2018 Winter Kansas Child

A publication of Child Care Aware ® of Kansas
Winter 2018 Volume 17, Issue 1
PUBLIC
HEALTH
4
IMPROVING
THE HEALTH
OF KANSANS
EVERY KANSAN
DESERVES TO
8 BE HEALTHY
12
RISKS
OF
VAPING
PROTECTING AND SECURING
HEALTHIER LEARNING
18 ENVIRONMENTS

Kansas Child
is a publication of
Child Care Aware ®
of Kansas
Executive Director
Leadell Ediger
Editors
BWearing Consulting
Angie Saenger, Deputy
Director
Publication Design
Julie Hess Design
On the Cover
Da’Sayvion Lee Hopkins, age
2, son of Misty Mathews and
Thaddeus Hopkins, of Salina,
likes to play with Tinkertoys ® and
balls, and run and jump around.
LEADELL EDIGER
Executive Director
Child Care Aware ®
of Kansas
Child Care Aware ® of Kansas,
1508 East Iron, Salina, Kansas 67401,
publishes Kansas Child quarterly,
which is made possible through the
financial support of the members
of Child Care Aware ® of Kansas and
sponsorships from our corporate,
private, and foundation partners.
Kansas Child is intended to provide
a forum for the discussion of child
care and early education issues and
ideas. We hope to provoke thoughtful
discussions within the field and to
help those outside the field gain a
better understanding of priorities
and concerns. The views expressed
by the authors are not necessarily
those of Child Care Aware ® of Kansas
or its sponsors.
Copyright © 2018 by Child Care
Aware ® of Kansas, unless
otherwise noted. No permission
is required to excerpt or make
copies of articles provided that
they are distributed at no cost.
For other uses, send written
permission requests to:
Child Care Aware ® of Kansas,
1508 East Iron, Salina, KS 67401
Kansas Child is distributed at
no cost to Child Care Aware ®
of Kansas donors. Single
copies are available
to anyone at $5 each, prepaid.
I can remember when I was a child, sometime
in the early 1960s, I think, standing in a very
long line with my dad. At the end of the line I
received a sugar cube. That was how the polio
vaccination was given at that time. It was
painless and important, and I was fortunate my
parents saw the need to have me vaccinated.
Vaccinating children is still one of the most
important functions of public health, but it is not
the only public health issue to consider for child
care providers.
In my early years with KACCRRA, the
predecessor to Child Care Aware® of Kansas,
I met an incredible woman who worked
for the Kansas Department of Health and
Environment. Her name was Shirley Norris.
As early as 1957, Shirley played a significant
role in keeping children safe while they were
in child care through her efforts to establish
child care licensing regulations. She continued
work to expand and revise those regulations as
late as 1988. Shirley advocated for children and
changed the face of child care in Kansas.
While you may not think of regulations as a
public health issue, public health encompasses
many important issues that affect our work in
early childhood care and education.
Over the past 20 years, our work at Child
Care Aware has evolved to a focus on the whole
child and the family, as well as the provider.
Today, health -- in a broad sense -- consumes
much of our staff time.
Our work includes
education
and advocacy
on obesity
prevention,
nutrition and

p. 4
IN THIS ISSUE
physical activity. We also have worked on
prevention of abuse and neglect, and emergency
preparedness and planning. We have worked
with providers to become a welcoming place for
breastfeeding moms.
This issue of Kansas Child reflects the
importance of public health as it relates to child
care and highlights many of the providers of
these important services. Our partners at the
Kansas Department of Health and Environment,
Health Promotions Division, have been
instrumental in this issue of Kansas Child.
Moving forward, we know our children will
be safer because of the work of KDHE. Its efforts
and ours are built on the efforts of those who
came before us, such as Shirley Norris, and to a
lesser but equally important extent, parents like
my dad.
p. 12
p. 16
Improving the Health of Kansans:
We’re not in Samuel Crumbine’s
stream anymore!.......................................4
Immunize Kansas Coalition
Recommends Keeping Kansas
Children Healthy by Getting the
Influenza Vaccine...................................... 7
Every Kansan Deserves
to Be Healthy............................................ 8
Strengthening Healthy Food Access
Across Kansas......................................... 10
Growing Healthy Kansas Kids:
A Child Care Provider’s Story..................11
Risks of Vaping........................................12
Smoke-Free Public Housing....................13
Clean and Healthy Outdoor Spaces....... 14
Safe Routes to School:
You can do it, too!................................... 16
Fit-Tastic! Healthy Habits
for a Healthy Future.................................17
Protecting and Securing Healthier
Early Learning Environments..................18
Project NeuroNuture
to serve 850 families...............................20
Book Nook: Creating a Village
for Successful Living............................... 22

A statue of Dr. Samuel Crumbine was installed October 27 in the Kansas Health
Institute’s pocket park on the corner of Southwest 8th and Van Buren Streets,
Topeka. (Chris Neal/The Capital-Journal)
DAN PARTRIDGE, RS, MPH
Image from the Kansas Historical Society
Director, Lawrence-Douglas County Health Department
Dan Partridge has worked in public health since 1991. He became
director of the Lawrence-Douglas County Health Department in
2007.
