harm.

2.     The government should aggressively restrict marketing of e-cigs to youth and should, in the interim, classify e-cigs as tobacco products (as the FDA has) for the purpose of taxation, all while keeping in mind that tax breaks (and even credits) could be worthwhile if e-cigs are shown to enable smoking cessation (like nicotine gum).

3.     Public health officials should actively market smoking cessation products to young people—with PR campaigns focused near schools, parks, and malls. Whether hooked on conventional cigarettes or the trendy-tech version, all people—but especially our children—deserve a chance to wean themselves from addiction.

Despite a multi-billion dollar settlement in 1998, the tobacco industry has proven resilient in developing new and deadly campaigns to hook young people on nicotine. We are in the opening stanzas of the E-Cig industry and it is incumbent upon us to not exhibit the same naïveté in the face of the tobacco companies as we did for much of the 20^th century. If we do, the effects will continue to be measured in billions of dollars and millions of lives.