Data Tell a Powerful Story about Racial Inequities

Dear Kidsdata Community,

The appalling deaths of Rayshard Brooks, George Floyd, Ahmaud Arbery, Breonna Taylor, and other victims of racism have caused immense pain for communities across the country, for all of us at the Lucile Packard Foundation for Children’s Health, and for our colleagues in the Stanford Medicine community. Our country’s longstanding and deeply embedded racial bias, injustice, and discrimination stand in direct contrast to our values and mission to improve health for children, moms, and families. Yet, every day we see the disparities in health outcomes for Black children and communities of color.

We recognize at the Foundation and through Kidsdata that we have a powerful and privileged position to use data and resources to practice anti-racism and inspire change. We look forward to sharing our next steps in the coming weeks, and we welcome your thoughts and suggestions. Please send your ideas to info@lpfch.org.

 

Infant Mortality Rate: 2012-2016

Data expose the consequences of racial injustice. But, data do not produce change. It’s you and I who must make the change. We wield data to expose the inequities and stoke the passion for transformation. We draw on data to help us remake policies and institutions to eradicate racist behaviors, practices, and violence.

Black children, from birth to young adulthood, experience the burden of systemic and institutionalized racism in health care, education, juvenile justice, and other social institutions. In California, persistent disparity has gone on for far too long, and the data continue to show us areas to prioritize in children’s health and well-being.

Infancy

  • Black infants are less likely to be born to mothers who had received prenatal care than white infants (79% versus 88%)
  • Black mothers who recently gave birth are more likely to report that they had four or more hardships in their youth than white mothers (12% versus 9%)
  • Black infants are more likely to die than white infants (10 per 1,000 infants versus 4 per 1,000)

Adolescence and Transition to Adulthood

  • Black students are less likely to graduate from high school than white youth (73% versus 87%)
  • Black students are less likely to complete college preparatory courses than their white peers (36% versus 52%)
  • Black youth ages 10 to 17 are more likely to be arrested than white youth (20 per 1,000 versus 2 per 1,000)

Safety, Violence, and Death

  • Black students in 7th, 9th, and 11th grade and non-traditional programs feel more unsafe at school than their white peers (12% versus 6%)
  • Black babies and youth ages one to 24 are more likely to die than white youth (59 per 100,000 versus 31 per 100,000)
  • The leading cause of death among Black youth ages one to 24 is homicide which is 10 times the rate for white youth (21 per 100,000 versus 2 per 100,000)

Leveraging data and remaking policies and institutions would mean that more Black infants, children, and youth will live, Black children will feel safe, and Black young adults will have opportunity through education to become healthy, economically secure adults. At Kidsdata, we will continue to provide data that expose inequity and bring the most egregious findings to your attention. Please use them to transform our policies and institutions.

Summary and Fact Sheet Describing African American/Black Children in California »

Recently Released Data

We recently released data about high school graduation and college eligibility. See links to the latest here.

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A Collective Impact Approach to Prevent and Reduce Childhood Adversity in California

Children as friends celebrate children's birthday in the summer with colorful pinwheels

Adverse childhood experiences, such as poverty or mental illness of a family member, can lead to harmful health outcomes. However, effective policies and programs can prevent, nudge or even dramatically shift a child’s trajectory toward a brighter future. Guest author, Elena Costa, from the Injury and Violence Prevention Branch of the California Department of Public Health, introduces you to a collaborative approach to address childhood adversity in California.

The California Essentials for Childhood (EfC) Initiative is a statewide initiative that utilizes a collective impact model to address child maltreatment and prevent and reduce childhood adversity. This important work is led through a partnership with the California Department of Public Health (CDPH), Injury and Violence Prevention (IVP) Branch, and the California Department of Social Service (CDSS), Office of Child Abuse Prevention (OCAP).

The EfC Initiative supports and participates in mutually reinforcing activities and strategies across multiple agencies and stakeholders to optimize the health and wellbeing of California’s children. In its second cycle of funding from the Centers for Disease Control and Prevention (CDC), this project seeks to:

  • Prevent and reduce child maltreatment through a public health approach
  • Raise awareness and commitment to promoting safe, stable, nurturing relationships, and environments (SSNR&E)
  • Create the context for healthy children and families through social norms change, programs, and policies
  • Utilize data to inform actions

The EfC Initiative engages 70 organizations and more than 130 stakeholders in a statewide coalition and supports five, topic specific, subcommittees (i.e., Data, Policy, Strengthening Economic Supports, and Trauma-Informed Practices) to define where there are opportunities to realize the Initiative’s vision that all California children, youth, and families thrive in safe, stable, nurturing relationships where they live, work, and play.