He has a dual bachelors of science degree in Fisheries Biology and
Chemical Science from Kansas State University and a master’s
degree in public health from the University of Kansas School of
Medicine-Wichita.
Partridge currently serves on two NACCHO workgroups, public
health informatics and performance improvement. He is a Kansas
Health Foundation Fellow and a graduate of the Kansas Public
Health Leadership Institute and the Kansas Public Management
Center Public Health Certification program. He is a member of the
Kansas Association of Local Health Departments Board.
Improving the
Health of Kansans
We’re not in Samuel Crumbine’s
stream anymore!
Dr. Samuel Crumbine is an iconic public health figure. His
work as health officer with the Kansas State Board of Health in the
early 1900s was innovative and life-saving and is still recognized
as such today throughout the public health field.
So what did he do? In part, Crumbine recognized that “disease
drivers” were community based, and he actively intervened
upstream of diseases to prevent rather than treat illness.
One hundred years ago, public health prevention was largely
centered on preventing communicable and infectious diseases
by reducing environmental sources of disease and improving
hygiene. In the 1885 Douglas County Health Officer’s annual
report, Dr. N. Simmons reported on the presence of diseases
such as typhoid, diphtheria and malaria. His description of living
conditions and the acceptance of death as commonplace seems
unreal and disconnected to the world we know today.
4 Kansas Child A Publication of Child Care Aware ® of Kansas

Paradoxically, while the burden of disease has shifted from
acute and infectious to chronic and non-communicable, there
remain some truths that have stood the test of time. Chief among
them, in my mind, is that place matters to our health. Current
evidence and theory tell us that our health, while rooted in our
genetics and moderated by the medical care we receive, is largely
determined by our behaviors and socio-economic status. The
diagram (right) illustrates the “Determinants of Health.”
In 2017, we know life span varies based upon where a
person lives. Census tracts show us that people associated with
lower socio-economic status (e.g. income and education) and
unhealthy behaviors (e.g. tobacco use, physical inactivity and
poor diet) consistently have shorter average life spans. In Douglas
County, the average life expectancy ranges from 75 to 83 years.
That’s an eight-year difference that can be attributed to placerelated
factors.
PERCENTAGE CONTRIBUTING
TO OVERALL HEALTH
40%
10 %
10 %
❉ HEALTH CARE
(e.g., access to and quality of
care, insurance status)
❉ PHYSICAL
ENVIRONMENT
(e.g., place of residence,
exposure to toxic substances,
built environment such as
buildings and transporation
systems, natural environment
such as plants and weather)
❉ SOCIAL
& ECONOMIC
FACTORS
(e.g., discrimination,
income, education
level, marital status and
economic factors)
40% ❉ HEALTH BEHAVIORS
(e.g., eating habits, alcohol or substance
use, hygiene, unprotected sex, smoking)
Source: Kansas Vital Statistics (2010-2015).
Here’s what else we know:
In 1985, life expectancy in Kansas was more than a year greater
than for the United States as a whole. Today, it is less.
Today, more Kansans live in poverty.
From 1995 to 2014, the rates for obesity and diabetes in Kansas
have more than doubled.
Today, public health continues to focus on the upstream causes
of disease, just as Crumbine did so effectively 100 years ago.
However, we are not in Crumbine’s stream anymore. Instead we
are in the “determinants of health” stream. This stream requires
public health practitioners to develop different skills and strategies
if we are to be effective in improving population health outcomes.
To accomplish this, we need leaders who will challenge health
departments and communities to change streams and to have the
willingness to start the journey without a clear roadmap of how to
get there.
At the Lawrence-Douglas County Health Department, our
journey began with a desire to expand our focus beyond the
20,000 individuals walking through our doors to receive clinical
services, and to instead address the health needs of all of the
county’s 116,000 residents. A population-focus for public health
means that we work across the health care, education, civic,
business and faith systems to establish policies and change our
environment so that place no longer determines how healthy we
will ultimately be.
Source: Booske B.C., Athens J.K. Kinding D.A. et al. County Health Rankings Working Paper: Different Perspectives
for Assigning Weights to Determinants of Health. February 2010. Available at: www.countyhealthrankings.org/sites/
default/files/differentPerspectivesForAssigningWeightsToDeterminantsOfHealth.pdf.
