The Poverty Center’s ChildHood Integrated Longitudinal Data (CHILD) system is a comprehensive integrated data system used to carry out research and evaluation in order to improve child health and wellbeing in Cuyahoga County, Ohio. Our system is nationally recognized as among the oldest and most comprehensive in the country and includes continually updated administrative data from 1992 to the present from nearly 20 data providers. Funding for CHILD comes via grants from Cuyahoga County, the MacArthur Foundation, the City of Cleveland, and others. The CHILD system is used by Poverty Center researchers for research and evaluation of over a dozen projects.
The ChildHood Integrated Longitudinal Data (CHILD) System incorporates administrative data from almost 20 different governmental and nonprofit sources to provide information on the experiences and outcomes of children born or living in Cuyahoga County since 1992. When it was first created, the CHILD System included records such as child welfare, public assistance, birth records, home visiting, and publicly subsidized child care. The system expanded to include receipt of well-child care, early childhood mental health services, and exposure to high quality early learning (through the Universal Pre-Kindergarten project). As technology has advanced, the CHILD System has recently expanded to include data concerning older youth, such as public school attendance and proficiency test data, childhood lead exposure, public housing, homeless shelter use, and juvenile justice involvement. Used together, these data can inform planning, monitoring, evaluation, and action to improve services to families in Cuyahoga County, Ohio.
Cuyahoga CHILD System Overview (printable PDF)
Overview of Integrated Data Systems
Video from the Children’s Data Network
- Analysis of Data Related to Pay for Success
- Child Well-Being in Cuyahoga County
- Effects of Foster Care and Juvenile Justice Involvement on Early Adult Outcomes: A Study of Cleveland’s Youth
- Evaluation of the MomsFirst Program
- From Foster Care to Juvenile Justice: Exploring Characteristics of Youth in Three Cities
- Investigating the Pathway to Proficiency from Birth through 3rd Grade
- Leveraging Integrated Data Systems (IDS) to Examine the Role of Housing and Neighborhood Conditions on School Readiness and Early Literacy
Analysis of Data Related to Pay for Success
D. Crampton, R. Fischer et al.
The Pay For Success initiative seeks to identify potential areas of investment in County programs that could yield ‘cashable’ savings and a return to investors. There are several high risk groups that are believed to engender high costs for the County, and there is an interest in whether a program targeted to these individuals can result in cost savings for the County. The purpose of this data analysis is to determine the size of these high risk groups, the county agencies they are being served by, and the quantities of high cost services that they are currently utilizing. Based on these service levels, it will be possible to estimate the costs that are likely to result if patterns remain the same into the future, along with the potential cost savings if the level of high cost service use can be reduced through investing in a new program or intervention. Our focus to date has been on mothers who use homeless shelters and whose children are in foster care.
Child Well-Being in Cuyahoga County
R. Fischer, E. Anthony, N. Lalich, and M. Blue
In collaboration with Cuyahoga County’s Invest in Children, the Center on Urban Poverty and Community Development produced a series of data briefs examining multiple dimensions of child well-being, including birth outcomes, health insurance coverage, lead exposure, child maltreatment, child care receipt, school readiness, and child poverty. Results indicate that with approximately 30% of children under the age of six living below the federal poverty threshold in the suburbs and 60% of children living in poverty in the City of Cleveland, the need for programming and interventions to remediate the burden of poverty is great.
The Cuyahoga County 2010 Child Well-Being and Tracking Update is the most recent evaluation of the Invest in Children program.
C. Coulton, D. Crampton, Y. Cho, and S.-J. Kim
The transition to adulthood can be challenging for many individuals, but youth who have been involved with various public systems face additional hurdles in completing their education, finding employment and managing their everyday lives. Using linked administrative data from multiple agencies, this policy brief looks at what is happening to Cleveland’s youth from 9th grade until age 21 and how involvement in the child welfare and juvenile justice systems affect their success. We find that system-involved youth are at elevated risk compared to their non-involved peers for poor high school performance and attendance, unemployment, homelessness and incarceration. This study begins to quantify the various points at which Cleveland youth are touched by public systems along their paths toward adulthood. This type of information can be used to estimate potential savings in human suffering and public spending that might be achieved through targeted prevention programs with this population.
