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The Impact of Nutrition Program Service Cuts on a Senior Population in Northwest Indiana

Reliance on social services and health care safety net programs has spiked as the country muddles through the “great recession” and a sputtering economic recovery; but just when need is increasing, budgets for these programs are being trimmed due to declining tax revenue at all levels of government and a pervasive concern regarding soaring government budget deficits. Countercyclical federal aid from the 2009 economic stimulus bill helped state and local social service agencies mitigate some of the more disastrous consequences during the first two years of the recession. However, these funds are nearly depleted. In order to balance government budgets, deep program cuts are being debated in Washington and state capitals as there is little appetite for additional government borrowing or tax hikes.

Private philanthropy is unable to fill the shortfalls in publicly funded programs. Aggregate national giving declined by 3.6% in 2009, marking just the second time in the last 50 years where total giving declined from a prior year. (Giving USA, 2010). Hence, local safety net programs, including those for home-bound seniors, are now facing some of their most extraordinary challenges in several decades.

Among the programs in the cross-hairs of the budget deficit hawks is the Older Americans Act (OAA) which is scheduled for funding reauthorization this year. Title IIIC of the OAA funds senior nutrition components, and on June 21, 2011, the Senate Committee on Health, Education, Labor & Pensions conducted a subcommittee hearing on Senior Hunger and the Older Americans Act. There, Senator Rand Paul(R-KY) and others questioned whether these nutrition program expenses are justified. (http://help.senate.gov/hearings/hearing/?id=8dd4f284-5056-9502-5d30-a66996ae4d55). This national debate has a direct impact on senior nutritional services and the health and well-being of seniors in Lake County, Indiana.

Background

Two rounds of belt tightening hit clients of the Meals on Wheels of Northwest Indiana (MoWNI) program, the first in October 2010 and another in January 2011. MoWNI is a local nonprofit organization affiliated with the national Meals on Wheels program. It offers nutritional and other services to seniors in the northwest region of Indiana including home-delivered meals to nearly 800 seniors in Lake County, approximately half of whom are fully or partially funded by Northwest Indiana Community Action (NWICA), the state’s designated Area Agency on Aging for the six-county region. It also provides services to other Northwest Indiana counties and receives financial support from the Lake Area United Way and other private donors.

NWICA reduced funding and trimmed care plans for 283 low-income seniors receiving services from MoWNI in Lake County. It had little choice but to require the reductions. Demand for senior services increased dramatically since the onset of the recession in 2008, food and fuel costs rose, and as the NWICA costs grew its budget was cut. In July 2010, NWICA was handed a 10% budget reduction in federal OAA, Title IIIC funds.

The other principal funding source for senior nutrition programs is the state-funded CHOICE plan. It is available to seniors who are not eligible for Medicaid services under the state’s waiver. CHOICE’s budget is fixed because it is not eligible for federally-subsidized Medicaid funding. The state could have supplemented the Title III funding, but it did not choose to do so.

Concerned about the potential impact these service cuts would have, MoWNI asked the School of Public and Environmental Affairs (SPEA) at Indiana University Northwest to determine if these service reductions were having deleterious effects on their beneficiaries. The assessment was taken on as a service-learning project by the Spring 2011 SPEA Management in the Nonprofit Sector class of Indiana University Northwest.* 

MoWNI provides home-bound seniors with nutritionally balanced hot lunches and cold supper snacks (sandwich, fruit and milk) five days per week. In addition to the direct nutritional benefits, the weekday visits provide welcomed social contact to an often isolated population. This reassurance checking and regular social interaction buttresses the goal to have seniors “age in place” instead of living in institutional settings. MoWNI services also help community-based seniors financially since money which beneficiaries would have been spent on food can be reallocated to medications, heat, and other necessities.

In October 2010 and again in January 2011, NWICA reduced the services authorized in the care plans of 283 of MoWNI’s clients, roughly three-fourths of its publicly-funded beneficiaries in Lake County. These clients sustained cuts in one of the following ways. Some seniors had their food deliveries reduced from five to three days per week, a 40% reduction. Others had their cold supper snacks eliminated.

Among the beneficiaries who were reduced from five to three weekly home deliveries, some volunteered to pay for the other two days at the modest rates charged to privately-funded beneficiaries. It costs MoWNI $5.90 per day to purchase, prepare, and deliver its meals, but thanks to philanthropic support, private clients pay only $4.25. However, purchasing the food deliveries, even at the subsidized price, can cause hardships that have health status consequences for this low-income population, so we consider this as another type of benefit cut.

Methods

A confidential survey was mailed on March 1, 2011 by MoWNI to the 283 beneficiaries who sustained service cuts. (See Appendix A for a copy of the survey.) Of the 283 surveys sent, 95 MoWNI beneficiaries replied, for a credible response rate of 34%.  We would have preferred a larger response rate but this was prevented in part by confidentiality constraints. To assure complete client privacy, responses were returned to MoWNI, and the surveys had no identifiers. Consequently only one round could be fielded since we could not identify nonrespondents and send a second request for their participation.

However, if there is a bias in the sample, it likely to be an underrepresentation of the most functionally impaired, such as those beneficiaries who have the most difficulty seeing, reading, completing forms, etc. If the most frail elderly are underrepresented in the sample, then the impact of the service cuts we were trying to determine would likely be understated.

The survey items were developed from a literature review of senior hunger, geriatric nutrition and dietary research, and an examination of validated survey instruments used to measure senior hunger risk factors (Chen, Schiling, & Lyder, 2001; Holmes, 2006; Poh, 1996; Soderhamn, Bachrach-Lindstrom, and Ek, 2007; Shepherd, 2009; Ziliak and Gundersen, 2009). It targeted nutrition, behavioral factors, social isolation, and food security based on their documented ties to overall geriatric health and the impact these factors have on maintaining the independence of individuals in the community as they advance in age (Chen, Schiling, & Lyder, 2001).

The consensus in the literature is that although energy requirements tend to fall with advancing age as people become less active, seniors’ nutritional requirements are similar to those of younger adults. Elderly people still need small nutritionally dense meals and regular healthy snacks to achieve optimal nutritional status (Shepard, 2009). Inadequate nutrition is closely associated with increased and more extended hospitalizations, frailty, exacerbation of medical conditions and increased incidence of disability (Chen, Schiling, & Lyder, 2001).

Social factors such as isolation have been shown to affect seniors negatively in multiple ways, including depression which reduces appetite, level of energy, and the likelihood to prepare and eat meals (Lee, 2004). Seniors tend to eat more and better when others are present, and the absence of mental stimulation has been shown to accelerate and exacerbate the onset of Alzheimer’s and other mental degenerative conditions (Denny and Sara, 2008).

Food insecurity is “a lack of access, at times, to enough food for an active, healthy life for all household members; limited or uncertain availability of nutritionally adequate foods; or an uncertain ability to acquire acceptable foods in socially acceptable ways” according to the U.S. Department of Agriculture defines (Nord, Andrews, and Carlson, 2008).  Both food insecurity and poor nutritional status figure significantly in the need to institutionalize a senior (Ziliak and Gunderson, 2009). Hence, our survey targeted both food insecurity and nutritional status.

The survey also asked demographic information on age, gender, ethnicity, household size and income so we could determine if there were subsets of seniors at greatest risk.

Results

Population Characteristics

The MoWNI beneficiary population which sustained benefit cuts was comprised primarily of low-income seniors. A majority (57%) reside in households with incomes less than $13,000, which is 119% of the federal poverty level(FPL) for a family of one and 88% of the FPL for a household of two for 2011 (Federal Register, 2011). Thirty-six percent resided in households with incomes between $13,000 and $26,000, and just 7% reported household income in excess of $26,000.

Survey respondents ranged in age from 65 to 98, with a mean age of 80 and a median of 81. With respect to ethnicity, respondents were nearly equally divided between African-Americans (n=42) and Caucasians (n=41). Two respondents identified their ethnicity as Latino, one as Asian, one as Other, and eight did not respond to this question.

Respondents reported maintaining good health habits. Fewer than 9% smoke; just 3% consume three or more alcoholic drinks per day; 91% see a doctor regularly; and 99% are aware of the importance of good nutrition to their health.

However, MoWNI beneficiaries are a vulnerable, socially isolated population. As one respondent stated on her survey form, “They are the only people I see during the day.” Most MoWNI beneficiaries are home-bound, two-thirds eat alone, and only 29% have a daily caregiver. The prevalence of risk factors associated with senior nutritional deficiencies is shown in Table 1. Although 95 surveys were returned, not all items were answered by all respondents, so the number of respondents as well as the percentage of those who answered affirmatively is shown in both tables.

