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REMARKS BY:	DONNA E. SHALALA, SECRETARY OF HEALTH AND HUMAN SERVICES
PLACE:		World Bank Conference on Investing in Our Children's Future
DATE:		April 10, 2000

An ancient Chinese philosopher once said, "The great man is he who does not lose his child's heart." Ordinarily I would not go out of my way to quote someone who so easily overlooks great women. But I'm making an exception in this case. First, these words are over two thousand years old. Second, they wonderfully describe Jim Wolfensohn. And third, the philosopher never met Elaine Wolfensohn.

Neither Jim nor Elaine Wolfensohn have ever lost their child's heart. Instead, they have given children a chance to claim the dignity most of us take for granted.

I've spent much of my career convincing people who control money - wealthy individuals, Congress, foundations - to invest in the most vulnerable people, or in the conditions that make them poor.

Sometimes just a few choice words - spoken at the right moment, and in the right way - were enough to remind my listeners that we are not put on this earth to be, we are put on this earth to do.

So here's my well-rehearsed message - and I know you welcome it.

Every dime we invest in poor children, every dime we invest in improving child care, training teachers, building schools, and supporting parents, every dime we invest in the curious minds and naturally loving souls of very young children - is a dime well spent. That has always been true. That is still true. But no institution - not government, not the private sector, not the academy - can say they're doing enough.

All of us - I repeat, all of us - need to do better.

That is why today I want to use the extraordinary forum of the World Bank to talk about some of the lessons we've learned from intervening early to help poor children. Even though my country is doing less in this area than I would like, there is still a wide consensus in the United States that investing in poor and other at-risk children - early in their lives - pays big dividends. Yes, more money is better than less. But some money is always better than none. The important point is that investment in early childhood development works. Notice the term "investment." It's a business term - first used by our corporate leaders in a report about education and children.

Building brainpower builds economic power - and building healthy bodies builds healthy nations. We cannot afford to waste a single future worker.

Let me give you an example. In the United States, April is National Child Abuse and Neglect Prevention Month. The number of children who were victims of abuse and neglect declined in the United States for the fifth straight year. And the incidence of maltreatment fell to 12.9 per 1,000 children - the lowest rate in ten years.

My Department released these numbers today. They demonstrate that by investing in child prevention programs that are community-based - and work with parents, schools and local health organizations - we can buy ourselves not only fewer abused children, but less violence in our schools, less substance abuse, less mental illness - and less intergenerational poverty.

We still have an unacceptably high level of child abuse. But we also have hard evidence that making life better for at-risk children is not a dream. Even with modest investments we can make a difference.

We know far more today about early childhood development than we knew even a decade ago. And we're still learning - still researching. That's why this conference is so important. We're here not only as a call to action - but to share what we've learned. Every child, in every corner of the globe, deserves to benefit from what we know - and from the progress we've made.

For the United States some of the most important lessons we've learned about early childhood development come from a program called Head Start. Let me give you a little background about Head Start. All you have to do is pick up an American newspaper to realize that much of what our government does starts with an argument over whether it should be done. That argument will sometimes go on for years. But Head Start - which this year celebrates its 35th anniversary - is different. This program of comprehensive early intervention for low income pre-school children - and their parents - enjoys remarkable support in both of our political parties.

The reason is simple. We know Head Start works. We know it's cost-effective. And we know it benefits our country.

Head Start began as part of President Johnson's War on Poverty. In the early 1960s, books like, "In the Midst of Plenty," by Benjamin Bagdikian, Michael Harrington's, "The Other America," and the television documentary, "Harvest of Shame," about poor migrant farm workers - raised the curtain on the extent - and depth - of poverty in the United States. Harrington, for example, in 1962 wrote that America's growing wealth was "creating a new kind of blindness about poverty." Millions of low - and very low - income families were suffering alone and in the shadows, unprepared to help their pre-school children, and passing on a life of poverty from one generation to the next.

At the same time, child development experts like Dr. Julius Richmond - who later served as both Assistant Secretary of Health and the United States Surgeon General - came to the view that poor children needed a hand up very early in life. Waiting until a poor child entered kindergarten was often too late. The public schools were simply incapable of making up the ground poor children were losing in the first years of life. Something had to be done. The time for making a national investment in poor children had arrived. So along with many other War on Poverty programs, we created Head Start.