A critical component to the EfC Initiative’s efforts to identify and undertake mutually reinforcing activities is improving access to data that tells the story of childhood adversity as well as cultivating partnerships. Collaboration with programs, such as Kidsdata, ensures that the solutions proposed are based in data and need as well as the guidance given by subject matter experts.

Join us in defining solutions to address childhood adversity. You can learn more about the program by visiting the EfC’s Initiative webpage or contact me directly: elena.costa@cdph.ca.gov.

COVID-19 Resources on Children

During this difficult time, Kidsdata continues to work on behalf of children and families. If you have resources about children and COVID-19 to share, please contact us at kidsdata@lpfch.org. We have included a few selected resources below.

10 Ways to Avoid ACEs, from Tufts Medical Center, provides guidance for parents, providers, and community members to prevent ACEs during COVID-19. Grounded in HOPE – Healthy Outcomes from Positive Experiences – this resource offers a new way of seeing and talking about experiences that support children’s growth and development into healthy, resilient adults.

Road to Resilience: Raising Healthy Kids, from the Mayo Clinic, offers a virtual self-paced program to reduce the effects of adverse childhood experiences. It includes videos and activities directed toward young children, tweens, and teens, as well as the adults who care for them.

COVID-19: Mapping vulnerable populations in California, from the Othering & Belonging Institute at UC Berkeley, identifies California regions most in need of resources and support. The maps can assist nonprofits, government agencies, and health organizations that are developing plans to allocate resources or are working on the ground to reach particular groups.

The Lucile Packard Foundation for Children’s Health continually updates a curated list of COVID-19 Resources for Children with Special Health Care Needs.

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New Childhood Adversity Data and Dashboards

Image of Childhood Adversity and Resilience flier

New and updated data describing childhood adversity and resilience are now available on kidsdata.org. The data cover more counties than previously offered and provide greater detail on childhood adversity. Also, in partnership with the Essentials for Childhood Initiative, you can now access data dashboards for every county in California.

Adversity and Resilience Data
See the latest parent reported data on childhood adversity and resilience in California. Based on the National Survey of Children’s Health, 38% of California children had at least one adverse childhood experience (ACE) during 2016-2018, and almost 4% had four or more ACEs. This measure includes nine types of ACEs. Statewide, the largest percentage of children experienced economic hardship or parent divorce (18% to 21%), but 7% were exposed to alcohol or drug abuse in the household and 5% had a family member with mental illness. County-level data show that the percentage of children experiencing two or more ACEs varied widely in 2016-2018, from 8% in San Mateo County to 30% in Humboldt County.

Child Adversity and Well-Being Dashboards
Access adversity and well-being dashboards for California and for all counties on ACEs Connection. These dashboards are a compelling way to tell a story of child adversity, health, and well-being using key data findings. They describe periods across the child life course, from pregnancy and birth, through early/middle childhood and adolescence. Every county’s dashboards are customized based on available data to ensure that all parts of California have equivalent information to address childhood adversity and promote protective factors. Partners across sectors can use dashboards to support decision-making and promote action to maximize health and well-being for babies, children, and youth.

These dashboards are a product of the Essentials for Childhood Initiative (EfC), a CDC-funded child maltreatment prevention project hosted by the California Departments of Public Health and Social Services.

 

Additional Resources on Adversity and Resilience

ACEs Aware, an initiative led by the Office of the California Surgeon General and the Department of Health Care Services, shares a toolkit that describes ACEs science and provides guidance on how to screen for and respond to ACEs.

For a framework that promotes positive childhood experiences, read Responding to ACEs with HOPE: Health Outcomes from Positive Experiences.

 

COVID-19 Resources on Children

During this difficult time, Kidsdata continues to work on behalf of children and families. If you have resources about children and COVID-19 to share, please contact us at kidsdata@lpfch.org. We have included a few selected resources below.

