Starting School Healthy and Ready to Learn: Using Social Indicators to Improve School Readiness in Los Angeles County

BACKGROUND: School readiness is an important public health outcome, determined by a set of interdependent health and developmental trajectories and influenced by a child's family, school, and community environments. The same factors that influence school readiness also influence educational success and health throughout life. CONTEXT: A California cigarette tax ballot initiative (Proposition 10) created new resources for children aged 0 to 5 years and their families statewide through county-level First 5 commissions, including First 5 LA in Los Angeles County. An opportunity to define and promote school readiness indicators was facilitated by collaborative relationships with a strong emphasis on data among First 5 LA, the Children's Planning Council, and the Los Angeles County Public Health Department, and other child-serving organizations. METHODS: A workgroup developed school readiness goals and indicators based on recommendations of the National Education Goals Panel and five key domains of child well-being: 1) good health, 2) safety and survival, 3) economic well-being, 4) social and emotional well-being, and 5) education/workforce readiness. CONSEQUENCES: The Los Angeles County Board of Supervisors and First 5 LA Commission adopted the school readiness indicators. First 5 LA incorporated the indicators into the results-based accountability framework for its strategic plan and developed a community-oriented report designed to educate and spur school readiness-oriented action. The Los Angeles County Board of Supervisors approved a countywide consensus-building plan designed to engage key stakeholders in the use of the indicators for planning, evaluation, and community-building activities. INTERPRETATION: School readiness indicators in Los Angeles County represent an important step forward for public health practice, namely, the successful blending of an expanded role for assessment with the ecological model.