Head Start was never intended to be simply an education program. It was always about creating a socially, emotionally and physically healthy child. A typical Head Start class will have 17 children, one teacher, one assistant and one other adult - usually a parent. At least ten percent of enrollment opportunities must be available to children with disabilities. The Head Start curriculum is high quality and standard across the United States, comprehensive and age-appropriate.

The curriculum pays a lot of attention to cognition and language. But that is only the beginning. Head Start children receive comprehensive health services, including immunizations, physical and dental exams, and nutrition services. Children receive help overcoming their fears. They learn to share, cooperate, listen and take turns. Head Start children receive lunch and a snack - and some Head Start children receive breakfast. So a typical day is a mixture of instruction, creative play - both inside and outside - and balanced meals. Head Start also focuses on family building. There is a lot of parental involvement - and parental learning. Parents make progress toward their own educational, literacy and employment goals by training and working in Head Start.

Although the funding for Head Start - and enrollment - have increased dramatically since 1965, Head Start maintains its core mission of developing the whole child - and enabling each child to reach his or her full potential.

That is exactly what Head Start has accomplished. Research tells us that children leave Head Start with a wide range of specific skills and knowledge they need to succeed in kindergarten. These practical, common sense achievements lay the groundwork for future learning and emotional development - in all our early childhood programs.

However, we refuse to rest on our past achievements. We have spent the last seven years expanding Head Start, strengthening parental involvement and learning, improving quality and demanding more accountability. Today, almost 900,000 children are enrolled in Head Start - and another 45,000 are in Early Head Start. Early Head Start was created by the President and Congress to meet the special needs of children zero to three.

A year ago, the President requested - and received from Congress - the largest budget increase ever for Head Start. This year we're asking for an additional one billion dollars for Head Start. This new funding will keep us on track to reach President Clinton's goal of one million children enrolled in Head Start by 2002. I know those are big numbers.

I also know that most countries are not in a position to fund early childhood education at that level. But the investment is more than worth the price. That's because every child we get into Head Start is one less child on the road to poverty with no off-ramp. I'm not saying that for every child, enrollment in Head Start is certain to break the cycle of intergenerational poverty. Nothing is that certain. But I am saying that the chances of escaping poverty go up.

So I repeat what I said earlier: When it comes to investing in early childhood development programs like Head Start, more money is better than less - and some is better than none.

I don't have all the answers on where that money should come from - although there are two international bankers sitting behind me. But I do have some answers on how to get the most out of the investments you make in early childhood education. These are lessons learned primarily from our three and one-half decades of experience with Head Start.

I call these Donna Shalala's Six Lessons for Children to Grow By.

The first, and perhaps most important lesson is: The Earlier Intervention Begins the Better.

That's why we started Early Head Start - for children zero to three. And that's why in April 1997, we held a White House Conference on Early Childhood Development and Learning. Research presented at the conference showed that ages zero to three are absolutely critical to a child's later development. Visual stimulation, touching, talking and emotional support all help an infant's brain to grow.

In one long-term study of poor children, half the children were assigned to high quality day care from infancy to age 5. The other half received only nutritional supplements and visits from social workers. As these children grew older, the group assigned to high quality day care were more successful later in life in almost every measurable way.

I emphasize the word quality. Because that is Lesson Two: Quality Counts. There's just no question about it.

I mentioned earlier how we continue to support Head Start with new money. But money alone is never the answer. That's why we're imposing new performance standards on Head Start centers. We have actually set aside 25 percent of all new money for quality investments - to pay for higher standards. These standards are tough. They're clear. And they're mandatory. Head Start's performance standards cover everything from whether a child is ready to read, to social development, to effective management.

Our goal is excellence - plain and simple.

If a Head Start grantee is having problems - we'll do our best to help. But in the end, if they can't measure up - they're out. Since 1995, 150 Head Start grantees have been terminated or relinquished their grants. The real winners of our demand for high quality are parents and children. I am very proud that at the end of last year, Head Start received the highest score of any government agency - or private company - in customer satisfaction. We even surpassed Mercedes-Benz and BMW.

Lesson Three is the logical extension of lesson two: Quality Early Childhood Education Begins With Training.

This may surprise some people, but the turnover rate for Head Start staff is a little under 11 percent a year. That is very low. Eighty percent of our teachers have five or more years experience - but not because we've lowered our standards. In fact, we've done just the opposite.