Coronavirus in Kids (COVKID) Tracking and Education Project, by The Women’s Institute for Independent Social Enquiry, compiles epidemiologic surveillance data on COVID-19 in children and teens to present timely data for clinicians, public health practitioners, policymakers, elected officials, and journalists.

A Guide to COVID-19 and Early Childhood Development, from the Harvard University Center on the Developing Child, pulls together resources that can help parents, caregivers, child care providers, pediatricians, and others who work with families.

The Lucile Packard Foundation for Children’s Health continually updates a curated list of COVID-19 Resources for Children with Special Health Care Needs.

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How COVID-19 Impacts Children’s Mental Health

Hospitalizations for Mental Health Issues Among California Children and Youth, by Age Group: 2002 to 2018

Trend Line for Hospitalizations for Mental Health Issues Among California Children and Youth, by Age Group: 2002 to 2018

In this issue of Kidsdata News, we will explore how data and research could provide guidance for the COVID-19 response to the mental health impact on youth.

Mental health among children and youth is already a concern. In 2018, there were 41,087 hospital discharges for mental health issues among California youth ages 5-19, a 38% increase in the last decade. With the emergence of COVID-19, children with existing mental health issues must endure the added burden of a pandemic. Children often rely on schools to provide mental health services, but school closures have made it difficult to access and preserve the quality of these services. Historical research on the effects of pandemics on children’s mental health is limited, but current analyses on the impact of COVID-19, in the U.S. and across the world, can help inform best practices for promoting resilience among children facing adversity.

Mental health supports at school
Due to the public health crisis, educators have had to close their doors and open their laptops, forcing children to adapt to new ways of learning and accessing needed services. Having to relate to teachers, friends, and school staff solely through virtual means may be especially challenging for some students. Distance learning and social isolation because of COVID-19 may worsen existing mental health issues and lead to more mental health cases among children.

Public health experts are particularly concerned for children living with an abusive or substance-dependent guardian. Children growing-up in unsafe homes may view school campuses as dependable, trusted hubs of social support that offer a safe space. While pediatric mental health specialty services may be available in the community, most children who need treatment do not receive it. To bridge the gap, schools play an important role in identifying mental health issues and providing supportive services. Now more than ever, students facing adverse experiences at home, compounded by the consequences of COVID-19, need access to quality mental health services to protect their emotional well-being.

How children are faring outside the U.S.
We don’t yet know the extent of COVID-19’s mental health impact on youth. However, lessons learned from analyzing the impact of shelter-in-place orders instituted in other countries could light the way to how we can best prepare for the future outcomes of our current situation.

Researchers in the UK carried out a survey among youth with existing mental health issues to assess how the pandemic and the subsequent restrictions are affecting them. Although the students understood the need for restrictions like school closures, many reported increased anxiety, problems with sleep, and panic attacks as a result. Key findings indicated 51% of students agreed that the pandemic had made their mental health a bit worse, and 32% agreed it made it much worse. When asked which activities were most helpful for their mental health, the more popular responses were face-to-face calls with friends, watching TV, exercise, and learning new skills. Encouraging youth to participate in these positive activities could help mitigate the added emotional health impacts on youth in the U.S.

In China, research on the mental health effects of school closures during COVID-19 emphasize the need to protect children living in unsafe homes. Researchers found that social distancing measures possibly had a harmful effect on children living in an abusive home, and likely exacerbated abuse during this time of economic uncertainty and stress. In parts of China, reports of domestic violence more than tripled, and increased rates of child abuse, neglect, and exploitation were also reported. China’s cautionary tale leads us to wonder how we can prevent similar adverse outcomes and provide opportunities for resilience for at-risk children.

A data-driven approach to resilience
We must safeguard our children’s long-term health by looking at the best data-driven practices for promoting resilience among children facing adversity. The more a child feels connected and supported, the more likely they are to have better long-term emotional health. Beyond support, communities have a shared responsibility to nurture sound mental health practices in children and youth for them to develop effective coping skills and adapt in the face of unexpected challenges.

Having safe, stable, nurturing relationships and environments within the family, community, and at school are critical. School staff may not be able to support their students in-person, but by maintaining their consistent, caring relationships online, they can strengthen children’s resilience against adversity.

