Sonoma County Early Childhood Landscape Scan Prepared for May 19, 2020 Prepared by Sarah Katz, MPH Data Strategy Consulting [email protected] 1 Contents Executive Summary 4 Introduction 5 Purpose of this Report 6 First 5 Sonoma County Goals and Mission 7 Report Methodology 8 Data sources 8 Time period of Study 9 Strengths and Limitations 9 Organization of report 9 Current and Future Demographics 11 Birth Rate and Trends 11 Where are babies born in Sonoma County? 12 What percentage of births are Medi-Cal births? 13 0-5 year-olds in Sonoma County 15 Impact of COVID-19 Shelter-in-Place Order on Parents & Parenting (April 2020) 16 Impact of COVID-19 on Income 16 Emerging Family and Child Needs 17 Initial unemployment claims in Sonoma County (April 2020) 17 Early Relational Health & Development 18 Maternal and Infant Health Assessment, 2013-2015 18 Substance use diagnosis among hospitalized pregnant females 19 Preterm births 19 Mood disorder hospitalizations among women of reproductive age 20 Reports of substantiated abuse or neglect per 1,000 children 21 Children with Special Needs 21 Adverse Childhood Experiences (ACEs) 22 Family Resiliency and Neighborhoods 23 CA Strong Start Index 24 CA Strong Start Index + Families in Poverty + Communities of Color 26 Families living under 200% of the federal poverty level 28 Neighborhood resource level by race/ethnicity, 2015 29 2 Social and economic determinants of health: Priorities from two 2019 community health needs assessments 30 Housing & Homelessness 30 Economic Security 30 Education 30 Families with children experiencing homelessness 31 Teen Parents 31 High-Quality Early Child Care and Education 32 Children Eligible for Subsidized Care, 2017 32 Early Care Quality, 2019 32 Where Are We: Reviewing the Benchmark of Kindergarten Readiness 2016-2019 33 Kindergarten Readiness, 2019-2020 34 First 5 Focus Schools, 2018-19 34 Summary of Findings 36 Appendix 38 3 Executive Summary Research has consistently shown that children’s health and healthy development is inextricably linked to family and community health. Children born into highly-resourced families and communities experience better outcomes across their lifespan than do children born into lower resourced environments. These factors, which range from the macro to the micro levels, contribute to the divergent health trajectories that young children experience, and are starkly reflected in the disparities in some Sonoma County’s youngest children. According to the 2019 National Academy of Sciences Vibrant and Healthy Kids: Aligning Science, Practice, and Policy to Advance Health Equity report, “persistent, additive disadvantages and early adversity are significant contributors to the widening gaps. Past historical injustices continue to impact children… and create barriers for health for those who live in contexts that undermine their opportunity to reach their health potential.” Between the years 2020-2029, approximately 4,700-5,000 babies will be born each year in Sonoma County. Demographic projections indicate a continuing, declining birthrate. In 2018, one out of every 3 Sonoma County babies were born into 15 of the County’s 99 census tracts. Most of these 15 tracts are distinguished by their high family poverty rates, fewer neighborhood resources, and a higher percentage of people of color, each an indicator of systems’ disinvestment. A review of these key indicators, along with differences in early relational health and development, family resiliency, and early childcare capacity, reveals that persistent inequities in family and neighborhood resources will likely maintain inequities in health and healthy development without targeted, coordinated and sustained investment. Some of these highest need, lowest resourced communities are in Santa Rosa (such as Taylor Mountain, Kawana Springs, Wright, Bellevue, and Sheppard), along with three census tracts in Rohnert Park, two census tracts in Sonoma Valley, and West Cotati/Penngrove and East Cloverdale. Kindergarten readiness has long been a goal of First 5 investments. In 2019-2020, 36% of kindergarteners in Sonoma County entered kindergarten “ready to go.” Kindergarten readiness, like nearly all the outcomes reviewed for this report, is correlated with family income level and race/ethnicity. Children whose annual family income was $75,000 or more were over two times more likely to enter kindergarten Ready to Go compared to children whose annual family income was $34,999 or less, and white students were twice as likely to be Ready to Go compared to Latino students. In addition, early data on the effects of COVID-19 and the local Shelter-in-Place (SIP) order on health and financial security in spring 2020 demonstrate an outsized impact on Spanish-speaking Sonoma County