The health status of the early care and education workforce in the USA: a scoping review of the evidence and current practice

Abstract

Background: More than two million early care and education (ECE) providers care for young children in the USA each day. These providers tend to earn low wages and many are enrolled in public assistance programs. Nearly all ECE providers are female and they are disproportionately women of color. Despite the fact that these attributes place the ECE workforce at greater risk of chronic disease, the health status of the workforce is not established and the availability and effectiveness of interventions to improve their health status is also not known. Methods: We conducted a scoping review of both the published literature and current practice to identify all articles and interventions targeting the health status of the ECE workforce. Our search strategy identified scientific articles published in English within the past 10 years as well as any interventions targeting the ECE workforce that have been implemented within the past 3 years. Data from both scientific articles and practice were extracted using systematic methods and summarized. Results: Thirteen studies described some component of physical health including diet quality (11 studies), physical activity (8 studies), and height/weight/body mass index (7 studies), and 21 studies assessed component(s) of mental health including depression (15 studies), stress (8 studies), and mindfulness (3 studies). ECE providers reported a high prevalence of overweight, obesity, and chronic disease diagnoses and spend significant time being sedentary, and some report low diet quality. Mental health concerns in this population include depression and high stress. Eleven interventions targeting ECE workforce wellness were also identified; most focused on nutrition, physical activity and/ or stress. Conclusion: The limited evidence available for review describes a workforce in need of health promotion interventions to address high levels of mental and physical health challenges, some above and beyond peers with comparable demographic characteristics. Several promising interventions were identified from both the published and unpublished literature; these interventions should be further implemented and evaluated to assess their impact on the workforce.

Educator Perspectives of Early Childhood Mental Health: A Qualitative Study in Colorado

“…In particular, it is not clear that the findings here can be generalized to other populations. The current study participants self-identified as female, which is consistent with the early childhood field as a whole (Lessard et al, 2020). However, it is possible that an important perspective is missing from men who work in early childhood settings.…”

Food Insecurity Is Associated with Depression among a Vulnerable Workforce: Early Care and Education Workers

“…Similarly, a 2017 Arkansas workforce study reported that 33% of their sample of ECE teachers were at risk for depression, and 40% reported being food insecure [ 9 ]. A 2020 scoping review on the health status of the U.S. ECE workforce and health-promoting interventions targeting this population further validated that this workforce experiences significant mental health challenges, including stress and depression, and has a heightened chronic disease risk due to suboptimal health behaviors, regardless of ECE setting (e.g., federally funded Head Start Programs for low-income households vs. for-profit or non-profit childcare centers) and job title [ 22 ].…”

“…When examining the ECE workforce beyond the U.S., research shows that workplace stress is common among workers in other countries [ 22 ]. ECE workers in other countries, such as Singapore, also experience low pay, high turnover rate, and poor prestige [ 23 ].…”

Association Between Food Insecurity and Diet Quality Among Early Care and Education Providers in the Pennsylvania Head Start Program

“…More than 2 million early care and education (ECE) providers, mostly women, provide care to over 10 million preschool-age children in the US (1). As adults who take care of children for a substantial part of the day, they model and cultivate healthy eating behaviors essential to children's long-term health and behavior outcomes (2,3). Therefore, the health and well-being of ECE providers are essential to a child's early learning and development success (2).…”

“…Therefore, the health and well-being of ECE providers are essential to a child’s early learning and development success ( 2 ). However, ECE providers are susceptible to poor diet quality, sedentary lifestyle, stress, and economic worry ( 4 ) because they are more likely to live in poverty than, for example, K-12 teachers ( 5 ), earn low wages (national median wage = $24,230) ( 6 ), are often uninsured, and lack support and flexibility in their work environment ( 1 ).…”