Concern for our children’s mental health has only increased since the start of the pandemic, putting a strain on school mental health supports. If students cannot rely on quality mental health services from schools, then we must ensure children receive appropriate care and support in our homes and communities. Timely, yet limited data show COVID-19 is already impacting our children’s mental health, but it is up to us to define to what extent it affects their long-term health and well-being.

Additional Resources

Rock Results provides a tool designed to support teachers, counselors and others who might have contact with children and youth isolated at home during crises such as the COVID-19 pandemic.

Child Mind Institute shares tips and resources on managing anxiety and dealing with loss for families struggling with mental health issues at home due to COVID-19.

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Safeguards for Youth and Responding to COVID-19

A note from Lori Turk-Bicakci, Ph.D., Director, Kidsdata Program.

Working with data has been my world for years. Stories unfold through data, and I take comfort in knowing that some of these stories are powerful enough to be a linchpin for change. As a result of COVID-19, some health and well-being trend lines will pivot in previously unimaginable ways. I am committed to bending these impending pivots to benefit children. I do this through data, but we all contribute in our own way.

As your organization responds to COVID-19, you might find our Safeguards for Youth information helpful. Our dedicated webpage is a compilation of the latest data on protective factors and supportive services for the state’s children. The data are continually updated and the page includes:

  • Links to indicators of protective factors that describe preventive health care, a strong start in education, and a nurturing school community.
  • Links to indicators of supportive services including those that address health challenges, abuse, and family poverty.
  • Recording of our Safeguards for Youth briefing on adopting a prevention mind-set and using trauma-informed practices.
  • New: A series of six data focus briefs on topics recently highlighted in Kidsdata News.

I would like to suggest using Safeguards for Youth data to help anticipate and address the pandemic’s long-term impact on California children by assessing intransigent gaps in protections and services. For example:

  • Health insurance promotes preventive care and early intervention on health issues. Hispanic/Latino children and American Indian/Alaskan Native children have historically lacked health insurance at higher rates than most other race/ethnic groups of children. Hispanic/Latino children ages 0-17 also make up the largest share of COVID-19 cases compared with other race/ethnic groups.

    What new approaches could be taken to ensure that the children in these populations are adequately protected with health insurance?

  • Children’s usual source of health care might change as a result of COVID-19. Over the last couple of decades, just over 60% of children usually went to a doctor’s office or HMO when faced with a health issue, and about 25% went to a clinic or hospital.

    With an increase in telehealth and other unforeseen consequences, will this pattern of health care utilization change for children? What does it mean for your community?

A third example will be highlighted in the next issue of Kidsdata News. We will explore how data and past research could provide guidance for the COVID-19 response on the issue of mental health among youth.

As you work with data to inform your response to COVID-19, please feel free to reach out to me with questions or comments. Through our collective efforts, I believe our approach to addressing children’s health and well-being will strengthen with a sharpened focus as we find new ways to relate to each other and to children. Almost all parts of society are in a shake-up, and my hope is that from it, the best parts of who we are and what we do will emerge and flourish.

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Estimates Show a 14 Percentage Point Reduction in Child Poverty from Safety Net Programs

Poverty Reducing Effects of the Social Safety Net in California According to the California Poverty Measure: 2014-2016

Table Image of the Poverty reducing Effects of the Social Safety Net in California According to the California Poverty Measure: 2014-2016

Safety net programs such as tax credits and supplemental nutrition help mitigate economic hardships for families and safeguard children. Children who face economic hardship, or who experience deep and prolonged poverty, are at greater risk for poor emotional and physical health than children in more economically secure households.
Based on the California Poverty Measure, social safety net programs reduced child poverty by an estimated 14 percentage points in 2014-2016. Estimates show how each program contributed to reducing poverty. The Earned Income Tax Credit and Child Tax Credit had a particularly strong effect, reducing poverty by six percentage points. Also impactful was CalFresh, known federally as the Supplemental Nutrition Assistance Program, which reduced poverty by four percentage points.
The effects of poverty extend beyond individuals. The estimated total annual cost of child poverty in the U.S. is more than a trillion dollars, due in part to loss of economic productivity and increased health costs. For every dollar spent on poverty reduction strategies, the U.S. could save an estimated $7 related to the economic costs of poverty.

Data About Programs for Families in Poverty

These data are a part of Safeguards for Youth, a compilation of the latest data on protective factors and supportive services that promote California children’s health and well-being. Learn more at kidsdata.org/Safeguards.