families, and people with traditionally lower wage occupations. A survey conducted by First 5 Sonoma County of almost 300 families revealed that 65% of Spanish-speaking households lost or reduced income compared to 35% of English-speaking households in roughly the first month of SIP. Taken together, the data in this report clearly show that there are neighborhood inequities where more the majority of babies and families live, and this influences early relational health and development, family resilience, and access to high-quality early childcare. These placed-based or neighborhood inequities contribute to the stark inequities of kindergarten readiness in Sonoma County. Intentional investments in lower resourced communities will improve overall kindergarten readiness by reducing the negative conditions that set the trajectory for young children’s futures. 4 Introduction In 2020, about 5,000 babies will be born in Sonoma County. About 40-45% of these babies will be Latino and about 40-45% will be white, non-Hispanic. Based on trends from the past seven years, an estimated 20% of these children will be born into a household that receives public assistance and 13% will be born into a household confronting extreme poverty. According to the California County Scorecard on Children’s Well-being, more than 1 in 3 (or 37,000 children) live at 200% of the federal poverty level (FPL) in Sonoma County. These 2020 babies will also be born into a community with numerous strengths and assets, resulting from over two decades of investments in high quality early childhood education, health care access, family literacy, parent capacity, community engagement, healthy development, and systems change. As a result of coordinated and dedicated investment, nearly all children 0-5 years of age in Sonoma County had health insurance in 2018.1 Other Sonoma County assets include a culture of collaboration across providers and key system stakeholders, commitment and leadership of community-based organizations that serve children and families, and partnerships that maximize impact through pooled and aligned funding.2 Numerous studies reveal that children’s health and healthy development is inextricably to their family’s health and neighborhood conditions. Children who are born into highly-resourced families and communities experience better health outcomes across their lifespan than do children born into lower resourced environments. Children’s early experiences vary considerably by race, ethnicity, and family income. These inequities, driven in part by historical and current institutionalized racism, such as segregated neighborhoods, result in developmental, health, and educational gaps that solidify before children arrive at kindergarten, and can persist into adulthood.3 As a result, communities of color often have higher rates of preterm birth, infant mortality, and exposure to adverse childhood experiences, to name just a few. For many communities, population-level inequities remain or are widening. However, investment in neighborhoods; access to high-quality healthcare for mothers and babies; high-quality early childcare and education; systems improvement, integration, and coordination; parental education; and family and community resources can improve the health and healthy development of 0 to 5 year-olds and ensure that all children enter kindergarten ready to learn. 1 U.S. Census Bureau, American Community Survey, 2018 1-year estimate, Table S2701 2 First 5 Sonoma County, 2017 Update to the 2010-2020 Strategic Plan 3 Child Opportunity Index, Early Childhood. 5 Purpose of this Report The purpose of this report is to inform decision-makers as they engage in First 5 Sonoma County’s strategic planning process to determine priorities for the next three to five years. It provides the most up-to-date data and analysis on key indicators of health and development of children 0-5, their families, and the socioeconomic environments in which they are born, grow, and learn. By looking at the totality of factors currently facing children 0-5 and their parents in Sonoma County, decision-makers will be provided with the wider perspective they need to identify the most impactful strategies to improve the health and development of Sonoma County’s youngest children. The report examines several economic and social community indicators because these factors contribute to the divergent health and development trajectories that children experience.4 According to the 2019 National Academy of Sciences’ Vibrant and Healthy Kids: Aligning Science, Practice and Policy to Advance Health Equity report, a child’s “health ecosystem is influenced by the social, economic, cultural, and environmental factors that impact healthy development and well-being.” It