To accomplish this required a shift in personnel and resources.
Over time we have replaced some of our traditional positions
with new ones, such as Community Health Planner, Analyst and
Health Promotion Specialist. We have done this without adding
staff or expanding our reliance on local tax support. These staff
are the nucleus of our Community Health program. As with each
of our program areas, the Community Health program is guided
by its unique purpose statement, which reads, “Improving the
health of all Douglas County residents by informing policy and
influencing systems and environmental change.”
Along the way Community Health staff have leveraged local
tax support with Kansas Department of Health and Environment
(KDHE) and Centers for Disease Control and Prevention (CDC)
funds to help communities in Douglas County accomplish the
following:
Eudora: Passage of a tobacco-free public spaces ordinance and
creation of a walking path that connects their elementary school
to surrounding neighborhoods.
Continued on page 6
www.ks.childcareaware.org Kansas Child 5

Continued from page 5
With support from the Kansas Department
of Health and Environment, tobacco-free
signage was posted in Eudora, Lecompton
and other communities in Douglas County
Lecompton: Passage
of a tobacco-free parks
policy.
Lawrence: Passage
of a tobacco-free parks
policy; expansion of
the multi-use concrete
pathway called the
Lawrence Loop;
development of Safe
Routes to School
program, bicycle
safety and local food
procurement policies at
Lawrence Public Schools,
creation of a healthy
food vending policy with
Lawrence Parks and
Recreation along with
a “Fuel Good – Feel Good” public media campaign promoting
healthy food choices.
Douglas County: Support for the Douglas County Food Policy
Council and the development of plans and programs to support
local agriculture, including direct sales to schools in Lawrence,
Baldwin City and Eudora.
Not only do our Community Health staff work in the social
determinants of health stream, but so do our traditional health
department programs. The staff in these departments had to
rethink how they do business.
Clinic staff has:
•§
Shifted from providing flu clinics at businesses as fee-forservice
to providing flu clinics at the Lawrence Homeless
Shelter, local food kitchens and other venues, with the goal
of providing no-cost flu shots to those who would otherwise
likely not be vaccinated.
•§
Partnered with a local federally qualified health care center to
establish a primary care team within the Health Department
clinic. This was done after recognizing that pre-hypertensive
and hypertensive family planning clients were not receiving
sufficient primary care service.
•§
Received training to provide smoking cessation referrals and
track the success as part of their performance metrics.
Family and Senior Support staff have:
•§
Partnered with local pediatricians to screen new families
for exposure to adverse childhood experiences (ACES).
At-risk families are referred to the Health Department for
potential enrollment in the Healthy Families or Healthy Dads
programs.
•§
Partnered with the Lawrence-Douglas County Fire Medical
to provide in-home screening and care-connection services
for elderly individuals who frequently require EMS services.
Working upstream means working to address root causes. It
no longer makes sense to wait for people to get sick and then care
for them. Instead, let’s recognize and address the determinants of
health in our communities.
Kansans have their share of health challenges but also believe
in the value and importance of community. If we leverage this
strength, I believe we can create communities all across Kansas
where the opportunity for good health exists for all. n
Stephen Mason, of Lawrence Parks and Recreation, shows students how to
change a bicycle tire at a Lesson and Safety Training class at Broken Arrow
Elementary School in Lawrence.
Dr. Jeff Mincher of Heartland Community Health Center, visits with Public
Health Nurse Nicole Herrera, of the Lawrence-Douglas County Health
Department. Dr. Mincher leads the primary care team that is located in the
Health Department’s clinic.
Robert Kortlucke, left, Fatherhood Initiative case manager at the Lawrence
Community Shelter, visits with Healthy Dads Coordinator Jery Màrquez, of the
Health Department. Kortlucke and Màrquez facilitate classes for the Healthy
Dads program, which aims to help fathers build positive, lasting relationships
with their children.
6 Kansas Child A Publication of Child Care Aware ® of Kansas

Immunize Kansas Coalition
Recommends Keeping Kansas Children
Healthy by Getting Influenza the Vaccine
The flu vaccine is necessary and safe for
children.
The flu virus is common and
unpredictable, and it can cause serious
complications and death, even in healthy
children. Immunization for influenza is the
best way to protect children.
Five to 20 percent of the U.S. population
gets the flu, and every year, more than
200,000 people are hospitalized from
complications. At least 101 children died
from the flu in the 2016-2017 influenza
season. In Kansas, 99 deaths were directly
attributed to influenza. This was a fivefold
increase from the previous season,
with only 19 deaths (Kansas Department
of Health and Environment Kansas
Surveillance Report Sept 2016-2017).