Evaluation of the MomsFirst Program
R. Fischer, E. Anthony, M. Blue, and N. Lalich
The evaluation of MomsFirst consists of four complementary/concurrent/cooperative studies, each with a different approach to measuring the effectiveness of the program. An outcomes study looks at the program’s success in achieving better health outcomes through a longitudinal analysis of the experiences of those families served, allowing for the detection of any changes in outcomes as a measure of treatment effect. A multilevel study utilizes the CHILD system to analyze the broader impact of elements of the program associated with improving outcomes at both the individual and community level; using a broader system perspective allows for the examination of additional family outcomes and comparisons between families involved in the MomsFirst program and those of comparable risk that are not involved. A network study focuses on the connections between different involved organizations and how involvement in one service affects the likelihood of a family using another service. These will be evaluated by analyzing coverage indicators, system gaps indicators, system interaction indicators, and neighborhood impact indicators. Finally, an implementation study investigates the best practices for program delivery by measuring how closely services are being provided when compared to the intended model, identifying particular service subgroups that have made significant improvements, and analyzing the degree of correlation between the use of services and positive outcomes.
C. Coulton, D. Crampton, N. Lalich, and E.-L. Lee et al.
This project was a multi-site effort coordinated by Actionable Intelligence for Social Policy (AISP) involving integrated data systems in Cook County, IL, Cuyahoga County, OH, and New York, NY.
This study investigates rates and predictors of juvenile justice involvement among children who first experience foster care. Utilizing integrated administrative records from multiple birth cohorts, analyses considered populations of children from three urban areas: Cook County (Chicago), Cuyahoga County (Cleveland), and New York City. Data were prospective and longitudinal, covering birth through maturity. Crossover rates ranged from 7 to 24%. African American male children and youth, and children and youth who experienced congregate care were at highest risk to crossover to Juvenile Justice. Age at first foster care placement produced a risk gradient with older age associated with progressively greater risk. More foster care spells signaled risk for those first placed as infants. Findings are discussed in terms of understanding processes of risk and resilience, and as actionable intelligence to inform practice and policy.
Investigating the Pathway to Proficiency from Birth through 3rd Grade
C. Coulton, R. Fischer, S.-J. Kim et al.
The purpose of this project is to address pressing developmental and educational research questions concerning kindergarten readiness and third-grade reading achievement by drawing upon shared data between Local Educational Agencies (LEAs) and a broad range of agencies that serve young children. Specifically, the project links student records data from K-3rd grade with early childhood experiences as reflected in administrative records from child care, early education, health and social service providers, along with measures of conditions in the child’s housing and neighborhood. The data was analyzed to examine how early childhood risk factors and programs affect school readiness and student progress in grades 1-3. The results of this work is particularly timely with respect to informing state-level interests concerning school readiness (both its antecedents and its consequences) and third-grade reading achievement.
C. Coulton, R. Fischer, S.-J. Kim, F. Richter et al.
Children in many big cities enter kindergarten already well behind in their educational progress, presenting a major challenge for public education systems. While it is generally acknowledged that the environment in which children spend their early years is crucial, little is known specifically about how housing conditions both in children’s own homes and the immediately surrounding areas, factor into the problem of school readiness and early learning. Drawing on two, existing, Integrated Data Systems (IDS), this longitudinal, population-based study examines the influence of housing and neighborhood conditions on early childhood experiences, school readiness and early literacy for all children entering kindergarten over a three year period in a big city school system. In addition, this study also demonstrates the cost effectiveness of using IDSs that cover both individuals and properties to investigate housing policy concerns. This study hypothesizes that early exposure to adverse housing and property conditions, at varying levels of spatial granularity, are contributing factors to a lack of school readiness and early literacy among children entering a big city public school system (Cleveland, Ohio). These effects are net of family socio-economic factors, potentially moderated by residential mobility and partially mediated by early exposure to trauma.
