Most healthcare professionals who work with the pediatric population are aware that the first few years of life are a critical period while a child’s brain is quickly developing and the most neuroplastic. There is existing evidence indicating that inequalities between races exists in the early intervention (EI) program. A 2019 report highlights in detail the inequalities in New York State’s early intervention program. Due to funding from New York State there are major racial and socio-economic disparities in access to EI services. There are several problems that are highlighted.
In 2018, 1 out of every 4 children who were found eligible for EI services in NYS did not receive services in the necessary time frame.
Lower income communities are consistently the least likely to receive evaluations after referral to EI services.
The neighborhoods where children were found to be eligible for EI services and are least likely to receive them are primarily low-income communities of color
To further this, in neighborhoods where there are higher rates of eligibility the black children are less likely to receive services.
There are two drop off points that were found: referral to evaluation and eligibility to receive services. On average the drop off rate between referral and evaluation is 11.9%, what is significant is that when you break it down by race there is clear inequality:
11.3% Asian
16.5% Black
12.7% Hispanic
11.1% White
The average drop-off rate in NYC between evaluation and receiving services is 5.4%. This again varies based on race:
5.7% Asian
6.8% Black
6.3% Hispanic
3.9% White
This report suggested steps that both state and city leaders could take to address these early inequalities. New York as a state should consider increasing rates for EI workers. The state should fund a cost-study to assess and recommend changes to improve payment to help address the low capacity of workers in low-income and underserved communities. They should consider policy changes that make sure health insurance companies pay their share to help cover EI services. They should conduct a statewide analysis of disparities in access to evaluations and services for EI and implement a quality improvement plan.
The city should issue an annual public report on the provision of EI evaluation and services so the public can hold the city and state accountable for addressing disparities and children getting their mandates met. The city should analyze the disparities in EI services and evaluations and create a plan to address the problems. This could be anything from training service coordinators on cultural competency to following up with families better.
On a personal level what we do? We can all check our implicit and unconscious biases. Do we have any prejudices that are embedded from society? Before refusing a case based on the zip code, remember that these children need services. This report is critical for other states and cities to look at and consider allocating funding to assess if their state and cities also have inequalities. By addressing these early inequalities, lives of many children and families will be improved leading to overall improved quality of life and improved future outcomes. As early intervention providers, we must be aware of the disparities in our state and advocate for that change.
Access the Full Detailed Report at the Link Below:
https://cccnewyork.org/new-report-details-inequality-in-states-early-intervention-program/
Reference
Early Inequalities How Underfunding Early Intervention Leaves Low-Income Children of Color Behind. (2019, December). https://s3.amazonaws.com/media.cccnewyork.org/2020/12/OAyzWd1P-EI-Report-FINAL-12-4-19.pdf