The American Academy of Pediatrics
(AAP) and the Center for Disease Control
and Prevention (CDC) recommends
annual influenza immunization for all
people ages 6 months and older, including
children and adolescents.
Sometimes people think because they
have never received a flu shot they do not
need one. Other people believe because
they have already been sick with a cold,
they do not need a flu shot. The fact is
that it is still important to get the vaccine
now. This is especially true for children,
people with asthma, heart disease,
diabetes, weakened immune systems, and
Has child received 2 or more total doses a
of any trivalent or quadrivalent vaccine b
before to July 1, 2017?
YES
1 Dose
NO/Don’t Know
2 Doses
(Interval is 4 weeks)
pregnant women, who are at particularly
high risk for complications of influenza,
such as pneumonia.
The flu vaccine cannot cause the flu
and has been safely given to hundreds of
millions of Americans over the past 50
years (Centers for Disease Control).
Infants and children up to 8 years of
age receiving the flu shot for the first
time may need two doses of the vaccine,
administered at least four weeks apart. It is
important that these children get their first
dose as soon as possible to be sure they can
complete both doses before the flu season
begins. (American Academy of Pediatrics
Gateway September 2017 Publication)
For the 2017-2018 season,
manufacturers of the vaccine have
projected that they will produce up to 166
million doses of flu vaccine. This year’s
vaccine is available only as a shot. The
nasal spray is not available this year.
Children with an egg allergy can safely
get the flu shot from their pediatrician
GRETCHEN HOMAN
MD, FAAP
Dr. Gretchen Homan earned her medical
degree from The University of Kansas
School of Medicine and completed
residency training in pediatrics. She is
an Assistant Professor with KU Wichita
Pediatrics and her area of focus is
preventive medicine with special interest
in immunizations. She is a board member
of the Kansas Chapter of the American
Academy of Pediatrics and Chair-elect
for the Immunize Kansas Coalition.
,without going to an allergy specialist.
Even those with a history of severe egg
allergy are not likely to have a reaction to
the flu vaccine. n
Additional Information & Resources:
•§
Immunize Kansas Coalition
•§
Kansas Department of Health and
Environment Immunization Program
•§
Preventing the Flu: Resources for Parents &
Child Care Providers
•§
Flu: A Guide for Parents of Children and
Adolescents with Chronic Health Conditions
•§
Influenza Immunization for All Health Care
Personnel: Keep It Mandatory (AAP Policy
Statement)
•§
Flu.gov (Centers for Disease Control and
Prevention)
•§
PreventChildhoodInfluenza.org (National
Foundation for Infectious Diseases/
Childhood Influenza Immunization
Coalition)
•§
Flu Fighter Coloring Book (National
Foundation for Infectious Diseases)
•§
Ready Wrigley Prepares for Flu Season:
Activity Book (Centers for Disease Control
and Prevention)
•§
FamiliesFightingFlu.org
www.ks.childcareaware.org Kansas Child 7

Every
39%
of those making
less than $15,000 a year
are uninsured
Adult tobacco
rate is
17%
Kansan
Deserves
to Be
Healthy
STEVE COEN
President & CEO,
Kansas Health Foundation
Steve Coen has worked to improve
the health of all Kansans in his
30-plus years at the Kansas Health
Foundation. He has held his current
position as president and CEO since
August 2008. Steve is a native
of St. John, Kan., and graduated
from Emporia State University and
Washburn University School of Law.
For more than 30 years, the Kansas Health Foundation has invested
in ideas to promote healthier people and stronger communities. Through the
years, we have used data to identify top health threats across the state, and
worked with partners in Kansas communities to make positive and longlasting
change.
Many of our efforts have focused on improving the health of Kansas children
and families and reducing health threats. From programs, to awareness
campaigns, to policy efforts, KHF’s work in collaboration with many groups
across the state is making a difference in the lives of Kansans of all ages.
At KHF, we have worked with partners on programs to increase the
number of primary care physicians in underserved areas, providing greater
access to care. We’ve funded efforts to reduce tobacco use and created the
“Take it Outside” awareness campaign to encourage parents not to expose
children to cigarette smoke. All Kansans, young and old, have benefitted
from partnerships to adopt clean indoor air policies and restrict tobacco use.
Kansas schools are promoting more physical activity through the funding of
a statewide physical education curriculum and training. Working with both
nonprofit organizations and government agencies, we have also advocated for
local and state policies to improve health and healthier behaviors for Kansans.
Despite these efforts, much work remains. Today, our work is focused
in four areas: increasing access to quality, affordable healthcare; improving
healthy behaviors; encouraging greater civic and community engagement;
and promoting educational success. Our vision is to create a culture in which
every Kansan can make healthy choices where they live, work and play.