Table 1: Percentage of Respondents with Risk Factors for Senior Nutritional Deficiencies

	Percent Answering “Yes”	N
Eat alone most times	67	86
Unable to prepare a meal even with food in home	38	84
Have a daily caregiver	29	85
Have visitors regularly	49	88
Ability to leave your home unassisted	44	90
Leave your home during the course of the day	44	77

Impact of Reduced Services: Food Insecurity

We were unable to obtain region-specific information on food insecurity among seniors, but we did identify recent statewide and national data. In 2007, 5.9% of Indiana seniors were food insecure, making it the twelfth worse state in the country on this measure, and the only state among the lowest quartile above the Mason-Dixon line or in the Midwest. For example, the proportion of seniors who were food insecure in adjacent Illinois was 3.9%. The national 2007 average rate of senior food insecurity was 5.7%, with the worst state in the country, Mississippi, at a 12.3% rate. (Ziliak and Gunderson, 2009) In relative terms, Indiana seniors were starting from an already relatively food insecure base when the recession hit.

Table 2 illustrates the prevalence of food insecurity among MoWNI beneficiaries experiencing benefit cuts. One-fourth of respondents answered “Yes” to at least one of the four questions designed to capture food insecurity, and more than one-fifth of the group either feared they would run out of food or were unable to purchase foods recommended for their diets.  Positive correlations among these four items were strong (r=.62 to .67) and statistically significant at <.01 level.

It should be noted that due to an inadvertent error in two items in the survey instrument (“Worried you would run out of food in the last 6 months” and “Unable to buy the right foods because of lack of money in the last 6 months”), there were particularly low response rates for the second and fourth items reported below. Had this not occurred, it is quite likely that more than 23 of the respondents would have answered “Yes” to one of the four items used to capture food insecurity and the overall estimate of food insecurity would have been greater than 25%.

Also, we should note that there were several comments indicating an increase in food insecurity from the individual comments made on the survey and in follow-up phone calls to those who agreed to be interviewed. Two examples are: “I’m receiving fewer meals after the second budget cut. I only receive ‘Meals on Wheels’ three days. I lost 14 pounds since January”; and “I miss my cold supper meals. I’m getting by on frozen meals. The portions are too small; I don’t feel full but it will do.”

Table 2: Food Insecurity Indicators

	Percent Answering “Yes”	N
Run out of food in the last 6 months	13	89
Worried you would run out of food in the last 6 months	21	52
Hungry or did not eat because you could not afford food in the last 6 months	8	89
Unable to buy the right foods because of a lack of money in the last 6 months	23	60
Respondents answering “Yes” to one or more indicator	25	91

Impact of Reduced Services: Weight Loss

The most disturbing finding from the survey is not shown in the tables. More than one-third (35%) of respondents reported losing weight during the previous six month. This is a larger proportion than those who were found to be food insecure, but this seemingly anomalous result may be explained in a number of ways. First, the survey may not have captured all respondents’ opinions due to the error in the instrument noted above, so the percentage may have been considerably more than 25%. Also, seniors are known to be reticent with respect to “complaining” as exemplified by the respondent comment above, “I don’t feel full but it will do.” So although their services were reduced and they experienced weight loss, respondents may not have revealed their true opinions on the food insecurity questions. Finally, some respondents may have lost weight due to medical conditions or other reasons unrelated to food insecurity brought on by the service cuts.

We know that there was weight loss from the individual comments made on the survey and in follow-up phone calls to those who volunteered to be interviewed. As noted above, one respondent stated he had lost 14 pounds and another contended that she had “lost 9 pounds” since the services were reduced.

Program cuts were found to be an equal opportunity stressor with weight losses reported proportionately in all demographic categories. Statistically significant correlations with weight loss during the prior six months were found when examining individual variables. However, when multiple regression was applied, these associations all washed out except for age which was found to be a tiny (.013), but statistically positive predictor for weight loss during the prior six months.  This finding contradicts Ziliak and Gunderson (2009) who found that the younger a senior was, the more likely they were to be food insecure.

No statistically significant differences were found in the likelihood of recent weight loss due to income level, gender, ethnicity, household size, eating alone, caregiver presence, or for any other measure of social isolation. Except for a very weak statistical association with advancing age, these service cuts were harming all beneficiaries similarly.

Discussion

We acknowledge limitations to this study. Our database will not allow us to determine how much of the reported weight loss or food insecurity status found here is attributable solely to service cuts. However, given that the respondents’ proportions are so much greater than statewide and national benchmarks, certainly some of the reported weight losses and status as a food insecure household must be a result of receiving less food and/or having to pay out of pocket for previously funded meals. Clearly, some seniors are being harmed as a consequence of these budgets cuts.

Given today’s political climate, we fear that these recent cuts are just the tip of the iceberg for the frail elderly and other vulnerable populations. Today, proposals are being debated by the Congress which would turn Medicare into a health insurance premium subsidy program and Medicaid into a state block grant. The loss of entitlement status for these two longstanding health programs that seniors rely upon would be quite detrimental to health and well-being of the elderly population. Other seniors’ programs like Social Security which have been fixtures for generations are similarly threatened.

We hope these findings will make public policy-makers slow down and consider more carefully the potential harms that can befall safety net program beneficiaries as they review options to reduce spending at the federal, state, and local levels. Like the predominant positions of the experts who testified at the recent Senate hearings on the reauthorization of the OAA, (http://help.senate.gov/hearings/hearing/?id=8dd4f284-5056-9502-5d30-a66996ae4d55) we too believe that reducing community-based supports for the elderly is a penny-wise-pound-foolish deficit reduction strategy with a high likelihood of backfiring.

Program cuts like the ones examined here can easily lead to more senior hospitalizations and more of the frail elderly leaving the community to spend the rest of their days in nursing homes, paid for by Indiana Medicaid. Nutritional frailty leading to Sarcopenia (unintentional loss of body weight and lean muscle mass in seniors), is a leading cause for hospitalization and eventual institutionalization for the elderly (Bales and Ritchie, 2002). Fifty percent of hospitalized elderly patients are malnourished (Chen, Schilling and Lyder, 2001).

Seniors account for roughly one-eighth of the U.S. population, but in 2009 more than half of U.S. hospital admissions and 70% of the aggregate cost for hospitalized patients with a principal diagnosis of “Nutritional Deficiencies” came from the age 65 and older population for a total price tag of $345 million (AHRQ, H-CUP, 2009). More than half of all admissions and nearly 60% of all costs for hospitalized patients with a principal diagnosis of “Fluid and electrolyte disorders” were also patients age 65 and older. The national hospital tab for seniors with this diagnosis is nearly $5 billion (AHRQ, H-CUP, 2009).                                         

If the risk of increased hardship is not a sufficient deterrent to senior nutrition program budget reductions, perhaps the risk of far greater hospital and nursing home costs will dissuade the deficit hawks. Nutritionally-caused nursing home admissions can be averted with the standard MoWNI five-day-per-week hot lunches and cold supper snacks. As April 30, 2011 the weekly cost to the state for full MoWNI services was $29.50, and the statewide average Medicaid reimbursement rate for one week in a skilled nursing facility (SNF) was $1,067  (Myers and Stauffer, 2011).

Of the 86 respondents who answered the question, 30 seniors stated they lost weight in the last six months. If just one member of this group of 30 ends up in a SNF due to the recent service cuts, that person’s nursing home costs will exceed the entire cost for all 30 beneficiaries for full MOWNI services by 20%. If  just one-tenth of this group, three of these 30 seniors, are admitted to a SNF, the state will have forfeited enough funding for full MoWNI services for more than 100 beneficiaries. Which is a more prudent taxpayer expense, home-delivered meals or nursing home care?

 State and federal policymakers should heed the findings in this case study and the rest of the literature. Seniors want to live out their lives in the community and taxpayers want smart fiscal policies. Cutting seniors’ community-based nutrition programs thwarts both goals.

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

* The authors are indebted to the Spring 2011 class members of the Management in the Nonprofit Sector class (V525) of Indiana University Northwest who developed the survey instrument and completed an initial analysis. Those students are: Sheree Barnett, David Blakely, Dolores Blakely, Alice Chess, Joyce Dix, Vincent Harris, Aleeza Moore, Daniel Paredes, Linda Randolph, Sharon Read, Cynthia Rivas, Patricia Rocha, Cynthia San Miguel, Iris Sanchez, Raul Sanchez, Cheryl Smith, Laura Smith-Wynn, Monique Watson, Lena Wilburn, and Almeta Williams.

We also thank Sandra Noe and Tula Gogolak executives from Meals on Wheels of Northwest Indiana, without whose cooperation and support, this study could not have been undertaken or completed.

