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Early Childhood Development

Before the Committee for Economic Development

HHS Secretary Kathleen Sebelius

Washington, D.C.
May 2, 2014

Thank you very much.  I’m delighted to join you here this morning.

Since we have some great business leaders with us today, I thought I’d begin by talking with you about an exciting investment opportunity.

It’s an investment which promises solid dividends and long term growth.  In fact, its payout ratio is so solid that it’s projected to return at least $7 for every dollar that’s put in.

And there’s no fine print.  In fact, there’s only one catch: It’s an investment we must make together.

And when I say together, what I mean is that we need everyone: business, government, nonprofits, parents, doctors, nurses, educators, social workers, military, law enforcement, clergy and community leaders.

As you may have guessed by now, this investment is not a T-bill or a mutual fund.  Rather, it’s the investment we make together as a country in the health and education of our youngest children: infants and toddlers in those precious early years from birth to kindergarten.

I believe that this is the most significant and important long-term growth fund our country can invest in.

And you don’t just have to take my word for it.  Let me share with you a few words from a study released by a very impressive organization:

“Over recent years, the case for investment in the early years of childhood has become stronger and more urgent…We continue to believe that these human investments are among the most important that our nation can make, and that the business community should take the lead in making this case…”

These words are from the Committee for Economic Development’s study, “Unfinished Business.”

As an organization, you’ve been on the bandwagon for this issue since before the band started playing.

And I can tell you that we need your voice now more than ever.  President Obama is proposing to expand access to quality early education and important services for our country’s youngest children – and he’s being joined by leaders from business, the military, the faith community, and communities all across our country.

If we’re able to move forward, it will have an important impact on what kind of future we give the next generation.

Now, Martin Luther King once said that it’s important to preach to the choir, because otherwise, they could stop singing.

In this spirit, I want to talk with you today about why these investments matter – not only to our children, but to our country, to our economy, to our public safety, and to the fabric of our communities.

700 Neurological Connections a Second

Let me invite you to think, just for a moment, about a young child who’s been a part of your life.  Maybe you have a son or daughter.  Maybe you’re blessed –as am I – with a grandson or granddaughter.  Or maybe a niece or nephew, or a friend’s young child.

Remember what it was like to hold them in your arms for that first time.  Think of your astonishment at the first time you heard them speak.  Or when they took their first step.  Or when it was clear they started recognizing different people and objects.  Think about how quickly they started to form a personality and grow before your very eyes.

The human mind is every bit as sophisticated, complex, and miraculous as any technology out there.  And a child’s brain grows to 90 percent of its adult size by age 5.

In these first few years of a child’s life, the brain develops 700 new neurological connections every single second.

Harvard University’s Center on the Developing Child explains this phenomenon as “the connections that build brain architecture – the foundation upon which all later learning, behavior, and health depend.”

As these connections occur inside the brain, thousands upon thousands of connections happen external to it as well:

A child’s past is connected to the future by the choices a parent makes, and the choices we make as a country.

Our future economy is connected to how prepared that child is as she or he enters kindergarten.

That child’s health and ability to focus and concentrate in school are connected to how available and affordable we are able to make health care coverage to parents.

It’s also connected to the built environment.  The quality of the air that child breathes.  The cleanliness of the water that child drinks.  The amount of quality playtime.  The resources available at home. The presence of at least one caring adult.  And – very, very significantly – whether they are able to obtain quality preschool education.

What the Research Tells Us

What we know as parents and grandparents – and aunts, uncles, sisters and brothers – is that the actions we take at the beginning of a child’s life are actions that shape the course of that child’s life.

The science bears this out as well.  We know from a wide array of research that the investments we make in early childhood initiatives put those kids on a path to learn more in school, and earn more in the workplace.

Quality early education also is connected to fewer scrapes with the law, so as a community, we experience less crime.

As a country we save on prisons and jails, and the safety net services for those who can’t make it on their own.

And as more of our kids realize their fullest potential, we all benefit from a new generation of innovation, entrepreneurship, poetry, discovery, art, and progress.

From a classroom perspective, the research shows that students who attend preschool, succeed in elementary school.  A Utah study, for example, found that kids who received preschool education in the Beehive State went on to score 51 percent higher on their third grade math exams than kids who did not.

And findings in other states suggest that this phenomenon isn’t particular to the rarified air of the Rocky Mountains.

There is also a correlation between preschool and high school graduation.

And studies have shown that kids whose parents are able to get a home visit from a quality nurse, ultimately score better on their elementary school reading and math tests – and they go on to graduate high school in higher proportions.

The impact is felt outside the classroom as well.