Unfortunately, not all Kansans have the opportunity to lead a healthy life, and
significant differences in health outcomes exist for thousands.
We know from looking at Kansas data that health outcomes are greatly
affected by race, income, education level and geography. This affects both
individuals and families. Children from lower-income families, racial/ethnic
minority groups, and certain zip codes, experience lower health outcomes
and educational challenges. As child care and early childhood education
professionals, you see every day how children are affected by these social
factors and how other factors, including lack of nutritious food, serious dental
problems, and learning struggles can negatively impact the physical, social and
emotional development of Kansas children.
In order to make change happen, we first need to be sure others understand
the significance of these problems, and that means building greater awareness
of the gaps or disparities for these health-related issues.
For example, today more than 15 percent of all Kansans do not have access
to affordable health care. Some Kansans experience even greater challenges.
Forty-seven percent of working individuals are without a high school diploma,
and 39 percent of those making less than $15,000 a year, are uninsured.
8 Kansas Child A Publication of Child Care Aware ® of Kansas

The obesity
rate is
31.2%
36%
of Kansans with less
than a high school
diploma vote
Hispanics and African Americans in Kansas are less likely to have access to
health care, at 46 percent and 21 percent, respectively.
A similar story unfolds when we look at disparities in healthy behaviors,
as indicated by rates of obesity and tobacco use. While the statewide adult
tobacco rate is 17 percent and the obesity rate is 31.2 percent, the rates for
our priority populations are significantly higher. For example, tobacco use by
African Americans is at 24 percent, and obesity rates of those with less than
a high school diploma are nearly 40 percent. Unfortunately, the likelihood
is high for children growing up in these environments to experience similar
outcomes as they become adults.
There is a significant, but often overlooked, factor that can contribute to
improved health and stronger communities – and that is civic engagement.
However, Kansas data indicate that the same groups that traditionally
experience disparities in health outcomes (race, income, education level and
geography) also experience disparities in voter registration, voter turnout,
attending public meetings or contacting public officials. For example, while
more than 56 percent of Kansans vote in local elections, only 36 percent of
Kansans with less than a high school diploma vote, and only 27 percent of
Hispanics vote.
Active, engaged community members help to shape policies, express
needs and expectations, determine how resources are allocated, and elect
their representatives. Involvement in this process is essential for policies on
health issues such as access to affordable health care, eliminating food deserts,
promoting an environment for physical activity, and investing in quality child
care and schools. The result is both improved health outcomes for residents
and healthy, vibrant communities for all.
To make the greatest impact with our resources, the Kansas Health
Foundation has focused our efforts on addressing critical health and
civic engagement gaps. We reach out to low-income and racially diverse
communities, both rural and urban, and help individuals reach higher
education levels. This strategic approach helps engage and support these
priority populations, and work within communities and neighborhoods
for change.
Child care providers and early childhood educators are key stakeholders in
this process. You have an incredible voice to help inform policy and support
families as advocates for healthier children. Each day, you are the “boots on
the ground” to provide healthy environments and encourage lifelong healthy
behaviors. This provides children great support to thrive and succeed. We are
proud of your work with children, reaching out to families, and leading by
example as you have adopted healthy policies and habits.
We believe the next big step to make wider change possible is to encourage
greater civic engagement. Working together, we can create a culture where
every Kansan can make healthy choices where they live, work and play. n
www.ks.childcareaware.org Kansas Child 9

Strengthening
Healthy Food Access
Across Kansas
DR. DAVID E. PROCTER
Center for Engagement and
Community Development,
Kansas State University
David Procter is the Director of K-State's
Center for Engagement and Community
Development. Since arriving at K-State in
1987, he has worked in partnership with
communities across the state. He has
worked on issues of school consolidation,
community strategic planning, heritage
museum education, facilitation of
community dialogue, and strategies for
re-populating rural communities. Procter
has authored two books on community
building - Enacting Political Culture (1991)
and The Rhetoric of Community Building
(2005) plus numerous essays and book
chapters on the subject. Before becoming
the Director of CECD, Procter served on the
Advisory Board for the Kansas Center for
Rural Initiatives.
Ten years ago, Kansas State University’s Center for Engagement and
Community Development, along with several K-State faculty, communitydevelopment
Extension specialists, healthy food stakeholders, and four grocery
owners, applied for and received a small USDA grant to assist rural Kansas grocery
stores. Through this collaboration, Kansas State University’s Rural Grocery
Initiative (RGI) was launched.
We had come to understand the incredible importance of grocery stores in
rural communities. These small businesses are one of the primary economic
drivers in rural towns, annually adding nearly a million dollars to local economies;
employing, on average, 17 full-and part-time workers; and providing these towns
significant tax revenue. Not only do these businesses strengthen local economies,
they also provide healthy foods to rural residents.
