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Health Manager Orientation Guide

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Physical Health

A doctor using a light to look at a young boys mouth and throat.Physical health is the foundation of school readiness. Children can build the skills, behaviors, and knowledge they need to succeed in school when they have access to nutritious foods, are physically active, and get enough rest. Head Start programs play a critical role in preparing children for learning by partnering with families to make sure their children have health insurance and a continuous source of medical and oral health care. Programs can also promote daily routines to help children learn and practice healthy and safe behaviors that lead to a lifetime of health and wellness. By engaging families in healthy practices through education, socializations, and home visits, programs can promote skills that support family wellness and physical health.

Programs can help families understand developmental screenings and referrals, illness and injury prevention, and how health issues affect children’s learning. Head Start programs should try to empower families to exercise their rights and seek out educational and community resources that address health.

Early and Periodic Screening, Diagnostic and Treatment (EPSDT) is a benefit through Medicaid that offers comprehensive and preventive health care services for children under age 21. EPSDT is key to making sure that children and adolescents receive appropriate preventive, dental, mental health, developmental, and specialty services. The program makes sure children get health checks at regular, age-appropriate intervals. Children receive physical, mental, developmental, dental, hearing, vision, and other screening tests to find potential problems and diagnostic tests to follow up when a risk is found, as well as treatment to control, correct, or reduce health problems. Besides meeting the requirements of EPSDT in their state, Head Start programs need to meet the Head Start Program Performance Standards (HSPPS) for health, nutrition, mental health, and safety.

Head Start programs can promote the physical health of children by helping families stay up to date on immunizations and their state’s EPSDT schedule. Programs can use screening and assessments to find children’s needs early, implement observations or other strategies for program staff and families to find new or recurring concerns, and suggest prompt referrals and evaluations.

Programs can also help families set a foundation for school readiness by supporting healthy pregnancies. Programs can provide education to families about what happens during pregnancy and how to ensure the baby’s healthy development. Pregnant people with early and consistent prenatal care have better birth outcomes. Families who have postpartum support are better able to nurture their growing infants.

Head Start Health Services Competencies

CFH-1 Believe that children and families have the right to be healthy and safe.

CFH-3 Be familiar with early childhood developmental milestones including cognitive, motor, language, and social and emotional.

CFH-4 Be aware that maternal and family health and wellness beginning with preconception influence health across the lifespan.

CFH-5 Know current EPSDT, dental periodicity schedules and immunization recommendations and requirements, and understand screening, assessment, and examination results.

CFH-11 Know about physical activity and screen-time recommendations for infants, toddlers, and preschool children, and physical activity recommendations for adults

CFH-14 Identify whether children are up to date on their EPSDT and immunization requirements.

CFH-15 Help families identify and overcome barriers to completing further diagnostic testing, follow-up, and treatment.

CFH-26 Assure staff implement health and safety practices including daily health checks.

CFH-28 Maintain effective recordkeeping systems, and accurately track individual child and family health information.

CFH-29 Collect and use child and family health history, including current health needs, to help children and families achieve optimal wellness.

HSPPS Related to Physical Health

Social Determinants of Health and Equity Considerations

Research suggests that many disparities in health and well-being are rooted in early childhood. For example, young children who live in poverty are more at risk as they grow up for illness and death and more likely to have poor quality of life. Unsafe and insecure housing, food insecurity, lack of access to high-quality early care and education, and other factors can harm children’s physical, cognitive, and behavioral development. Compared to other wealthy countries, the United States has some of the lowest indicators of early childhood health, including infant mortality rates, and health inequities in infant mortality are striking. The infant mortality rates for non-Hispanic Black infants are two times the rate of non-Hispanic white infants.

Preterm birth and low birth weight are related to infant death, chronic health conditions, and developmental delays. The rate of preterm birth among Black women is about 50% higher than the rate of preterm birth among white or Hispanic women.

Household income is a social determinant of health that affects the health of children. Children who live below the poverty line are more likely to have physical illnesses, including asthma. As a result of structural and systemic racism and other forms of oppression like classism, poverty disproportionately affects the health and wellness of Black, Indigenous, and children of color.

Comprehensive services in high-quality early childhood programs can help families by identifying concerns and reducing the time to diagnose and start treatment. Activities such as hearing and vision screening and identifying motor delays or children at risk for developmental disabilities improve early detection and referral to treatment.

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