Social Safety Net

COVID-19 Resources on Children

SupplyBank.Org supports under-resourced children and families by manufacturing and collecting then distributing basic needs material items to local agencies. They are accepting requests for supplies from social service agencies, WIC, First 5, school districts, domestic violence shelters, or other public assistance agencies in need of basic material resources.

California’s Maternal, Child and Adolescent Health Division compiled COVID-19 Resources for Women and Families to offer guidance for both families and health professionals in areas such as pregnancy, breastfeeding, and family nutrition.

The National Institute for Children’s Health Quality outlines the challenges in Supporting Children’s Health During and After the COVID-19 Pandemic. They offer insights in areas such as home-visiting services, communications with pregnant women, and parent and caregiver mental health.

The Lucile Packard Foundation for Children’s Health continually updates a curated list of COVID-19 Resources for Children with Special Health Care Needs.

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One in Four Youth in Foster Care Do Not Receive Timely Medical Exams

Timely Medical Exams for California Children in Foster Care:
1998 to 2019

Trend line showing the number of timely medical exams for California Children in Foster Care from 1998 to 2019

The foster care system is a critical safeguard for youth. It provides temporary, safe living arrangements and therapeutic services for youth who cannot remain safely at home. In California, 59,172 children ages 0-20 were in foster care on July 1, 2018.

While foster care aims to reunify children with their family, or unify them with another family as safely and quickly as possible, some children spend months or years in the system. Among children ages 0-17 who entered foster care in 2017, half spent more than 17 months in foster care. Thus, ensuring timely access to medical and dental care for these children is critical to promoting their long-term health and well-being. Over the past 20 years, the percentage of children in foster care receiving timely health exams has improved dramatically, though fewer than one in four still do not receive timely care. In 2019, 73% of children in foster care received timely medical exams, up from 11% in 1998, and 67% received timely dental exams, up from 8%.

Services to Address Abuse Data

These data are a part of Safeguards for Youth, a compilation of the latest data on protective factors and supportive services that promote California children’s health and well-being. Learn more at kidsdata.org/Safeguards.

Foster Care

Domestic Violence Calls

COVID-19 Resources on Children

Alliance for Children’s Rights compiled resources for foster care youth and families impacted by COVID-19. Resources are focused on California, particularly Los Angeles, and covers topics such as food assistance, health care, and housing.

The California Department of Public Health shares the latest about the state’s actions related to COVID-19 and links to services and information for sectors such as education, health care, and housing.

Common Sense created Wide Open School to offer resources to support kids’ educational, emotional, and physical development. It includes sections such as academic supports, emotional well-being practices, and children with special needs.

The Lucile Packard Foundation for Children’s Health continually updates a curated list of COVID-19 Resources for Children with Special Health Care Needs.

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Supporting Children Through Health Challenges

Usual Source of Health Care Among California Children: 2015-2016

Image of a pie chart displaying the usual source of health care among California children from 2015 to 2016

A coordinated approach to health care that is affordable, evidence-based, and family-centered safeguards youth most effectively. Children receive care from a complex system of clinics, hospitals, schools, and more. Important measures of this broad system of care include how often these health care services are accessed, why they are used, and to what extent they are adequate.

Over nine in ten California youth ages 0-17 experienced no delay in medical care in 2015-2016. During that time period, their usual source of care was visiting a doctor’s office or HMO (61%), going to a clinic or hospital (27%), and using an emergency room or urgent care center (3%). Ten percent of children had no usual source of care. In California, the main reason children ages 0-17 were discharged from hospitals in 2017 was for mental diseases and disorders (14% of discharges). However, about four in ten youth who needed help for emotional or mental health problems received counseling in 2015-2016.

Schools can be a safe and accessible environment to address health issues among children. One in four elementary school teachers and one in five high school teachers strongly agreed that their school provided adequate health services in 2015-2017. Among school support personnel, there were 2,410 nurses, 1,041 psychologists, and 626 counselors for every student in California schools in 2019. School-based health centers provide medical care, dental care, mental or behavioral health care, and other services through on- and off-campus sites and mobile vans. In 2019, 268 school-based health centers served California children in 33 counties.