The CHILD System is composed of linked administrative records of children in Cuyahoga County, Ohio, beginning with the 1992 birth cohort to the present (see the Data Sets link below). The linkage of records across time and systems is performed via deterministic and probabilistic matching techniques. The records contain geographic information that enables aggregation to the neighborhood, city, county or other jurisdiction level and also allows linking with other data systems at various levels of geographies such as parcel, address, or census tracts. The end result is a longitudinal data system in which children are observed if and when they are served by one of the 17 administrative systems that compose CHILD.
Incoming data are geocoded and standardized in preparation for linkage. A third-party SAS macro, LinkPro performs deterministic and probabilistic matching to determine whether the new records match those already in the system. Matching variables include the child’s and mother’s names, birth dates, social security numbers, family address, child’s race and gender. Non-matched records are manually reviewed and either matched or appended to CHILD. Continuous evaluation of these methods guarantees that the linkages are at acceptable levels of reliability and completeness.
For more information on the structure of the CHILD System, a technical paper, AN OVERVIEW OF THE CHILDHOOD INTEGRATED LONGITUDINAL DATA SYSTEM, written by Nina Lalich, Dr. Elizabeth Anthony, Dr. Francisca Richter, Dr. Claudia Coulton, and Dr. Robert Fischer, is available here.
A table containing the data included in the CHILD system, the providers of each data set, and the years included for each data set is available here:
Information on data privacy will be available soon.
A retrospective analysis of the housing histories of more 13,000 entering kindergartners in 2007-10 in Cleveland demonstrates the role that housing plays in early childhood development. Children who spent more time living in or near properties that had signs of deterioration and disinvestment were more likely to have elevated lead levels and to have low scores on a kindergarten readiness assessment. Nearly 40 percent of the entering kindergartners tested above the public health threshold for lead exposure (i.e. blood lead level >5mg/DL). Each year from birth to kindergarten approximately one-third of the children spent time either in or near properties that were in poor condition or showed signs of disinvestment.
The transition to adulthood can be challenging for many individuals, but youth that have been involved with various public systems face additional hurdles in completing their education, finding employment and managing their everyday lives. Using linked administrative data from multiple agencies, this policy brief looks at what is happening to Cleveland’s youth from 9th grade until age 21 and how involvement in the child welfare and juvenile justice systems affect their success. We find that system-involved youth are at elevated risk compared to their noninvolved peers for poor high school performance and attendance, unemployment, homelessness and incarceration in local jail. This study begins to quantify the various points at which Cleveland youth are touched by public systems along their paths toward adulthood. This type of information can be used to estimate potential savings in public spending and human suffering that might be achieved through targeted prevention programs with this population.
Healthy Start 2016 (Presentation)
This presentation summarizes the Discerning Healthy Start Impact on Birth Outcomes using Propensity Score Matching Methods.Overall, the outcome evaluation found that Women who participate in MomsFirst have statistically significantly better birth outcomes than they would have had, had they not participated.
The number of children who are lead poisoned in any given year has been steadily declining; however, as illustrated by this poster, these point-in-time incidence data should be interpreted with caution as longitudinal data demonstrate many more children are lead poisoned throughout the early childhood period.
Birth outcomes are important early indicators of individual and community well-being, particularly a newborn’s weight at birth and the time of gestational delivery. Adverse outcomes such as low birth weight and premature delivery present common threats to a child’s development, and have been shown to increase a child’s risk for a variety of conditions, ranging from cognitive impairment to attention-deficit disorder to asthma.
Child maltreatment includes physical, sexual, and emotional abuse, and neglect of a child under the age of 18 by a person in a custodial role. The long-term outcomes of child maltreatment are persistent and pervasive, affecting the physical, emotional, behavioral, and cognitive domains of an individual’s life. Young children, especially infants, are particularly vulnerable to child maltreatment, demonstrating victimization rates two to three times higher than older children.
Family income is one of the strongest predictors of child well-being. The effects of poverty on early childhood development are well documented, including higher rates of health and cognitive impairments, and emotional and behavioral difficulties. Since 2000, poverty rates among children in Cuyahoga County increased by nearly 40%. Increases in Cuyahoga County and the state of Ohio are higher than the national increase of 32% since 2000.
