The Five Whys

The Five Whys

Stephanie Harrison

Stephanie Harrison, CEO, Wisconsin Primary Health Care Association. Executive Member Wisconsin Partners

In health care, we recognize the vital importance of early childhood education on long-term health and well-being. As we seek to eliminate health disparities and ensure that everyone in Wisconsin achieves their highest health potential, we must pay attention to brain development in our infants and toddlers if we are going to create long-lasting change in the health of the population.

One strategy is to include early childhood education in our quality improvement processes. For example, one of the tools we use is “The Five Whys” – a technique from the Six Sigma framework. When facing a systemic problem, asking “why” five different times assists in getting to the root cause.

Here’s an example of the technique:

1. Why is our county doing so poorly in the County Health Rankings?

Because a high percentage of people are living in poverty.

2. Why are a high percentage of people living in poverty?

Because the high school graduation rate is low and young people can’t access living-wage jobs that fit the education they have.

3. Why is the high school graduation rate low?

Because a significant number of students need remedial education services and struggle with  emotional and social difficulties that make completing school difficult.

4.Why do a significant number of students need remedial education and struggle with  emotional and social difficulties?

Because they did not get a firm foundation in these skills between infancy and age five  –  when their brains are undergoing the most significant development.

5. Why didn’t they get a firm foundation in these skills in their early education?

Because their families couldn’t afford high-quality early education.

The connection of health status to early childhood
The UW Population Health Institute  has shown that much of our health is actually about our behaviors and social and economic factors, like education and employment. As we ask why even more, we can trace things like poor health, smoking, substance abuse, graduation from high school, and employment back to the foundations for language, vocabulary, and socialization that are built in early childhood. In fact, the Center on the Developing Child at Harvard University notes that disparities start to show up around 18 months of age.  This is particularly evident in vocabulary. In response, many community health centers in Wisconsin participate in the Reach Out and Read program as a way of getting health care providers to urge parents to read regularly to their kids – thereby providing a more language-rich environment for their children.

If we are serious about making our state a healthier place, we need to pay more attention to the education that our children are receiving at home and at childcare centers in their earliest days and years.

By Stephanie Harrison, CEO, Wisconsin Primary Health Care Association. Executive Member Wisconsin Partners

Investing in America’s Children

Investing in America’s Children

In April the Economic Policy Institute released a comprehensive report on child care in America – as an economic driver, a foundation for young children’s later success, and a source of financial stress both for parents seeking childcare and the workforce that provides it. The report is rich with infographics and gives a state-by-state view of the costs. Wisconsin’s data prompted a piece by Wisconsin Public Radio. In it WECA Executive Director Ruth Schmidt points out that despite high costs for families, early childhood teachers in Wisconsin earn an average of about $10 an hour. With an annual average income of $20,080, – 36%- of the childcare workforce relies on public assistance to meet the financial needs of their own families.Childcare-is-out-of-reach
If childcare costs are so high, why aren’t childcare teachers paid better? Part of the answer has to do with child-to-staff ratios. For example, by law one Wisconsin infant teacher can only care for a maximum of four children under the age of two. Meeting infants’ social, cognitive and basic needs requires a great deal of individual attention. Facility operating costs, equipment and supplies, the ever-increasing cost of rent and property, and the cost of complying with various governmental regulations contribute to the high cost. Ms. Schmidt says the onus can’t be on parents, businesses or government individually to come up with a solution, but rather “there has to be some sort of a tri-part approach.”

Return on Investment- Wisconsin-style

Return on Investment- Wisconsin-style

Many studies connect high-quality child care to positive impacts for children as they get older.  And many studies by economists, such as Dr. James Heckman, attach real dollars to the savings that are obtained. Articles, blog postings and opinion pieces appear on this topic with high frequency. The message that it makes good economic sense to invest in early childhood education has hit the mainstream, which is a good thing.

WECA wanted to tell the return on investment story that is unique to Wisconsin.  With funding from the Alliance for Early Success, WECA worked with the Committee for Economic Development to do just that.

Follow the story of Jack – a child who has access to 5-star child care in Wisconsin. See the benefits that accrue, and the dollars saved when certain things don’t happen (being held back a grade in school, being placed in special education, dropping out of high school, being incarcerated, relying on public assistance). See the economic impact when other things do happen (high school and college graduation).  The benefits and numbers grow exponentially as the scenarios expand to show the financial impact on Wisconsin if all our low-income children attended 5-star childcare programs.

WECA looks forward to sharing this powerful new advocacy tool and we ask you to share it widely and often. It’s yet another way to work together to create new practices and policies that enable all children to start off strong.