Support for Health Challenges Data

These data are a part of Safeguards for Youth, a compilation of the latest data on protective factors and supportive services that promote California children’s health and well-being. Learn more at kidsdata.org/Safeguards.

Hospitalization

Physical and Mental Health Care

School Services

Related Resource

Common Sense shares resources for families during the coronavirus pandemic including helping children understand COVID-19 news coverage, helping parents support children through school closures and online learning, and recommending what to watch, read, and play.

Recently Released Data

We recently released data about pupil support personnel, disconnected youth, and juvenile arrests. See links to the latest here.

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Protecting Youth Requires Meaningful Relationships

Caring Relationships with Adults at School: 2015-2017

Image of Caring Relationships with Adults at School Data
Meaningful relationships are fundamental to safeguarding youth. Every child needs an adult who is both caring and supportive as well as attentive to basic needs. When an adult demonstrates a deep commitment to a child’s emotional and physical well-being, that child is more likely to feel secure and protected which supports their long-term health and well-being. These relationships are most critical at home but are also important in all youth environments such as in school.

Many students in California lack a caring relationship at school. Less than half of students in 7th and 11th grade and about a quarter of students in 9th grade and in non-traditional programs highly agreed that they had a caring relationship with an adult at school in 2015-2017. Hispanic/Latino students in these grade levels may be least likely to have caring relationship with an adult (29% highly agreed) compared with white students (39% highly agreed), among race/ethnicity groups with data.

Nurturing School Community Data

These data are a part of Safeguards for Youth, a compilation of the latest data on protective factors and supportive services that promote California children’s health and well-being. Learn more at kidsdata.org/Safeguards.

Feeling Connected

Strong Relationships

Supportive Environment

Related Resources

Simple Interactions promotes a research and practice-based approach in child and adult relationship-building and provides free resources to support those who serve children, youth, and families. It is a partnership between the Fred Rogers Center, the Harvard Graduate School of Education, and the University of Pittsburgh.

Strategies 2.0 is a multi-dimensional initiative to help organizations strengthen families and communities by offering free resources and training. It is supported by the Office of Child Abuse Prevention.

The Second Annual Child Abuse Prevention Month Kids’ Art Contest has begun! This year’s theme for the art contest is “My Hero.” Entries are due March 22, 2020.

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Protecting Children Involves All Caregivers

Licensed Child Care Facilities Offering Evening, Weekend or
Overnight Care: 2019

Licensed Child Care Facilities Offering Evening, Weekend or Overnight Care in California Bar Graph

A strong start in education is an important protective factor in children’s health. Enriching and positive early learning experiences can boost confidence, engagement, and skills, reinforcing a child’s long-term educational outcomes and well-being. Education begins long before entering Kindergarten through experiences such as cooperative play in child care settings and reading stories with parents at home. Caregivers in child care settings and at home both play a key role in establishing this solid foundation.

Licensed child care aims to ensure children receive quality services that are safe and protective. It should be equally accessible to all who need it when they need it. However, some families struggle more than others to access licensed child care. Parents working non-traditional schedules or holding multiple jobs often need child care during evenings, weekends, or overnight, but these slots are least available. Two percent of licensed child care centers and 41% of family child care homes in California offer evening, weekend and overnight care. When addressing the need for more licensed child care slots, it is important to also be mindful of varying work schedules so that all types of families benefit from this protective factor.

Reading together in the home is another way of supporting a strong start in education. Almost two-thirds of California children, 64%, had parents who read to them daily in 2015-2016, and another quarter of children had parents read to them at least three times a week. Promisingly, almost nine out of ten children regularly experience this enriching and protective experience in California.

Strong Start in Education Data

These data are a part of Safeguards for Youth, a compilation of the latest data on protective factors and supportive services that promote California children’s health and well-being. Learn more at kidsdata.org/Safeguards.

Child Care

Reading

Related Resources

The California Child Care Resource and Referral Network recently released the California Child Care Portfolio and provided kidsdata.org with indicators describing child care supply, demand, and cost.

First 5 California encourages caregivers to Talk. Read. Sing. to children in support of early child development.

Register for Upcoming Safeguards for Youth Briefing

Join us on March 5 to learn more about the Safeguards for Youth data. We will discuss the importance of adopting a prevention mind-set and using trauma-informed practices to avert and address adversity among children. Learn more and register here.

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