Today, all Head Start teachers are required to hold a special child development certificate, and by 2002, we want at least a majority of Head Start teachers to have a two or four year degree in early childhood education. To help make that possible, we're increasing the capacity of colleges and universities to teach early childhood education. You cannot have a well trained staff without anyone - or any place - to train them. We're taking this lesson one step farther by expanding the capacity of higher education to train child care staff to work with infants and toddlers. At the same time, we're putting more money into salaries - and investing in the health and safety of Head Start facilities.

Which bring me to Lesson Four: Parents Must be Involved and Accommodated.

One of the reasons that parents express such a high level of satisfaction with Head Start is that they we listen to them. We learn from them. And we encourage them to stay involved. This has been true since the earliest days of the program - and is the key to Head Start's success. Many Head Start parents actually go on to become Head Start teachers.

But keeping parents engaged and involved is not enough. We must also accommodate their changing needs. When Head Start began, there were far fewer women in the workforce - and far fewer single parent families. As work patterns change - Head Start has had to change. So we're expanding hours. Being flexible with hours. And even moving early childhood education programs into the workplace. We're also encouraging Head Start centers to partner with quality child care programs - because many children, at the end of their Head Start day, still need child care until their parents get home from work. Similarly, we've learned the importance keeping parents connected to the communities in which they live. That means being culturally sensitive, working with community leaders, and keeping as much decision-making as possible at the local level.

Lesson Five: Integrate Early Childhood Education With Other Needs

Poor children do not need one strategy. They need a comprehensive strategy that goes beyond early childhood stimulation and education. Integrated services - especially for infants and toddlers - is absolutely necessary for success. That's how we reduced child abuse and neglect. And that's why childhood immunizations was one of our earliest priorities. Next week we will celebrate childhood immunization week in order to keep that goal front and center. Today, 90 percent or more of American children receive the most critical doses by age two.

It took us a few years to get this done because we don't have universal health care coverage. We know that many countries struggle to purchase and distribute vaccines. But we also know that immunizations not only save lives - they save money by preventing disease before it strikes.

For the same reason, we're expanding access to health insurance for poor children. Three years ago we started what we call - the State Children's Health Insurance Program - to make sure millions more children from low income working families have health insurance. Just last Friday, I spoke at a conference called "Covering Kids," where I talked about the importance of using programs like Head Start - or child care centers - to find children who are eligible for health insurance. That's what I mean by integrating services, making sure that nurses talk to the teachers. That teachers talk to nutritionists. That nutritionists talk to staff. And that everyone talks to parents.

Which brings me to Lesson Six: Make Early Childhood Education a National Laboratory and Catalyst for Change.

There was an American movies several years ago called, "Field of Dreams." It was about a farmer who is told to build a baseball field out of a cornfield. The most famous line in the movie was, "If you build it, they will come." "They" meaning baseball players.

I have a updated version of that line for early childhood development: Build it and change will come. Head Start has been a national laboratory and catalyst for change. Since its founding in 1965, Head Start has transformed how we think about, educate and care for young children in this country. It has also transformed how we measure quality in all child care settings. Early Head Start is now doing the same for infants and toddlers.

My point is this: As you invest in early childhood education, maintain an active research agenda. One size will never fit all. So be prepared to figure out what works for what children - and under what circumstances. Then use what you know and learn to keep building something better - and to integrate the best research as quickly as possible.

The most important reason for investing in programs like Head Start or quality child care, is to even up the odds for poor children. There are great economic benefits for doing so. You've heard about some, and you'll be hearing a lot more during the course of this conference.

But there is also a profound moral purpose to why we're here. We are living in a new millennium. We have reached a point in our technological development where almost no scientific advancement seems permanently beyond our grasp. Yet millions of our children - on every continent - are struggling to survive. In the United States we sometimes call this a "disconnect" - two inconsistent ideas traveling side by side at the same time. The time has come to connect - to narrow the gap between what we're capable of doing and what we are doing.

Yes, we have learned much about how to help very young children grow up smart and healthy. And thanks to this conference we will learn a lot more. But the important step is the next step - to return to our homes, and communities and ministries, and universities, and organizations ready to invest in the first and most lasting hope of this new century - our children.

A two year old in the barrios of Peru. A baby crying for milk in Lagos. A little girl not yet four years old in the slums of Calcutta. A three year old in Head Start in rural North Dakota.

These children. All children - are our future.

Thank you.