References

Agency for Healthcare Research and Quality (AHRQ). Healthcare Cost and Utilization Project (H-CUP) (2009). http://hcupnet.ahrq.gov/HCPUnet.jsp?Id=B45934B8E95B&Form Viewed May 27, 2011.

Bales CW and Ritchie CS (2002). Sarcopenia, Weight Loss, and Nutritional Frailty in the Elderly. Annual Review Nutrition. 22:309-23. Doi:10/1146/annurev.nutr.22.010402.102715.

Chen CCH, Schilling LS, and Lyder, CH. (2001) A Concept Analysis of Malnutrition in the Elderly. Journal of Advanced Nursing, 36(1), 131-142.

Denny A and Sara S. (2008). The role of nutrition in healthy aging. Practice Nursing, Vol.19, No. 5.

Federal Register, Vol. 76, No. 13, January 20, 2011, pp.3637-3638. The 2011 HHS Poverty Guidelines. http://hhs.gov/poverty/11poverty.shtml.

Giving USA Foundation, GIVING USA 2010, The Annual Report on Philanthropy, 2009, Executive Summary. The Center on Philanthropy at Indiana University. www.givingusa.org.

Holmes SB (2006). Nutrition Matters for Older Adults. Journal of Community Nursing, Vol. 20, Issue 2.

Myers and Stauffer LC, Indiana Medicaid Rate Setting Contractor, Cumulative Rate Listing, pp. 1-114. Viewed May 28, 2011 at http://in.mslc.com/Resources/documents/statenfautocumrpt.pdf.

Nord M., Andrews A, and Carlson S. Household Food Security in the United States, 2008. ERR-83, U.S. Dept. of Agriculture, Econ. Res. Serv. November 2009.

Poh RW (1996). Bridging the gaps in geriatric care. Health Progress. November-December 1996.

Shepherd A. (2009).Nutrition through the lifespan. Part 3: Adults aged 65 years and over. British Journal of Nursing, Vol. 18. No. 5.

Soderhamn U, Bachrach-Lindstrom, and Ek AC (2007). Nutrition screening and perceived health in a group of geriatric rehabilitation patients. Journal of Clinical Nursing, 16, 1997-2006.

US Senate Committee on Health, Education, Labor, & Pensions. Subcommittee Hearing – Senior Hunger and the Older Americans Act. http://help.senate.gov/hearings/hearing/?id=8dd4f284-5056-9502-5d30-a66996ae4d55. Viewed July 12, 2011.

Ziliak J and Gunderson C. (2009, Sept.) Senior Hunger in the United States: Differences across states and rural and urban areas. University of Kentucky Center for Poverty Research Special Reports. http://www.ukcpr.org/Publications/senior-hungerfollowup.pdf.

 Appendix A

Meals on Wheels Questionnaire

Please help us assess how the recent changes in your services have impacted you, by completing this confidential survey.

Please return the survey in the postage paid envelope by March 15, 2011. 

Tell Us About Yourself:

Female _____      Male _____   Age: _____     Household size:  ______

Ethnicity:  African-American/Black ___ Asian ___ Caucasian/White ___                    Latino/Hispanic ___ Other ___

Annual Income:

 Less than $13,000 ____  $13,000-$26,000____More than $26,000 ____

Place an X in the appropriate choices indicating how often you eat or drink the following:

	Daily	Most Times	Some Times	Never
Breakfast
Lunch
Dinner
Snacks
Fruits
Vegetables
Milk/Dairy
Eat fewer than 2 meals per day
Have 3 or more drinks of beer or liquor

 

Please See Reverse Side to Complete Survey

Please circle Yes or No
Did you know, if you don’t eat nutritious food, your health can be affected?	Yes	No
Are you a smoker?	Yes	No
Are you seeing your doctor regularly?	Yes	No
Are you drinking 8 glasses of water or fluid daily?	Yes	No
Do you have a daily caregiver?	Yes	No
Do you have the ability to leave your house unassisted?	Yes	No
Do you leave your house during the course of the day?	Yes	No
Do you have visitors regularly?	Yes	No
Do you eat alone most of the time?	Yes	No
Are you unable to prepare a meal even when there is food in the house?	Yes	No
In the last 6 months have you run out of food?	Yes	No
In the last 6 months were you worried you would run out of food?
In the last 6 months were you hungry or did not eat because you could not afford food?	Yes	No
In the last 6 months were you unable to buy the right foods for your health because of no money?
In the last 6 months have you had any weight loss?	Yes	No
Would you be willing to discuss your food and eating situation in more detail?	Yes	No
If Yes, please provide your First Name only, phone number and best time to call.   First Name:  ________________________ Number:  __________________________         Best time to call me: _________________

 

 

 

Cellphones in the Classroom?

• Cell phones: Marvelous technology however a ringing or beeping phone is rude and distracting to others in a learning environment.  Remove cell phones from your desk, hands, ears, waist, neck or head.  I will subtract (25) points for a ringing phone also for answering, talking, texting or receiving messages on a device during class without permission.  (Jones, 2010)

Curriculum & Schooling: Multiculturalism, Critical Multiculturalism and Critical Pedagogy

Schools exist to prepare young people for the future. Throughout that future, students will be exposed to a multiethnic societal curriculum. How they perceive the curriculum,  how it affects their beliefs and attitudes, and how it influences their interethnic behavior will, to a great extent, be a result of  today’s schools preparing them to be multiethnically literate (Banks & Banks, 2008).

Changing schools to reflect the ethnic diversity within American society provides a tremendous opportunity to implement the kinds of significant curriculum reforms —including conceptual teaching, interdisciplinary approaches to the study of social issues, and value inquiry. Such change also provides opportunities for student involvement in social action and social participation activities. Thus, multicultural education/critical multiculturalism can serve as a vehicle for general and substantial educational reform. This is probably its greatest promise. We can best view multicultural education/critical multiculturalism as a process as well as a reform movement that will result in a new type of schooling, presenting novel views of the American experience and helping students acquire the knowledge, skills, and commitments needed to make our nation and our world more responsive to the human condition. In the following sections of this article, I will provide a definition and overview of various approaches to multicultural education, describe its potential to reform schools, and illustrate how these goals may be achieved in the classroom, with a particular focus on the training of preservice teachers.

An Overview of Multicultural Education

Multicultural education has become the common term used to describe the type of pluralist education that its advocates are seeking for all children receiving an education.  Supporters of multicultural education (e.g., Banks, 2008; Sleeter & Grant, 2003) claim that, at the societal level, its major goals are to reduce prejudice and discrimination against oppressed groups, to work toward equal opportunity and social justice for all groups, and to effect an equitable distribution of power among members of different cultural groups (Sleeter, 1996). Within the field of education, Banks (1993) views the primary goal of multicultural education as transforming schools so that “all students will acquire the knowledge, attitudes, and skills needed to function in an ethnically and racially diverse nation and world” (p. 28). In what is perhaps the most comprehensive definition of multicultural education, Sonia Nieto (2000a) states:

multicultural education is a process of comprehensive school reform and basic education for all students. It challenges and rejects racism and other forms of discrimination in schools and society and accepts and affirms the pluralism (ethnic, racial, linguistic, religious, economic, and gender among others) that students, their communities, and teachers reflect. Multicultural education permeates the schools’ curriculum and instructional strategies, as well as the interactions among teachers, students and families, and the very way that schools conceptualize the nature of teaching and learning. Because it uses critical pedagogy as its underlying philosophy and focuses on knowledge, reflection, and action as the basis for social change, multicultural education promotes democratic principles of social justice. (p. 305)

Multicultural education relates to the recognition of values, lifestyles, and symbolic representations. Bennett’s (1999) definition of multicultural education provides a foundational explanation to an approach to teaching and learning that, from her point of view, is:

based upon democratic values and beliefs, and affirms cultural pluralism within culturally diverse societies … It is based on the assumption that the primary goal of public education is to foster the intellectual, social, and personal development of virtually all students to their highest potential. Multicultural  education . . .  [includes] . . . the movement toward equity, curriculum reform, the process of becoming interculturally competent, and the commitment to combat prejudice and discrimination, especially racism. (p. 11)

Although the promises of multicultural policies are, for the most part, yet to be realized, multicultural education continues to focus on adaptation of the schools to the idea of multicultural education (Ghaffari, 2000). Thus, one of the more effective ways to implement multicultural education in the schools is by preparing preservice teachers in the theory and practice of multicultural education.