Nearly 800,000 Kansas residents live in what are known as food deserts – areas
where significant poverty and limited access to grocery stores exists.
Research from the Academy of Nutrition and Dietetics explains that rural
grocery stores offer healthier foods, at lower cost, than convenience stores, and
that these stores are often distribution points for locally grown foods. Finally,
these businesses are community hubs. They are places where people gather,
socialize, and catch up on local happenings.
Despite their critical importance, rural grocery stores struggle to survive.
Since 2007, 45 rural communities have seen their independently owned grocery
store close. To address this rural community challenge, Kansas State University
launched the Rural Grocery Initiative. The RGI is a multi-state, multi-university,
campus/community collaboration involving numerous food access and small
business stakeholders from across the food system. Working in towns of 2,500 or
fewer people, the RGI has worked to: identify the challenges facing rural grocery
stores, develop responses to those challenges, identify sustainable grocery business
models, build virtual and face-to-face information networks for rural grocers, and
strengthen rural access to healthy foods.
10 Kansas Child A Publication of Child Care Aware ® of Kansas

Growing Healthy
Kansas Kids
A Child Care
Provider’s Story
In our efforts to address these goals, the RGI created a database of nearly 200
Kansas rural grocery stores, surveyed owners to better understand the challenges
they face, built an informational website (www.ruralgrocery.org), and developed
a rural grocery business toolkit. We have facilitated numerous community
conversations called FEAST (Food.Education.Agriculture.Solution.Together),
where citizens have come together to chart their path to strengthen local food
systems and their grocery stores. We have also hosted five national rural grocery
summits where hundreds of owners and food access stakeholders have come
from states across the U.S. to discuss the latest research and best practices
regarding rural grocery operations.
Perhaps most inspirational has been the amazing communities and people we
have worked with around this initiative. For example, following a FEAST event,
Crawford County is working to increase production of food to be consumed
locally by establishing a land bank to provide land for students who want to start
their own “farming” business. In addition, K-State Research and Extension is
offering classes for building food business plans and writing grants for funding.
In Little River, Kan., the city commission, a community foundation, local bank,
and the local grocery owners collaborated to secure stable financing for the
grocery store ensuring it will survive and also will be available to transition to
other owners when the current owners decide to step away. In Plains, Kan., the
community is not only planning to open a grocery store, but is also developing
programming focused on healthy eating. The community recognizes that
simply having a grocery store doesn’t necessarily translate to healthy eating, so
they are developing healthy recipes, grab-and-go healthy food products, and
planning for a commercial kitchen that will offer healthy-cooking classes.
Residents all around Kansas are working hard and innovatively to bring
healthy foods to their communities. K-State’s Rural Grocery Initiative is proud
to work alongside Kansans in this important work to increase healthy food for
all Kansans. n
By Kimberly Smith,
Community Outreach Coordinator,
Child Care Aware ® of Kansas
After 24 years in the early childhood
education world, Tammie Petrik knows
a thing or two about healthy, happy
children. And she knows that providing
an environment rich with experiences
leads to a love of learning. Within Little
Angels Daycare, her home-based child
care program, Tammie has created a
unique opportunity for the children. For
several years, Tammie and the children
have planted a garden. From tomatoes and
carrots to pumpkins and fruit trees, their
land yields a generous bounty.
During the spring and summer, one can
often see Tammie and her children out
and about at her Highland, Kan., home.
Tammie talks to the children about seeds
and plants. The children discuss if larger
seeds will yield larger plants, or if the plant
will have bigger leaves, or longer vines.
They understand that some seeds seem
to sprout miraculously overnight, while
others take a little more time and patience.
She and the children keep track of the
weather, and if the rains fall short, the
children help water their plants. They wait
with excitement for the first tender, green
shoots to break through the rich soil.
Once the fruits and vegetables are ripe,
the children are eager to harvest. Tammie
explains that when the children have a
hand in growing the different fruits and
vegetables, they are very willing to try even
unfamiliar foods. “I just love to see the
amazement in their eyes,” Tammie shares.
“They love to watch over their garden, and
pick their own fruits and vegetables to eat.”
In a time when most families are
rushed and busy, and processed
“convenience” foods are often more
readily available, Tammie is teaching
children a multitude of lessons. Not
only the science and academics behind
plants, but something much more.
She is teaching them about patience,
achievement, curiosity, respect for the
health of their bodies, as well as a love of
the land and the abundance it provides. n
www.ks.childcareaware.org Kansas Child 11

VAPIN
Risks of
Cartridge
(tank) holds
the liquid
“juice.”