From a health perspective, we know that healthier infants grow up to be healthier adults, who make healthier choices.

Unfortunately, we also know the inverse to be true.  Kids who experience difficulty like abuse or neglect in childhood are three times as likely to develop cardiovascular disease later in life.

They are also more likely to eventually be diagnosed with cancer, diabetes, and hypertension.  They are more likely to suffer strokes.  And they are more likely to become obese.

Unacceptable Disparities

The reality we face is that there are a number of unacceptable disparities between the opportunities provided to the children of lower-income families and the children of wealthier families.  And in some cases, these disparities become a self-fulfilling prophesy that follows a child throughout his or her development.

According to the Ounce of Prevention Fund, at-risk children who do not receive high-quality early education are:

  • 25 percent more likely to drop out of school,
  • 40 percent more likely to become pregnant in their teens,
  • 50 percent more likely to be placed in special education,
  • 60 percent more likely to never attend college, and
  • 70 percent more likely to be arrested for a violent crime.

In 2014, these disparities should not exist.

But the fact of the matter is that inequality in America begins in infancy.  Achievement gaps between kids from lower-income and wealthier families can begin showing up before a child reaches his or her first birthday.

More than 1 in 5 American children live in poverty.  More than 16 million American children live in households where they don’t always know where the next meal is coming from.  We know the air quality is often worse in neighborhoods with higher densities of lower-income families.  And we know that our youngest children often struggle to get basic health screenings and preventive care.

At the same time, fewer than 3 in 10 American 4-year-olds are enrolled in high-quality preschool.

All of these factors have major ramifications for our children’s health, education, and development.

As Geoffrey Canada – the President of the Harlem Children’s Zone – puts it, “Good dental care doesn’t MAKE you a good student, but if your tooth hurts, it's hard to BE a good student.”

Imagine trying to focus in a preschool or kindergarten setting if your stomach is growling because you haven’t had anything to eat.  Or if it’s upset because your family can’t afford healthier options.

Imagine trying to concentrate while wheezing from Asthma that has gone undiagnosed or untreated because your parents cannot afford health coverage – and with it preventive health services and screenings.

And imagine growing up in fear because you don’t live in a safe neighborhood.  Or without exercise because you don’t have a safe place to play.

This sort of adversity is still a part of daily life for far too many of our country’s youngest children.

At the same time, it’s been estimated that children from lower-income families are exposed to 30 million fewer words than kids from wealthier families – the so-called 30 million word gap.

Meanwhile, nearly half of children from lower-income families are not school-ready on their first day of kindergarten.  And by some estimates, kids from disadvantaged backgrounds can start school as many as 15 or even 18 months behind their fellow students.

Imagine starting a marathon 15 miles or 18 miles behind the other runners and trying to catch up to them as you all head for the finish line at mile 26.

Children from lower-income families often enter kindergarten knowing only one or two letters from the alphabet.  Middle-class kids are more likely to know every letter.  And along the same lines, only about half of children from low-income households are able to write their own name – compared to 3 in 4 kids from higher-income families.

One of the reasons that too few of our children are entering kindergarten fully prepared is that preschool is expensive in this country – and in far too many cases, it’s prohibitively expensive.

In the Economist magazine’s index of 45 OECD countries and emerging markets, the United States ranks 16th in affordability and 31st in availability of preschool education.  By contrast, the United Kingdom ranks 6th in affordability and 3rd in availability.  Germany ranks 12th and 8th.  France ranks 7th and 6th.

American parents who can afford to send their kids to preschool pay $36 billion every year for private care.

Given the expense of American preschool education, it shouldn’t be surprising that we rank only 26th among OECD members in 4-year-olds preschool participation.  Or that we rank 24th in 3-year-old preschool, and 22nd in the age that children begin early education.

Closing Disparities

I can tell you that President Obama is committed to reversing these trends and closing these disparities.

As one of his very first actions as President, he reauthorized the Children’s Health Insurance Program or CHIP, and with it, quality health coverage for 11 million American children – including some of our youngest kids.

Between CHIP reauthorization, Medicaid expansion under the Affordable Care Act, the availability of quality, affordable Marketplace insurance plans, and the new rights and protections afforded to families under the new health care law – we now have an unprecedented opportunity to get our youngest kids preventive services and screenings.

And when you consider that a child’s pediatrician can also screen for things like learning disabilities and parental depression, there is a considerable multiplier effect, when it comes to our ability to give our kids a healthy start.

From the earliest days of this Administration, I’ve been working closely with my friend and colleague, Secretary Arne Duncan, on a Birth-to-Kindergarten agenda.