Multiculturalism, an established discipline in the field of education, manifests a body of knowledge, texts, and curricula (Banks, 1993; Bennett, 1999; Gay, 2004; Giroux, 1983). Despite the debate about the nature and goals of multicultural education, the discipline has carved out a place in the minds and hearts of educators. An examination of the literature on critical multiculturalism leads to questions about multiculturalism and critical pedagogy: How might these constructs contribute to the ways we think about curriculum and education? And what are the implications for curriculum in general and teacher education in particular? To better understand the various conceptualizations of multicultural education, I briefly discuss traditional and liberal multiculturalism, and  provide an explanation of critical multiculturalism, connecting it to critical pedagogy that has been a focus in classrooms.

The Traditional Multicultural Perspective

The traditional perspective is often called conservative multiculturalism in education. Socially, it refers to an antagonistic tension between the recognition of diversity, with the risk of fragmentation, and the necessity of defining a common society with the affirmation of a national identity. Traditional multicultural tenets tend to see culture as fixed, essentialist, and predetermined (Taguieff, 1997). Traditionalists are concerned primarily with the expeditious transmission of the cultural heritage of the dominant society through the fixed body of knowledge and the perpetuation of the existing social order (Banks & Banks, 2007). Individuals such as Franklin Bobbitt, Ralph Tyler, E.D. Hirsch, and advocates of “back to basics” curricula fall into this category. What one assumes as being a universal culture is the manifestation of Western-centrism. This view has failed to “promote a systematic critique of the ideology of ‘Westernness’ that is ascendant in curriculum and pedagogical practices in education… [although its] proponents articulate a language of inclusion” (McCarthy, 1994, p. 89). In fact, the consequences are the perpetuation of established groups’ hegemony and the marginalization of disadvantaged or segregated groups. In education, traditional multiculturalism favors the reproduction of the value of the mainstream society or “cultural production” (Bourdieu & Passeron, 1970). From the traditional perspective, neither mechanisms of racism nor ethnocentric biases regarding Westernness or Eurocentrism are requestioned. Hence, from the traditional perspective, the world is as it is. 

Conservative Critiques of Multicultural Education

The target of conservative critics is not the multicultural education literature itself; their targets are curricular changes and policies being instituted in schools and universities on a wide scale. Their point of contention is not so much whether education should be multicultural but what that should mean. Ratvitch (1990) insists that the curriculum is already multicultural because “the common culture is multicultural” (p. 10). Stotsky (1991) optimistically explains that reasonable citizens “should applaud the integration of non-Western cultures and the histories of various minorities—women, Hispanics, Blacks, Native Indian communities—into our schools’ curricula” (p. 26).

The main concern of conservative critics is that schools and universities are responding to diversity in an increasingly harmful manner, and that damaging ideas increasingly drive public education, with “myths of multiculturalism fed to all school children by a state monopoly that is masquerading behind the values of tolerance, diversity, and pluralism” (Stotsky, 1991, p. 26). Furthermore, this “spread of new multicultural perspectives throughout schools has taken place without much notice” (Gray, 1991, p. 13). The public needs to be aware of perilous changes in schools (Gay, 2004) and of dangerous effects of U.S. immigration policies (Auster, 1992). These circumstances lead to changes in schools’ demographics, and teachers need to be prepared to be sensitive to the cultural diversity in their classrooms that results from these changes.

The Liberal Multicultural Perspective

Liberal multicultural education values cultural pluralism, which is, according to Bennett (1999):

an ideal state of societal conditions characterized by equity and mutual respect among existing cultural groups. It contrasts sharply with cultural assimilation or “melting pot” images, where ethnic minorities are expected to give up their traditions and blend in or be absorbed in the mainstream society or predominant culture. (p. 11)

According to Grant (1994), multicultural education proposes to adapt curricula, teaching styles, learning strategies, and communication between school and families. Also, it favors the adaptation of schools to the needs of students and parents. Most teachers who abide by the established practices of liberal multiculturalism try to incorporate some aspects of cultural diversity (such as diversity of religion) into their curriculum, support bilingual education, believe in the typology of racism, and reflect on the impact of ethnocentrism.

Based on the willingness to diversify the curriculum and add cultural content, this approach favors differences and similarities without trivializing and folklorizing cultures proposed in the curriculum. In such a reality, teachers will need to be prepared to understand students from different backgrounds, to teach content that does not represent mainstream culture only, and to learn to communicate with parents. This position sees culture not as fixed and essentialist, as in the traditional position, but as dynamic and flexible. From the liberal perspective, mechanisms of racism requestion the social construction of superiority and inferiority, discrimination, and exclusion based on physical or ethnic differences, whereas ethnocentric biases revisit the perspective of universality. Hence, from the liberal perspective, the world might be different.

Critical Multicultural Perspective

Historically, multicultural studies have encouraged us to advocate traditionally underrepresented and excluded cultures and to consider them in their own right rather than through the lens of any single culture (Giroux, 1983). Critical multicultural education encourages students to see in a variety of ways so that they may begin to understand the complex web of intersectional and intercultural relationships in the United States today. Contemporary scholars have called for a modification of traditional multicultural education toward a critical multiculturalism that seeks to promote democratic initiatives in curriculum, pedagogy, and social relations in the schools (McLaren, 2003). Critical multiculturalism promotes understanding and participating in a diverse society and supports the efforts directed toward attaining social, cultural and emotional harmony.

Critical multiculturalism suggests that, as teachers/learners, we each give ourselves to the process of transformation through our own personal means and in dialog with others (Freire, 1998). Transformation requires teachers to be “impatiently patient” and to become actors in our own development as human beings (Freire, 1994). Slowly, patiently, and with agency, transformation congeals around the central theme of developing a political economy of historical agency (Freire, 1998).

Critical multiculturalism is to be understood as referring to multicultural education operating on the notion that both the teacher and student in the classroom must have the flexibility to draw on the well-ground of history and on the variety of cultural resources that fan out across the myriad groups that make up society and the world.  In promoting this framework, I challenge the tendency toward lukewarm curriculum programs of cultural pluralism that are associated with models of multicultural education. A critical multiculturalism also seeks to safeguard the idea that teachers and students are products, not simply consumers, of knowledge, while at the same time pointing to the social interests and purposes that are implicated in the school curriculum. 

Criticizing modern society, Sleeter and Grant (1994) aimed at “the elimination of oppression of one group of people by another” and expressed their hope “that the entire educational program is redesigned to reflect the concerns of diverse cultural groups” (p. 209). This perspective recommends that all students take into consideration all aspects of educational practices—including curriculum concerns, instruction, different aspects of the classroom, and support for the regular classroom—to include as much diversity as possible. Other school-wide features can “involve students in democratic decision making...involve lower-class and minority parents actively...involve schools in local community action projects...[and] include diverse racial, gender, and disability groups in non-traditional roles” (p. 211). Sleeter and Grant (1994) argue that school goals have to “prepare citizens to work actively toward social structural equality; promote cultural pluralism and alternative life styles; [and] promote equal opportunity in the school” (p. 211). Although some authors have insisted that the development of learning skills is necessary for students to become critical, conscious, and socially active, others have focused on establishing congruence between what happens inside and outside the classrooms regarding students’ sociocultural backgrounds. For them, multicultural education is political or social reconstructionism. Therefore, the movement toward equity targets issues of accessibility to a rich and sound curriculum, within which all students will represent themselves when they attend school and, later, when they project their active and successful lives as wise citizens refuting predeterminism. 

From the critical-radical perspective, racial and ethnocentric biases are not only requestioned but also involved in transformative actions regarding all aspects of educational practices and social changes that are pluriethnic, pluricultural, democratic, equitable, and inclusive. Hence, from the critical-radical perspective, the world must change. The process of becoming a multiculturally competent teacher includes the commitment to denounce stereotypes, prejudices, and discrimination, as well as racist attitudes and ethnocentric biases toward transformative actions at school and in society, which may lead to problems in traditional classrooms where multicultural educational issues are not addressed.

According to the literature, though the debate over multiculturalism in education rages on, many critical educators have spent years developing a critical multiculturalist’s pedagogy. Objectives of a critical multicultural approach include:  (1) altering traditional student-teacher power relations; (2) emphasizing and nurturing an appreciation for diversity and global processes; and (3) facilitating a democratic and inclusive classroom environment. Overall, practicing critical multiculturalism in the classroom alters the traditional student-teacher power relations, nurtures an appreciation for an understanding of diversity, and empowers students to think critically about the world in which they live.

The critical aspect of this perspective of multiculturalism is found in its move beyond the goals of a promotion of pluralism and an appreciation of diversity to providing students with the tools to critique the relationship between power and knowledge and the related discourses that hold down certain members of society. A critical approach to multicultural reform needs to make salient connections between knowledge and power. Such an approach would bring the entire range of traditional and contemporary arrangements within schools, and between schools and communities, into focus for reexamination with a view toward transformation. Thus, in both theory and practice, the ideas of critical pedagogy are a part of critical multiculturalism (McLaren, 2003).  