Parts of an Electronic Cigarette
Mouthpiece
Microprocessor
Heating elelment/atomizer heats the
“juice” to make vapor.
Many devices have a
switch to activate the
heating element.
Some devices have a light-emitting
diode on the end to simulate the
glow of a burning cigarette.
Battery
BY DR. MICHELLE LOUIS
Tallgrass Family Medicine
Dr. Michelle Louis serves
on Tobacco Free Wichita
Coalition’s Medical Advisory
Council and is a practicing
physician with Tallgrass
Family Medicine in
Wichita, Kansas. She
graduated from the
University of Health
Sciences College
of Osteopathic
Medicine in 1988.
Parenting is fun, yet very
challenging. Just when it has become
cool for teens to make the healthy
choice not to smoke, the market
introduces another novel, exciting
way to get addicted to nicotine that
is marketed as a “healthy” and hip
alternative to smoking.
The modern e-cigarette was
invented in 2003 by Hon Lik, a
Chinese pharmacist and inventor, as
an alternative to smoking. E-cigarettes
were dismissed as a fad at first but
have since gained mass appeal. In
the U.S., tobacco producers have a
significant share of the e-cigarette
market. As of 2015, 80% of all
e-cigarette sales in convenience stores
were produced by the big tobacco
companies.
According to the U.S. Surgeon
General and leading researchers,
e-cigarettes (electronic cigarettes,
vape pens, tanks, e-hookahs)
contain harmful and potentially
harmful ingredients that are inhaled
by the user and exhaled into the
environment. The majority contain
nicotine, propylene glycol, and
flavorings. In addition, marijuana
and other drugs may be vaped.
The popularity of these products
among young people has increased
significantly over the past five years,
and the use of these devices is now
more common than the use of regular
cigarettes among middle and high
school students. In fact, e-cigarettes
are now the most commonly used
tobacco product among U.S. youth 1 .
Nicotine Poisoning on the Rise
The Kansas Poison Control Center
received 110 calls involving electronic
devices and liquid nicotine from
2014 - 2015, a significant increase
from previous years 2 . The liquid
for e-cigarettes can be purchased
at smoke shops, gas stations and
convenience stores, and is often not
regulated by city inspectors. Most
contain high enough levels of nicotine
to cause nicotine poisoning if ingested
or absorbed through the skin. It’s
especially dangerous for young
children, who may be attracted to
the liquid because of the flavors and
bright colors. In Kansas, there are no
child-proof packaging restrictions,
making the e-juice containers easy to
access for children of all ages.
According to the CDC, nicotine
in any form -- including e-cigs -- is
unsafe for youth. It is highly addictive
and can harm the developing
adolescent’s brain. The brain continues
to develop through the early to midtwenties.
Because the adolescent
brain is still developing, nicotine
use during this critical period can
disrupt the formation of brain circuits
that control attention, learning, and
susceptibility to addiction.
•§
Young people are uniquely
at risk for long-term effects
of exposing their developing
brains to nicotine, including
mood disorders and permanent
lowering of impulse control.
•§
Nicotine activates the limbic
system more strongly in the
adolescent brain than in the adult
brain, making addiction a greater
risk for youth who use nicotine.
•§
E-cigarette use is strongly
associated with other tobacco
product use, including regular
cigarettes.
12 Kansas Child A Publication of Child Care Aware ® of Kansas

Secondhand Vapor
G
In
The secondhand vapor exhaled
into the air is not harmless water
vapor as advertised by many. Besides
nicotine, e-cigarettes and their vapor
can contain harmful and potentially
harmful ingredients, including:
•§
ultrafine particles that can be
inhaled deep into the lungs
•§
flavorants such as diacetyl, a
chemical linked to “popcorn
lung,” (so identified because
of the incidence of the disease
in workers at plants that used
flavorants containing diacetyl in
microwave popcorn)
•§
volatile organic compounds
•§
heavy metals, including nickel,
tin, chromium, and lead.
How can we keep our children
breathing clean air? Traditional
tobacco prevention strategies that
have reduced tobacco use over
the past two decades can easily
be adapted to include electronic
devices and other new products. By
supporting the adoption of tobaccofree
building and ground policies,
tobacco-free park ordinances, smokefree
multi-unit housing policies, and
creating smoke-free home and vehicle
rules, parents and caregivers can
protect the health of their children
and help prevent exposure for
children in their care. n
Sources:
1. U.S. Department of Health and Human Services.
E-cigarette use among youth and young adults: a
report of the Surgeon General. Atlanta (GA): US
Department of Health and Human Services, Centers
for Disease Control and Prevention, National
Center for Chronic Disease Prevention and Health
Promotion, Office on Smoking and Health; 2016.