According to a report from the U.S. Census, nationally, young children spend an average of 32 hours a week in care settings. This is a substantial amount of time during a critical period of brain development, making access to quality care essential. Cuyahoga County has a broad and diverse system of early care and education settings, with a substantial number of child care providers meeting objective quality standards.
Access to health care is fundamental to the health of young children, but children without health insurance often do not have access to regular care. Uninsured children have lower immunization rates, are less likely to have common conditions and emergencies attended to, and have more unmet mental health and chronic health conditions.
Among environmental risks, lead exposure is perhaps the most serious threat to a child’s development. Adverse health effects of lead include damage to the brain and nervous system, slowed development, learning and behavior problems, and hearing and speech problems. Cognitive deficits in math, reading, nonverbal reasoning, and short-term memory have been associated with blood lead concentrations below the 5.0 μg/dL standard.
A lack of kindergarten readiness may significantly hinder a child’s educational trajectory. In recognition of the importance of kindergarten readiness, Invest in Children (IIC) has sought to improve the quality of early childhood education in Cuyahoga County. Since 2005, public schools in the State of Ohio have used the State-mandated Kindergarten Readiness Assessment Literacy (KRA-L) to measure kindergarten readiness.
Serious emotional and behavioral concerns in early childhood affect between 9-14% of the general population of children and as much as 24% of low-income children. Unfortunately, emergent mental health concerns among toddlers and preschoolers often go unidentified and untreated. Long-term research has shown untreated mental health issues in early childhood negatively impact a child’s health, social-emotional functioning, and academic success later in life.
Family child care is a home-based service where a caregiver provides child care in his or her home, and it is a widely used type of care for infants, toddlers, and preschoolers in the United States. The Family Child Care Homes (FCCH) initiative sought to improve the quality of the FCCH system in Cuyahoga County. The FCCH initiative supported the development of high quality FCCHs in the county as a part of creating an early care and education system that will prepare children for school and later life.
The NBHV program offers a single in-home visit by a registered nurse to high risk parents under 200% of the federal poverty threshold. This visit offers parents useful information about existing community services and resources, provides parents with an opportunity to ask questions regarding their infant’s health needs, and identifies families or infants in need of greater assistance.
A core emphasis of the UPK pilot is to invest in the quality of care in participating sites to enhance the child outcomes for the children in care. This report focuses on the analysis of data on the quality of the care provided in UPK sites, data on observations and assessments of a sample of 200 children, and data on UPK children who entered kindergarten in fall 2008 with a school readiness score.
This report reviews data collected by the UPK pilot as part of the evaluation of the program over the first five years. A key focus of the UPK pilot is to enhance child development during the prekindergarten years. The effects of the UPK pilot can be measured by analyzing collected data on child development while in a UPK program and the data on UPK children who entered kindergarten in CMSD with a school readiness score.
This policy brief examines the development of youth in Cleveland from 9th grade until age 21 and how involvement in the child welfare and juvenile justice systems affect their success. System-involved youth are at elevated risk compared to their non-involved peers for poor high school performance and attendance, unemployment, homelessness and incarceration in local jail. This study aims to pinpoint the level of risk and explore factors that distinguish youth who do well from those who do not.
This presentation provides an overview of the challenges and unique opportunities presented by integrating large amounts of data from various sources. An integrated child data system can be used to identify trends, develop programs, and implement supports for young children and their families. The CHILD system is expanding to include data related to older children and adolescents to better meet the needs of these children as they grow up.
Early Childhood Mental Health Outcome Evaluation (Presentation)
This presentation summarizes the outcome evaluation of the Early Childhood Mental Health program and its major findings. Overall, the outcome evaluation found that ECMH efforts led to behavioral improvements and relationship benefits, and that better outcomes were associated with the completion of treatment.
*Birth and Lead data provided by Ohio Department of Health. This should not be considered an endorsement of this study or these conclusions by the ODH.
Leveraging Policy and Evaluation: Integrated Data as a Tool
Presentation by Rob Fischer, Ph.D. at Ohio State University