Multiculturalism and Critical Pedagogy

Critical pedagogy is concerned with the use of power in the teaching and learning dynamic, such as what knowledge is produced and by whom it is selected. It is also concerned with ways to provide students with means to resist oppression, improve their lives, and strengthen the democratic process for everyone, thus insuring progressive social change and social justice. According to McLaren (2003), critical pedagogy is concerned with a critique of society, around issues of power and developing students’ critical abilities to work toward the transformation of society. McLaren also suggests that critical pedagogy focuses on the relationship between educational ideas, policies, practices, and larger oppressive political and ideological perspectives. Teachers using this approach engage students in critical questioning of their own beliefs and assumptions (deMarrais & LeCompte, 1992). Since Freire’s revolutionary work Pedagogy of the Oppressed (1970), radical (critical/feminist/multicultural) educators have endeavored to change the face of education by democratizing the student-teacher power relations into a more emancipatory form and by including the work and experiences of previously under- or unrepresented groups (Giroux, 1988a). Critical pedagogy tends to take a theoretical and political approach to education, focusing on the needs and autonomy of individual students and emphasizing the importance of critical thinking (Freire, 1970, 1985, 1994; Giroux, 1983, 1988b; McLaren & Hammer, 1989; Shor, 1980, 1992). While feminist and multicultural educators share these theoretical and political concerns, they concentrate on linking macro-social elements of gender, racial/ethnic, and sexual discrimination and oppression with the micro-social elements of the classroom (Aptheker, 1993; hooks, 1994; Kanpol, 1995; Lewis, 2001; Luke, 1994; Maher & Tetrault, 1994; McLaren, 2005;  Rich, 1979; Scanlon, 1993; Schieder, 1993; Spelman, 1985).

Critical pedagogy and liberatory praxis theories have become a focus in classrooms at the university level (hooks, 1994; Giroux, 1988b). Obidah (2000) defines critical pedagogy as a “systematic interrogation of schools and schooling processes that enables educators to see terrains not simply as sites of instruction or as arenas of indoctrination and socialization but as cultural terrains that promote and/or negate student empowerment and teachers’ self-transformation” (p. 1040). Giroux (1988b) states that critical pedagogy “takes into consideration how the symbolic and material transactions of the everyday provide the basis for rethinking how people give meaning and ethical substance to their experiences and voices” (p. 10). This type of pedagogy begins with human agency, with a view of teachers as transformative intellectuals who usurp traditional notions of power and authority in the classroom and allow intellectual and critical spaces to exist wherein students may make meaning and find power for themselves (Obidah, 2000).

The creation of critical spaces is fundamentally tied to the struggle for a qualitatively better life for all through the construction of a society based on social justice—a shared goal of multicultural education (Banks, 2008). McLaren (1994) elaborates on the concept of critical pedagogy that “should conceive of reality—most importantly classroom reality—as a multiplicity of social relations, embodied metaphors, and social structures which cohere and contradict, some of them oppressive and some of them liberating” (p. 201). Perceiving the classroom reality in this way creates an avenue for each individual teacher to address how his or her “self” potentially becomes an embodied metaphor in the course of teacher-student interactions. In terms of implementation, Grossberg’s (1994) model of a progressive pedagogical project is outlined below:

1. First model – Hierarchical pedagogical. A practice that assumes the teacher already understands the truth to be imparted to the students.
2. Second model – Dialogic practice. The aim of this model includes allowing the silenced to speak, and only when absolutely necessary does it claim to speak for them. According to Obidah (2000), a pitfall to this practice is the assumption that students are not already speaking, simply because educators do not hear them.
3. Third model – Praxical pedagogy. According to Grossberg, praxical pedagogy “attempts to offer people the skills that would enable them to understand and intervene into their own history” (1994, p. 17). One pitfall in the use of this type of practice is assuming that people are not already intervening in their own history and, more importantly, that educators know the right skills to utilize in the process every time. Grossberg cautions that “there are no universal skills which we can offer independent of the context into which we want to intervene, and, more important, into which our students want to intervene” (1994, p.17).
4. Fourth model – Pedagogy of articulation and risk. Grossberg (1994) asserts that such a practice, while refusing the traditional forms of intellectual authority, would not abandon claims to authority. Refusing to assume ahead of time that it knows the appropriate knowledge, language or skills, it is a contextual practice that is willing to take the risk of making connections, drawing lines, and mapping articulations between different domains, discourses and practices, to see what will work (p. 18).

The fourth model delineates a pedagogy that keeps the practice of teachers on its toes and is inclusive of all the moments when teachers falter, hesitate, and come face to face with their own limitations (Obidah, 2000). A pedagogy of articulation and risk also seems to include the moments when teachers assert their knowledge, but it also includes space within the assertions for students’ questions, contestation, and even resistance (Wink, 2005). Such responses then inform and/or alter the teacher’s knowledge (Obidah, 2000).

Debates on multicultural education can lead an educator to question pedagogy’s influence on, and effectiveness in, conveying the knowledge of multiculturalism. Questioning pedagogy led to my investigation of critical pedagogy, models for implementing practices based on the theories, and their impact on curricula. Advocacy for critical pedagogy, however passionate and forthright, is one thing.  Actually implementing it is another. What follows is a discussion of critical multiculturalism from a teaching perspective.

Critical Multiculturalism: Teaching Perspective

Critical multiculturalism raises an individual’s critical consciousness about his or her class, gender, racial (and other) identity, or beliefs that have been shaped by the dominant perspectives, ideologies, and educational practices rooted in such ideologies; it urges him or her “to question and rethink these paradigms and in the process empowers him or her to move toward learning to teach for educational and social equity and change” (Ukpokodu, 2003, p. 19). The primary theoretical precept that grounds this view and practice of critical multiculturalism comes from the scholarship on critical theory and critical pedagogy, especially the works of Paulo Freire, Henry Giroux, Ira Shor, Joe Kincheloe, Christine Sleeter, Maxine Greene, and Peter McLaren, to mention a few.

Freire, McLaren, and Fairclough are especially concerned with inequities, issues of domination, and social privileges as well as self-reflection, equalitarianism, social justice, and education for human conscientization. McLaren (1997) contends that it is:

important to remind those who participate in the struggle for liberation from White patriarchal capitalist exploitation that they must never cease to resist new forms of consumption and desires that sometimes seek to supplant the basic needs of the people. (p. 12)

Ukpokodu (2003) defines teaching from a critical multicultural perspective as a:

learning paradigm in which teachers and students consciously engage in the construction of knowledge, critique the various forms of inequities and injustices embedded in the educational system, and strive to gain the empowerment needed to engage in culturally responsive and responsible practice. (p. 19)

Teaching from a critical multicultural perspective means interrogating the social system from a critical and social justice standpoint (Kincheloe & Steinberg, 1997; McLaren, 1998; Shor, 1992; Sleeter, 1996). This means providing preservice teachers opportunities to question their cultural, social, and philosophical perspectives and identities so that they may develop the quality of mind necessary to work with and support the academic goals of students from diverse racial, cultural, socioeconomic, gender, and language backgrounds. In order for preservice teachers to be successful in today’s classrooms, a thorough attempt to understand diversity and multicultural education is necessary for them to become better equipped to meet challenges in the classroom.

Teacher Preparation and Multicultural Education

Ideally, a critical approach to multicultural teacher education will help preservice teachers develop the habits of mind or critical consciousness needed to work with students from diverse racial, cultural, socioeconomic, and linguistic backgrounds. Preservice teachers need to move beyond the idea that multicultural education entails simply developing superficial multicultural units or celebrating culturally diverse heroes and histories. Aspiring educators need to recognize the hidden curriculum (Lewis, 2001) —specifically the racism and oppression that are embedded in the school culture—and develop means to expose and expunge these covert prejudices (Banks, 2008).

Preparing teachers for our postmodern world has become a major challenge (Banks, 1996). The field of teacher education, in general, has been slow in advancing and imagining teacher education in both its theory and practice within an existing postmodern paradigm (Banks, 2008). While society has changed drastically over the past four decades, many teacher education programs and K-12 school districts continue to frame and carry out their daily rituals within a traditional modernist model (Darling-Hammond, 2005). Due to numerous historically constructed reasons, these traditional models: (1) cater to the working world’s demand for increased tracking and de-skilling (Fine, 1991); (2) adhere to the values of capitalism and all its inherent ramifications (Shapiro, 1990); (3) perpetuate the cultural construction of teacher work and the understanding of the ways in which gender shapes classroom practices, leading to teaching as a White middle class and female-dominant occupation devoid of power (Apple, 1990); (4) discourage teacher education professors from dealing with the world of popular culture and utilizing the field of cultural studies as a form of pedagogy (Giroux, 1995); and (5) complicate the exploration of or admission of our own social and cultural deficiencies (Kanpol, 1995). These issues in and of themselves have evolved because of the changing structures of society.