Just this week I had the pleasure of meeting with grantee recipients from one of our joint ventures: the Race To The Top-Early Learning Challenge.

The idea behind this initiative is that we invest in projects at the state and community levels that are doing innovative work around three goals:

  1. Increasing the percentage of low-income and disadvantaged infants and toddlers in early learning;
  2. Designing and launching new early learning initiatives and services; and
  3. Ensuring that outcomes are properly measured and benchmarked.

To date, we’ve invested more than $1 billion in initiatives across 20 states.

As we at HHS continue to partner with the Education Department on these initiatives, each of our Departments also has some other very promising work underway.

Under Secretary Duncan’s leadership at Education, they are doing important work on Promise Neighborhoods, which take a holistic approach to improving the educational and developmental outcomes of kids from birth all the way through their entry into the workforce.

At HHS, the Administration for Children and Families is doing very significant work through an initiative called “Watch Me Thrive!” which promotes universal developmental and behavioral screenings, so that we can track a child’s progress in areas like language, social development, and motor development.

We know that the earlier we identify delays and concerns, the more effective we can be in providing services to those of our kids who need them, so they can thrive alongside their peers.

We’ve also been working to reform Head Start by implementing new accountability measures, making use of best practices, and moving forward with advanced training.

Early Education For Every American

One of the best things we can do for Head Start would be to pass the President’s Early Childhood package – and therefore free up Head Start to serve more younger children, especially those vulnerable kids at the lowest income levels.

As you may recall, the President laid out a vision in last year’s State of the Union for every child in America to have access to quality early childhood education and services.

The idea is that all children should have an opportunity to be in a high-quality learning environment and acquire social, emotional, and educational skills at the same time.

How well you do in school shouldn’t be determined by whichever zip code you happen to grow up in, or how much money happened to be in your parents’ bank account.

The President’s plan is a three-legged stool:

  1. The first leg is universal preschool for every four-year-old child in America.

And this is something that our global competitors are already doing: In Japan, virtually every 4-year-old attends preschool.  In Britain, 97 percent of 4-year-olds are enrolled in preschool.  And by 2020, China plans to provide 80 percent of its three- and four-year-olds with preschool education.

Meanwhile, the United States ranks 21st among OECD nations in early childhood investment.  So our choice in this country is really between keeping pace with our global competitors or falling behind.

  1. The second leg of the stool is to grow the supply of effective early learning opportunities for our children.

One of the best ways we can do this is by investing in new Early Head Start-Child Care partnerships through which we award competitive grants to communities that make Early Head Start available to more families.

Since child care can cost more than a third of a lower-income family’s budget, in many cases, this is a particularly urgent priority.  

  1. The third leg of the stool is evidence-based, voluntary home visitation.  It’s based on the premise that a child’s best and most important teachers are a child’s parents.

Voluntary home visits give some of our most vulnerable families the opportunity to have a visit from nurses, social workers, and other trained professionals who are able work with them on strategies for improving a young child’s health, development, and ability to learn.

Now, each leg of this stool is important – but unfortunately, none of them are free.

The funding proposal would increase the tobacco tax – and this has some very positive ramifications for our kids’ health.  We know that this tax deters our kids from starting to smoke.  We also know that today – and every day – 3,200 of our kids will try their first cigarette, and 2,100 kids and young adults will become daily smokers.

If we fail to reverse current trends, 5.6 million American children who are alive today – our children and our grandchildren, will die prematurely from smoking.

So the outcomes we want are not only connected to the investments we make, but also to the way in which we are making them.


It’s been written that “A dream you dream alone is only a dream. [But] A dream you dream together is reality.”

The business community has an important voice in our national dialogue when it comes to making all this reality for every child in America.

Many of your businesses are already contributing financially to efforts designed to strengthen our communities and expand more opportunities to our youngest children and our families.

And many of you are already doing important work by reading to your own young children and grandchildren, bringing them to their pediatrician, or enrolling them in a great preschool.

I know that part of your mission as a Committee is “Sustainable Capitalism” and it brings to mind the classic definition of sustainable development:

Development that meets the needs of the present without compromising the ability of future generations to meet their own needs.”

When it comes to our children’s own sustainable development, the investments we make from birth through kindergarten actually go a step further.  They allow us to meet our needs in the present while strengthening the ability of future generations to succeed in the community of nations.

So as I close, let me ask you once again to think about your own experiences with a young son or daughter, or grandchild, or niece or nephew… about 700 new neurological connections a second… and about the connections between the choices we make today and the people our children and grandchildren will grow up to be tomorrow.

Thank you all very much.

Content created by Assist. Sec./Public Affairs - Speechwriting Division
Content last reviewed on June 13, 2014