History and literature are replete with quotations relative to paying for the decisions we make in the present at some point into the future, starting with the Bible in Galations 6:7, “whatsoever a man soweth, that shall he reap.”
Our national and state leaders are making decisions that will have dramatic consequences in the not-so-distant future. As of September 30, 2017, Congress allowed two programs to expire that directly affect the well being of our nation’s children. One, the Maternal, Infant, and Early Childhood Home Visiting program funds scheduled home visits by trained health professionals to work with at-risk first-time parents on a variety of topics including nutrition, safety, and parenting skills. The program has been linked to improved academic outcomes for children, reduction in child abuse, and improved economic opportunities for the parents.
The second program that expired is the Children’s Health Insurance Program (CHIP) which covers 9 million children in lower and middle income families who earn too much to be eligible for Medicaid but not enough to pay for needed medical care. In the overwhelming majority of cases, these parents are working full-time to provide for their families, and some have private insurance, but cannot afford the cost of expensive medications and treatments that are necessary to keep their children healthy, and in many cases, alive. Almost 50,000 children in Mississippi are covered under CHIP.
When pressed about investing in our youngest citizens and in the future of Mississippi, our leaders say essentially, “we can’t afford it.” Yet, Mississippi gets three dollars for every one dollar it sends the federal government under Medicaid, and the ground-breaking work by noted economist and Nobel Laureate Dr. James Heckman shows high quality early childhood programs can yield a 13% annual return on investment through reductions in the need for special education and remediation, social and health services, lower crime, and increased economic independence. It boils down to whether we will pay now, or pay more later.
Two recently released studies add to the body of knowledge on the importance of prenatal and infant health care. Logan (2017) found that, for premature babies, the Score for Neonatal Acute Physiology-II was predictive of cognitive and neurodevelopmental impairments at the age of 10. Another study (Fevang, 2017) reported that being born very prematurely or severely under weight was associated with behavioral problems later on.
Mississippi consistently ranks as one of the worst states for the percentages of premature and low-weight births, as well as infant mortality. Knowing that babies born prematurely or who weigh less than 5.5 pounds at birth are more likely to need special support once they are in school, it seems obvious that we should be doing everything we can to provide early intervention services that can mitigate against such a necessity.
Mississippi is one of eight states without a Nurse-Family Partnership (NFP) program. Research has found NFP programs to produce positive effects on parenting practices, home environments, and child outcomes. State and federal government savings average $2.90 for every dollar invested and total benefits to society of $6.40 per dollar invested in NFP programs. (Miller, 2015)
First Steps, Mississippi’s Early Intervention program for infants and toddlers with disabilities, has consistently been woefully underfunded by the state and parents regularly complain of long waiting lists for assessments and minimal services. During the time when children are experiencing the most rapid development of their lives, a 10-month wait for services, worsened by inadequate services, can be detrimental.
Mississippi has experienced a steady increase in the numbers of students eligible for special education (U.S. Department of Education data), and we can expect the number to continue growing unless we intervene early to alter the life trajectory of our most vulnerable children. I certainly want every child with a disability who needs special education services to receive them, but I also know evidence shows we can prevent disabilities in some children with high-quality prenatal, infant & toddler care, and early intervention.
Stress during pregnancy, lack of adequate medical care and early intervention services result in long term problems that are more complicated and costly to address later in childhood, and the problems often persist into adulthood and diminish economic opportunities. Our decision-makers are sowing seeds that will continue to reap multiple generations of individuals who need more assistance than our society is willing to provide. Instead, let’s invest in research-based strategies that will produce stronger families and a stronger economy.
By Dr. Melody Musgrove