Insights

If We Transform Early Childhood Systems, We Transform Society

Jill Sells, Clinical Director of Early Childhood Initiatives
"I believe all children should have the chance to reach their full potential. If we help them do so, we can transform their lives and transform society," says Jill Sells, MD, FAAP, NICHQ's Clinical Director of Early Childhood Initiatives.

Before Jill Sells, MD, FAAP, joined the National Institute for Children’s Health Quality (NICHQ), she helped spearhead the movement to bridge health and early childhood systems. “Publicity around the critical importance of early childhood began more than 20 years ago. At the time, I was working as a pediatrician immersed in the healthcare space,” recalls Sells. “I remember looking at a cover of Newsweek that focused on a baby’s brain and I found myself wondering, ‘Why hasn’t anyone connected this with healthcare?’ From that point forward, I knew I wanted to better support parents and young children, and find a way to make a difference.”

Sells succeeded at her mission. Among many other accomplishments, she served as executive director for Reach Out and Read Washington State, helped develop Washington’s Early Childhood Comprehensive Systems framework, Kids Matter, and helped lead the development of The Washington State Early Learning and Birth to 3 Plans.

Now, as NICHQ’s new Clinical Director of Early Childhood Initiatives, Sells is invested in improving early childhood systems on a national scale. Keep reading to find out more about her goals and learn what gets her up in the morning ready to drive change in early childhood systems.   

The early childhood landscape seems to be transforming. Can you provide some more context on how it has changed?

There has been a growing awareness that health and early childhood systems are trying to support the same children and families. Fifteen years ago, people working in healthcare didn’t often talk with people working in other aspects of early childhood, such as family support and early learning; and people in early childhood did not always see why doctors or the health system were relevant to their work.

Over time healthcare has transitioned to a quality approach to individual care with a broader understanding of the influence of population-level indicators of health—such as ethnicity, economic circumstance and education. And each of these indicators are powerful drivers in the early childhood and education systems as well. The growing awareness that the social determinants of health are the same as the social determinants of education, and that life outcomes are greatly influenced by what happens in early childhood, have created new opportunities to bridge systems together at the national, state and local level. It’s finally creating some impressive momentum in the early childhood space. Now we just need effective partnerships to make real progress.

Tell us more about the policy landscape and its impact on early childhood systems.

Advocating for policy shifts is critical, especially in terms of equity. We’ve already seen significant successes in this area—such as children gaining access to health insurance through Medicaid and CHIP—but we have a long journey ahead of us; and serious threats to access remain. Families need to be able to tap into all points of the early childhood system, from mental health to family support, to high quality child care and preschool. They should be able to access the information, skills and services they need to support their child’s health and development. Federal and state policies can provide more avenues to access this support, and begin to connect the dots into a more accessible system for families.

When the federal government invests in early childhood programs it makes others take notice, triggering increased state involvement while also driving funding from the private sector. And when energy builds around even one primary point of impact, that energy can spark change in children’s health systems across the nation. Policy changes are often the catalyst for important systemic changes.   

Why do you choose to work within this complex system?

To put it simply: if we get this right, we can really change the world.

I believe all children should have the chance to reach their full potential. If we help them do so, we can transform their lives and transform society. These children will grow up to vote, join the workforce and participate in their communities. Many will go on to have children of their own. We know that what happens in those first few years of life will set the stage for everything in a child’s future. Those early experiences will inform their social, emotional and cognitive development, as well as their overall health. If we prioritize these experiences, making a relatively small investment at the beginning of life, we can build people’s capacity to thrive and be part of a better world.

What’s your first piece of advice for those working to improve the early childhood system?

Focus on what already exists rather than what is missing. Start there.

We achieve sustainable change when we build from existing strengths. Most families are doing their best to help their children, but too often they face insurmountable challenges that many others will never face. If children don’t achieve their optimal health and development, it is a system failure, not a family failure. When we acknowledge this, we more easily identify both the significant barriers families face, and the efforts parents are already making to overcome challenges to their children’s optimal health and development. These bright spots, often family support networks and existing community organizations, are important places to start any change initiative. If, instead, we try new approaches that ignore the wisdom and strengths of families and communities, we will waste valuable resources, squander trust and ultimately fail our children.  

Finally, and most importantly, we must keep equity front and center. We need to be intentional about ensuring that our efforts enable those who face the most challenges to have a fair chance. Racism and poverty are two of the biggest challenges children and families face. Working within a community’s systems, genuinely listening to their struggles and their solutions: this approach, one that meets communities where they are, will be the most affective.

What do you most want to accomplish during your tenure at NICHQ?

To use cross-systems partnerships to create change. And create change quickly.

Since early childhood crosses so many systems and topics—from healthcare to home life; and from infant health to kindergarten readiness—the opportunities for change are seemingly endless. Yet, too many children still don’t reach their optimal health. We’ll change this when we fully leverage interdisciplinary approaches that put children and families at the center, and bridge the space between early childhood and health systems. This is part of the reason I am excited to be at NICHQ. It’s already built a foundation of partnerships across multiple sectors within different systems. And it’s doing this with others on a national scale. My goal is to work with our partners and build on this foundation to have national impact on early childhood health and development. Every child deserves a fair chance.

Interested in hearing more from our Executive Team? Click in to hear what NICHQ President and CEO Scott D. Berns is prioritizing in 2018 for children’s health.