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D. OVERALL HEALTH STATUS OF EARLY HEAD START CHILDREN AS INFANTS AND TODDLERS
Meeting the health care needs of infants and toddlers in Early Head Start is a challenge. In general, low-income parents are less likely than parents of children in higher-income families to report that their children are in very good or excellent health and are more likely to report that their children experience poor health (DHHS 2001). Early Head Start parents’ reports of their children’s health are consistent with this pattern.
Most children in the research sample, all of whom enrolled in Early Head Start before they reached age 1, were reported by their mothers to be in excellent or very good health at each assessment point.4 As children grew up, more were reported by their mothers to have excellent or very good health and fewer were reported in fair or poor health (Table 2). A little more than half of the children (56 percent) were reported to have excellent or very good health at 14 months of age, and 19 percent were reported to be in fair or poor health. By 36 months of age, nearly three-fourths (71 percent) were reported in excellent or very good health, and 8 percent were in fair or poor health. These trends can also be seen in the average ratings mothers provided to describe their child’s overall health status. On average, mothers’ ratings of their child’s overall health status increased from 3.6 when their children were 14 months old to 3.8 when their children were 24 months old and 4.0 when their children were 36 months old.
| Child's Age | |||
|---|---|---|---|
| 14 Months | 24 Months | 36 Months | |
| Child's Overall Health Statusa | |||
|
55.8 | 64.8 | 71.1 |
|
25.2 | 22.5 | 20.6 |
|
19.0 | 12.6 | 8.4 |
|
3.6 | 3.8 | 4.0 |
| Sample Size | 978 | 970 | 1,104 |
| Source: Parent interviews conducted when children were approximately 14, 24, and 36 months of age. | |||
| a Primary
caregivers were asked to rate their child's overall health status
as poor (1), fair (2),good (3), very good(4), or excellent (5). |
|||
The percentage of 3-year-old Early Head Start children reported by their parents to be in excellent or very good health was comparable to the percentage reported by parents of a broader group of low-income children—those under age 5 in families with incomes below the poverty level—in the National Health Interview Survey (NHIS). According to parents who completed the NHIS, 76 percent of children under 5 years of age in families below the poverty level were in excellent or very good health in 1998 (DHHS 2001). Given the rise in Early Head Start parents’ health ratings as children got older, the proportion of children reported to be in very good or excellent health by age 5 is likely to be comparable to that reported in the NHIS study for all children under 5.
Parents of Early Head Start infants and toddlers, however, were more likely than parents of infants and toddlers nationally to report them to be in fair or poor health and less likely to report that their children were in very good or excellent health. At 14 and 36 months of age, respectively, 19 and 8 percent of Early Head Start children were reported by their parents to be in fair or poor health. In contrast, nationally, 1.4 percent of children under age 5 (above and below poverty) were reported to be in fair or poor health (DHHS 2002), and in 1997, the Panel Study of Income Dynamics found that 3 percent of infants (less than 1 year old) and 4 percent of toddlers (1 to 2 years old) were in fair or poor health or were limited in their activities (Hofferth 1998).
A few children in the Early Head Start sample died during the course of the study. In all, 21 children died, 12 in the control group and 9 in the program group. Eleven out of the 21 deaths were to children who were unborn at enrollment, and among the 9 for whom a cause of death is known, 8 were miscarried or stillborn. Among the 10 deaths to children who were already born at enrollment, little is known about the causes of death.
4 Parents were asked to rate their child's overall health status as poor (1), fair (2), good (3), very good (4), or excellent (5). (back)
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