Teaching multicultural education from a critical perspective means engaging preservice teachers in understanding their cultural and social identities as well as their socioeconomic positions and how these aspects of their character may affect teaching and student learning. Preservice teachers need to understand that teaching and learning occur in sociocultural-political contexts that are not neutral but based on relations of power and privilege. More specifically, preservice teachers can achieve this understanding by examining their identities and their socialized selves, which have been constructed by their sociocultural circumstances, and by exploring the ways in which these circumstances influence their understanding and relationships with others, especially students from diverse socioeconomic backgrounds. Teaching multicultural education from a critical perspective involves taking risks to move preservice teachers beyond their comfort zones to experience diversity firsthand, which can be accomplished through field experiences, study abroad programs, and/or virtual interactive field experiences (Malewski, Phillion, & Lehman, 2005). These types of multicultural experiences should be incorporated into the total education of all children. Thus, multicultural education should permeate the schools’ curricula (Nieto, 2000b). 

Conclusion

Despite the continuation of these debates, multiculturalism has become (though at times reluctantly) an accepted paradigm in curriculum formation on all levels of education, and the establishment of this discipline has now led to other issues and concerns (Banks, 2008). Some of these concerns focus on the underlying assumptions upon which conceptions of multicultural education are based (Hoffman, 1996; McCarthy, 1994; McLaren, 2003). Concepts such as culture and identity, which are integral to curriculum, are objects of particular scrutiny.

In sum, changing the present content of the school curriculum is not an adequate and sufficient model for meaningful curriculum reform in the area of race relations in schooling. A critical multicultural education needs to look at the constraints and barriers to teacher creativity and innovation in the institutional culture of schools, in the educational priorities set by district offices, and especially in teacher education programs in colleges and universities.

Finally, efforts to redefine the curriculum in the name of multiculturalism must progress beyond the narrow prescription of incremental addition and replacement. A critical approach to multicultural reform must make salient connections between knowledge and power. Such an approach would bring the entire range of traditional and contemporary arrangements within schools, and between schools and communities, into focus for reexamination with a view toward transformation.  In the words of W.E. Dubois (1868 – 1963), Education must not simply teach work…it must teach life.

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The Twenty-first Century Child of Northwest Indiana: An Initiative Developed to Ensure Success by Six

The authors would like to acknowledge Dr. Janice E. Katz for her hard work and determination in bringing this initiative to Northwest Indiana.

Introduction

For decades in Northwest Indiana, policies have been enacted and services have been available to young children with the sole purpose of improving their condition. Those services are as diversified as the children whose needs these services meet. There is home-based care for children alone, in groups or care given in centers. There are services available to children whose development may be challenged by socioeconomic conditions developmental disabilities, mental health issues, or family trauma. Regardless of what type of service being provided, or policy for which they are advocating, the groups share one common goal; to improve the young child’s circumstances early in his or her development, recognizing that such an investment can lead to favorable outcomes (Shonkoff & Phillips, 2000). One such initiative created to advocate for urban and rural children developing in Northwest Indiana, and supported by all of the United Way programs in Northwest Indiana is Success by 6.

The first Success by 6 initiative was launched in 1989 by a group of business executives in Minneapolis. Their concerns about high school dropout rates and workforce development led them to examine the importance of the early years. Since then, over 350 public-private partnerships have built Success by 6 coalitions across the country (“Partners”, 2011). Within each community the priorities, definitions and focus for the efforts are uniquely defined and implemented.

When the United Way agencies of Lake, Porter and LaPorte counties chose to actively address the needs of young children in Northwest Indiana in 2009, a wide net was cast to capture a multitude of perspectives. This was necessary to assess the current compendium of services and to create an answer to the question “What does a successful 6 year-old from Northwest Indiana look like?” Representatives from the fields of pediatrics, early childhood education, infant toddler mental health, school corporations and the social services gathered to review the data, share information and begin to formulate a plan that would address the unique needs of families and children in Northwest Indiana.

The series of meetings, discussions and focus groups overwhelmingly revealed a need for the Success by 6 initiative, especially at a time when profound structural changes in both Indiana and the country are impacting young children and their families. These include: 1). changes in the number of work hours parents of young children must engage in, at all income levels, to provide for their families, 2). economic challenges encountered by families in the current economy, 3). increases in cultural and ethnic diversity within our communities as well as the contrasts between racial and ethnic groups’ health and developmental outcomes, 4). increases in children who from infancy are receiving non-parental caregiving (which varies greatly in quality) and 5). increases in awareness of family and community problems, which can have deleterious effects on the child’s well-being (Shonkoff & Phillips, 2000).

Any one of the 61,455 children under the age of 6 living in Northwest Indiana may be affected by one or more of these factors (The United Way, 2009).  Using KIDS COUNT 2010 data, the authors illustrate how some children of Northwest Indiana are likely to encounter more changes and challenges than others. The data also provides evidence that shows that Northwest Indiana is struggling in comparison to state and national averages in many areas.  Taken together these data highlight that support by the Northwest Indiana community for initiatives such as Success by 6 is essential to create impactful changes within the area (The United Way, 2009). At the conclusion of this paper, the authors discuss the need for support from those individuals and organizations in the region that have the capacity to bring about change, focusing on the institutions of higher education.

The Success by 6 Initiative

The Success by 6 initiative was introduced to Northwest Indiana to help meet the needs of children developing in the twenty-first century by creating optimal community conditions. In Northwest Indiana, the focus of the Success by 6 initiative concentrates on four areas affecting child development which include: 1). home environment, 2). childcare providers and caregivers, 3). health, safety and physical development, and 4). social and emotional development.  The welcome address identifies the goals of this preventative and proactive initiative to:

enhance the quality of education in Northwest Indiana, increase the economic development potential, ultimately reduce the number of social issues, raise awareness, improve access to information and services concerning early childhood education, and provide training and education to parents and childcare providers (“Welcome to NWI Success by 6”, 2011).

Success by 6 recognizes that development occurs rapidly from the time of conception until the time a child attends his or her first day of school (Shonkoff & Phillips, 2000; The United Way, 2009). During this time of incredible growth, there are many major developmental milestones to be accomplished including: linguistic, cognitive, emotional, social, physical, regulatory, and moral ones. Children at this stage of the lifespan can flourish in their developmental progress or be quite vulnerable to circumstances that can hinder their development (Shonkoff & Phillips, 2000).  The attainment of these milestones can be greatly influenced by issues that young children and their families encounter long before a child’s first day of school. Given that each of these domains of development overlap and are interconnected, what affects one aspect of development can impact other areas as well (Shonkoff & Phillips, 2000). 

There is no consensus within the literature about what constitutes a successful 6-year-old. Some researchers suggest there are 15 necessary capacities while others suggest 9 (The United Way, 2009). Regardless of the actual number of capacities, there appears to be some agreement as to the domains a child needs to be sufficient in order to ensure success. Those domains include:

1. Self-regulation: the ability to control one’s emotions, behavior, and attention
2. Communication and learning: the early development of language abilities, reasoning, and problem solving, and
3. Social and emotional health: including the ability to interact well with others, form friendships, resolve conflicts, as well as form trusting and nurturing relationships (Shonkoff & Phillips, 2000; The United Way, 2009).  Children who are unable to hold their attention, follow instructions, regulate their emotions, and get along with others will not become successful students or citizens regardless of whether or not they can read, write, and have basic mathematical skills (The United Way, 2009).

Success by 6 also recognizes that quality childcare is integral to preparing young children to be successful not only in school, but also in life.  Grunewald and Rolnick (2006) argue that children who have experienced high quality early care and education have an increased potential for higher earnings in their lifetime. Given that 65.8% of children under the age of 6 in Northwest Indiana are receiving non-parental childcare outside of their home, the quality of early childhood education they are receiving within the region is of great concern to Success by 6 (Dawson, 2010; The United Way, 2009).

Other programs do exist in Northwest Indiana that address some of the goals outlined by Success by 6. Programs such as the Indiana Parenting Institute, Parents As Teachers, All About Kids, and Prevent Child Abuse Indiana address the needs of children under the age of 6 and their families. Many of the region’s school corporations are engaged in outreach efforts to help children obtain kindergarten readiness. School corporations such as School City of East Chicago and Michigan City Area Schools have invested resources to establish preschool programs within the public school setting.

However, while many agencies and providers throughout Northwest Indiana currently focus on the challenges faced by children in Northwest Indiana, there is often duplication of services (The United Way, 2009). Unlike these regional agencies Success by 6 will not provide direct services to children under age 6. Rather, the purpose of Success by 6 is to bring agencies together which are currently addressing early childhood issues independently.  Collaboration among providers to pool resources, obtain funding and advocate with one voice for children in the community whose development may be impeded by the realities of local challenges offers opportunity to leverage resources and efficiently address these immediate needs.

A Review of the 21^st Century Challenges Faced By Children Living In Northwest Indiana

Data used by Success by 6 to evaluate the need for the initiative in Northwest Indiana was obtained from various sources including the Annie E. Casey Foundation’s KIDS COUNT project. The project provides national and state by state data that tracks the status of children in the United States (Annie E. Casey Foundation [AECF], 2010). There are 10 primary indicators of children’s well-being on which KIDS COUNT provides data including: percent of low birth weight babies; infant mortality rate; child death rate; rate of teen deaths by accident, homicide, and suicide; teen birth rate; percent of children living with parents who do not have full-time, year-round employment; percent of teens who are high-school dropouts; percent of teens not attending school and not working; percent of children in poverty; and percent of families with children headed by a single-parent. KIDS COUNT is also able to provide background information for each state and the counties within each state regarding demographic and family income (AECF, 2010).

Data reviewed from KIDS COUNT 2010 revealed that, overall, Indiana ranked 33 out of 50 states on the 10 primary indicators of children’s well-being. Regional data elaborating upon each key area of concern identified by Success by 6 (the home environment; childcare providers and caregivers; health, safety, and physical development; and social and emotional development) are disaggregated by county and provided in Table 1.[1]

Related to the home environment the KIDS COUNT data show that there are more children living in poverty in Lake County than in Porter and LaPorte counties. The percentage of children living in poverty in Lake and LaPorte counties is higher than the state and national percentages.  The data also show that the rate of abused or neglected children appears to be higher in Porter County than in Lake and LaPorte counties; however, the rate across the counties appears to be lower than what is average for the state.

In regards to health, safety, and physical development, Lake and LaPorte counties have higher percentages of low birth weight babies than does the state and national averages. Lake and LaPorte counties also have higher rates of teen births than the state and national averages, particularly so in LaPorte county. Finally, the average percentage of mothers receiving first trimester prenatal care is lower in Lake and LaPorte counties than in Porter and in the state.

Data providing information about the social and emotional well-being for children in each county does not exist. As a region, the Division of Mental Health reported that 10,468 Northwest Indiana children met their criteria for being “Seriously Emotionally Disturbed” (The United Way, 2009). Data from KIDS COUNT 2010 showed that 18% of children in Indiana between the ages of 2 and 17 have had a parent report to a doctor that their child has one or more emotional, behavioral, or developmental conditions.  This percentage is higher than the national average of 15% (AECF, 2010). This lack of information about the social and emotional well-being of children in the region is a concern for Success by 6. It should also be noted that in Northwest Indiana, only children enrolled in Head Start programs have access to mental health and behavioral consultations (“Northwest Indiana Statistics,” 2011). Currently, there are no consultation services available for other types of early childcare providers in Northwest Indiana with children enrolled who may be experiencing mental health or behavioral problems (The United Way, 2009).

 KIDS COUNT data pertaining to the quality of childcare in each county also does not exist. The only available data pertaining to childcare providers and caregivers comes from a state wide program called Paths to Quality. This voluntary enrollment program, introduced in 2007, has four levels. At Level 1, the most basic safety regulations are met. At Level 4, the childcare home, center or ministry has obtained accreditation. Families can be assured that programs that have secured Level 4 are also nationally accredited and uphold the highest standards and best practices. Within each tier, participants are rewarded for “moving up” the ladder toward high quality and accreditation.

In Northwest Indiana, there are 231 providers enrolled in Paths to Quality. However, the number of providers who have reached Level 3 or 4 remains low. Of the 163 childcare centers, homes or ministries in Lake County, 14 have secured Level 3 and only 6 have reached accreditation (Level 4). In LaPorte County, 2 of the 40 providers are accredited and only 3 have attained Level 3. Finally, in Porter County, only 3 of the 28 centers, homes or ministries are accredited and there are 0 Level 3 providers (K.D. Hendricks, personal communication, February 15, 2011). These data show that families seeking childcare in Northwest Indiana have limited access to a high-quality program. Of the 231 Paths to Quality programs across the region, only 28 fulfilled the requirements to achieve Level 3 (which include the provider’s existence for at least one year, a written curriculum, a plan for program evaluation and ongoing professional development) (Elicker, Langill, Ruprecht, & Kwon, 2007).

Collectively, the data reveal significant challenges faced by children and their families living in Lake, Porter, and LaPorte counties. In some instances, there appear to be more challenges for children living in some counties than others, as well as in comparison to children at the state or national levels. The patterns described demonstrate evidence for those community agents who have the ability to bring about change to support the regional Success by 6 initiative.

A Need for Broad Community Support to Ensure Success by 6

Decades of research from early childhood experts, economists, and advocacy groups show that early intervention, high quality early childhood programs, and support for initiatives such as Success by 6 are necessary not only to ensure that children are ready for school but also to improve their quality of life, reduce crime rates, and make the future workforce more productive, thus strengthening the regional, state, and national economies (Bartik, 2011; “Cradle to Prison”, 2008; Lynch, 2004; Shonkoff & Phillips, 2000). This requires a concerted effort from all stakeholders in the region. Gruendel  suggests “Just as public and private entities take an active interest in the construction and maintenance of roads, public transportation, utilities, housing and educational facilities to support economic development, quality early childhood education should be considered essential to economic health” (as cited in Kostelnik & Grady, 2009, p. 14).

Research shows that many children who have been served by early childhood programs will remain in the states and local areas where they attended school for their adult working careers (Bartik, 2011).  As many as half of Americans are estimated to spend their working careers in the local areas where they were educated. It has been argued that if investments were made to ensure high quality early childhood programs than it will result in a more skilled labor force, which will lead to more and better jobs in local communities such as Northwest Indiana (Bartik, 2011).  Although there is no existing data about the effectiveness of Success by 6 in Northwest Indiana, given the initiative’s infancy, there is an estimated $3 to $17 yield for every $1 investment in programs such as this supporting early childhood (Lynch, 2004; The United Way, 2009).

In Northwest Indiana, such an agenda can only flourish if it is grounded in broad backing from the community. Funding, support, and cooperation from all sectors is essential to address the specific needs identified in the Success by 6 strategic plan and to create an impactful change. Regional businesses, government agencies and non-profit organizations must dedicate resources to assist and sustain this initiative. Social service agencies, educational systems and programs must collaborate to provide the most effective, efficient, and accessible delivery of services. Partnerships and communication across the region directed at supporting the Success by 6 initiative will promote a shared understanding of the value of the early childhood years and the critical need for increased awareness and allocation of resources toward these efforts.

During its first year of implementation, Success by 6 has already garnered the support of a wide spectrum of partners: parks and recreation departments; mayors’ offices; local banks; school corporations; non-profit community foundations; service clubs; and chambers of commerce. With funding allocations from each of the United Way agencies, the Success by 6 initiative has started to address the issues identified by its Steering Committee as critical to serving the unique needs of Northwest Indiana’s youngest citizens. Success by 6 has provided training for early childhood professionals at regional conferences and speaker series. Collaboration with Indiana University Health has resulted in a summer kindergarten readiness camp. Funds have been committed to provide early learning tools in local libraries and child care centers. (J. Wright, personal communication, July 5, 2011).

 Institutions of higher education in Northwest Indiana also have a vested interest in and important resources to ensure children’s success and readiness to enter the kindergarten classroom, long before they enter the college classroom. Many of the region’s children who face the challenges identified in this review may attend the institutions of higher learning that are located in Lake, Porter, and LaPorte counties. Students need to be prepared for the intellectual demands of post-secondary education that include critical thinking skills, strong writing ability and proficiency in communication. Beyond academic skills, those students must also be equipped with the social-emotional capacity to function as independent young adults to advocate for one’s needs, to be accountable, and to relate to peers. 

Purdue University North Central (PNC) is one of Northwest Indiana’s institutions of higher learning that is taking an active role in building and supporting the regional Success by 6 initiative. Over 85% of the Purdue North Central student population is from Lake, Porter, or LaPorte counties (“Purdue North Central Enrollment Reports”, 2010). Since most of PNC’s graduates remain in Northwest Indiana, it is within PNC’s scope of responsibility to educate and prepare the region’s future workforce. Purdue’s core values of Learning, Discovery, and Engagement explicitly charge the university community to embrace this responsibility for the purpose of education, dissemination of information and cultivation of partnerships within the service area. 

PNC is currently creating a culture to support Success by 6 in several ways.  Members of the PNC community have already become involved with the Success by 6 initiative by serving on the Steering Committee, preparing research for strategic prioritization, and promoting the initiative through projects, internships, and volunteerism. PNC’s support for the initiative extends to a physical presence on campus as it is the site of the only campus-based Born Learning Trail in Indiana. The Born Learning Trail is an interactive and playful outdoor pathway that uses colorful signs and games to encourage family involvement, activity, and awareness. The signage promotes language, conceptual, and spatial development. For example, one sign reads, “Find a flower or a tree. Touch it. Talk about it. Is it hard or soft? Rough or smooth?”.  Together, children and adults enjoy the environment within the context of positive interactions. This Born Learning Trail on campus allows PNC to provide the community with an early learning opportunity for the region’s young children as well as spotlight the significance of learning in the early years (“Born Learning Tools”, 2010).

The authors challenge other institutions of higher education to embrace this initiative as PNC has. The view from campus to the kindergarten playground provides the higher education community with a rich landscape of opportunities to strengthen the Success by 6 initiative. Possibilities exist for faculty to serve the coalition as service learning partners, researchers, evaluators, and informed proponents. As there needs to be a collaborative effort among service providers, the universities in Northwest Indiana also hold a mutual obligation to educate, advocate, and serve the cause of ensuring that all children are prepared and equipped to enter school successfully. This genuine effort to broaden opportunities for student success must occur long before a student begins freshman year.  Creating partnerships with the region’s institutions of higher learning, social service agencies, child-care providers, and elementary schools strengthens the network of support for future students and their families.

Call to Action

A child’s development early in the lifespan can be modified by interventions to exchange maladaptive child outcomes for more adaptive ones (Shonkoff & Phillips, 2000). The development of infants, toddlers, and preschoolers should not just be a concern for their families but should be a concern at the regional, state, and national levels as well (Novotney, 2011; Shonkoff & Phillips, 2000 ). Infants born today will be future students, parents, workers, and citizens. Investing valuable resources in them today will significantly increase the quality of life for children being raised in Northwest Indiana as well as within their communities. It is necessary to obtain funding to remedy the problem of inadequate service availability in meeting the needs of young children with mental health problems (Shonkoff & Phillips, 2000). Even with the spotlight on early childhood care and education from institutions, public policy initiatives, community and family resources, the single most important factor remains for young children’s success are teachers (Hyson, 2003; Hedges, 2006). Therefore, it is also necessary for funding to be set aside and dedicated for child-care and early childhood education programs in order to raise the standards of the programs, as well as the compensation and benefits of early childcare workers with whom so many infants, toddlers, and preschoolers spend their time (Lynch, 2004; Novotney, 2011; Shonkoff & Phillips, 2000).

Success by 6 aims to assemble a cadre of stakeholders to champion this cause of early childhood in Northwest Indiana. This collaboration will foster cohesion and continuity across services and schooling for all children.  At this early stage in its development, Success by 6 has achieved notable accomplishments “to create optimal community conditions to meet the developmental needs of children under age six and their families.”  (“Welcome to NWI Success by 6”, 2011).

Community members and organizations have contributed over $42,000 in donations (cash & in-kind) to support the Born Learning Trails sprouting up all over the region. Over 75 early childhood professionals braved the snow and ice this winter to attend three evenings of speakers at Valparaiso University focused on addressing children’s challenging behaviors. In August, 28 incoming Westville kindergartners participated in a “Kindergarten Countdown” camp. These children gained essential knowledge and skills to equip them with the confidence, experience, and know-how to be successful on their first day of school.  Medical residents took part in “What’s Up Doc?” designed to train pediatricians to tune into families’ concerns about their child’s development. Other possibilities on the horizon include scholarships for visits to our region’s attractions such as BellaBoo’s in Lake Station and the Born Learning Trails, sponsorships to ensure that every child receives books before they enter school and, of course, more professional development. Each of these opportunities is possible only because some member of the regional community embraced this call to action.

Initiatives such as Success by 6 are important for the children from Lake, Porter, and LaPorte counties.  The attention that needs to be given to early childhood is not just necessary to make them high-functioning adults able to contribute to the gross national product. Shonkoff & Phillips (2000) believe cares for children is necessary because, “what is learned at the beginning of life establishes a set of capabilities, orientations to the world, expectations about how things and people will behave that affect how new experiences are selected and processed” (p. 90). Growth in all domains of development during the early years is the foundation for learning, relationships, and a stable sense of identity and self-worth. Success by 6 needs the support of those who have the capacity and the determination to transform – regional businesses, agencies, and institutions of higher learning to create impactful changes to improve the quality of life for the twenty-first century children of Northwest Indiana and the communities in which they live.

 “The time has come to stop blaming parents, communities, business, and government – and to shape a shared agenda to ensure both a rewarding childhood and a promising future for all children” (Shonkoff & Phillips, 2000, p. 414).  The authors invite you to join in this endeavor.

References

Annie E. Casey Foundation, KIDS COUNT Data Center. (2010). from http://www.kidscount.org

Bartik, T.J. (2011). Why investing in kids makes sense for local economies. Employment Research, 18, 1-3.

Born Learning tools. (2010). Retrieved February 27, 2011 from http://www.uwsuccessby6.org/programs/born-learning/175-born-learning-.html

Cradle to Prison Pipeline Campaign. (2008). Retrieved February 11, 2011 from http://www.childrensdefense.org

Dawson, R. F. (2010). Parents and child care in Indiana. Retrieved from Indiana Association for Child Care Resource and Referral website: http://iaccrr.org

Elicker, J., Langill, C.C., Ruprecht, K., & Kwon, K.A. (2007). Paths to Quality-A child care quality rating system for Indiana: What is its scientific basis? Retrieved from the Indiana Family and Social Services Administration website: http://www.in.gov/fssa/files/ScientificBasisPTQ.pdf

Grunewald, R. & Rolnick, A. (2006). A proposal for achieving high returns on early childhood development. Retrieved from the Federal Reserve Bank of Minneapolis website: http://www.minneapolisfed.org/publications_papers/studies/earlychild/highreturn.pdf

Hedges, L. C. (2006). Children's achievement: What does the evidence say about teachers ,Pre-K programs, and economic policies? Evanston, IL: Institute for Policy Research at Northwestern University.

Hyson, M. (2003). Preparing early childhood professionals: NAEYC's standards for programs. Washington, DC: NAEYC.

Kostelnik, M.J. & Grady, M.L. (2009). Getting it right from the start: The principal’s guide to early childhood education. Thousand Oaks, CA: Corwin.

Lynch, R.G. (2004). Exceptional returns: Economic, fiscal, and social benefits of investment in early childhood development. Retrieved from http://www.epi.org/publications/entry/books_exceptional_returns/

Northwest Indiana statistics. Retrieved February 11, 2011 from http://www.uwsucecessby6.org/resources

Novotney, A. (2011, January). Awakening the child inside. Monitor on Psychology, 42 (1), 34-36.

Partners. (2011). Retrieved February 15, 2011 from http://www.bornlearning.org/default.aspx?id=27

Purdue North Central enrollment reports. (2010). Retrieved February 15, 2011  from http://www.pnc.edu/about/EnrollSum10.pdf

Shonkoff, J. P., & Phillips, D.A. (Eds.). (2000). From neurons to neighborhoods. Washington, D.C.: National Academy Press.

The United Way. (2009). A strategic plan for the Northwest Indiana United Way Success by Six Initiative.

Welcome to Northwest Indiana Success by Six. (2011). Retrieved February 11, 2011 from http://www.uwsuccessby6.org/about-us/about-us.html

Table 1

Regional data for children living in Northwest Indiana in comparison to State and National data[2]

Indicator	Lake County	Porter County	LaPorte County	Indiana	U.S.
Child abuse/neglect rate per 1,000 children under age 18	9.7	13.0	6.6	15.6	6.8
Annual average unemployment rate (%)	10.4	9.2	11.5	10.1	9.3[3]
Percent of children living in poverty (Age 0-17)	24.7	11.2	19.0	17.9	18.2
Percent of low birth weight babies	10.6	7.7	11.1	8.5	6.7
Teen birth rate per 1,000 females age 15-19	43.1	25.0	58.2	45.0	43.0
Percent of mothers who received 1st trimester prenatal care	59.6	71.7	67.1	67.5	N/A