2. University of Kansas Hospital – Poison Control
Center – Kansas E-Cigarette Related Poisonings
2014 - 2015
SMOKE-FREE Public Housing
2006, the Surgeon General stated, “no amount of secondhand
smoke is safe.”
Secondhand smoke is not just annoying; it is deadly – containing hundreds
of toxic chemicals with approximately 70 of them known to cause cancer. Since
that warning was issued, cities and states across the country have adopted clean
indoor air laws to protect workers and the general public.
For many of us, including some of our most vulnerable populations in public
housing, the greatest amount of time spent indoors is in our homes. Science
has shown us that more than half of the air in multi-unit housing is “shared”
through ventilation, plumbing, electrical paths, etc. So, if you have a neighbor
who smokes, you and your family are exposed to secondhand smoke.
For many Americans who live in their own homes, they are able to make
their own “house rules,” and the majority of Americans have voluntarily made
their homes smoke-free. However, for
those who live in multi-unit buildings,
such as public housing, up until now
there has not been a choice to live in a
smoke-free home.
In order to protect the residents in
public housing from the real health
hazard of secondhand smoke exposure,
the U. S. Department of Housing
and Urban Development (HUD) has
announced that all public housing
nationwide is to implement a smokefree
policy by July 30, 2018. HUD has
provided an 18-month timeline for
public housing to work together with
residents to educate them, put a plan
together and to answer questions about
compliance and enforcement. HUD also
has provided an implementation guide.
Not only will the health of all
residents improve, but there is an
annual estimated cost savings of $326
million in property damage. Getting an
apartment ready for a new resident can
cost two to seven times more when the
previous resident was a smoker. The
smoke-free rule also will greatly reduce
PAT MCKONE
Regional Senior
Director, Tobacco
Control Programs and
Policy, American Lung
Association of the
Upper Midwest
Pat McKone, Regional Senior Director
– Tobacco Control Programs and
Policy, American Lung Association
of the Upper Midwest, has worked
with lung health programming for
more than 35 years. Her work has
included tobacco cessation programs
for adults and youth, limiting youth
access to tobacco, public and
school-based education, raising
awareness of the impact of tobacco
in those with mental illness and/or
substance abuse disorders, advocacy
for limiting exposure to secondhand
smoke, smoke-free housing, point
of sale, and e-cigarettes. She has
presented at international, national
and state conferences and provides
technical assistance to coalitions
across the Midwest.
the risk of fire-related deaths. The leading cause of fire deaths is smoking.
The change does not mean people who smoke cannot live in public housing,
rather, people who smoke cannot smoke in public housing units. The rule is
about the smoke, not the person. For those who smoke and want to take this
opportunity to quit, there are free resources online and by phone at 1-800-
QUIT NOW.
Let us be clear -- there is no constitutional right to smoke. For me, the
HUD rule is a social justice issue. As a child, I was raised in public housing.
Like me, many children are living in public housing, through no fault of their
own. They deserve the right to breathe clean air at home. My only sister was
developmentally disabled and lived in public housing her whole adult life.
Her apartment was saturated with secondhand smoke. As public housing
authorities move forward to implement this new rule, it’s important to
remember that everyone deserves the right to breathe clean air. n
www.ks.childcareaware.org Kansas Child 13

Clean & Healthy Outdoor Spaces
CHRIS THIEL
Student,
Wichita State University
Picture this: You take your family to enjoy the park
in your community. As your children begin playing,
it’s not difficult to notice other park-goers smoking
on or around playground equipment, lounging areas,
and largely populated spaces. You notice a substantial
amount of litter from cigarette butts and other tobacco
products just waiting to be picked up by a curious child.
This is a problem that needs to be addressed in the
interests of safety and cleanliness in your community.
This situation is a reality at many parks across the
nation and state of Kansas, where comprehensive,
enforceable tobacco-free park policies are few and
far between. This lack of policy allows community
members to smoke cigarettes and other tobacco
products in public recreation areas without
consequence, subjecting others, especially children, to
secondhand smoke and littering the ground with many
dangerous toxins for any child or pet to pick up and
perhaps accidentally consume.
When exposed to the effects of secondhand tobacco
smoke, people are at a much higher risk of serious and
life-threatening health issues, including heart disease,
cancer, asthma, and other respiratory disorders. 1 It’s
important to remember that there is no safe level
of exposure to secondhand smoke. Recent studies
have even found that secondhand smoke is just as
dangerous in an outdoor area as it is indoors, and can
deter those with asthma and allergies from going to
places where they might encounter tobacco smoke. 2
In addition to the obvious health benefits of
tobacco-free park policies, cigarette butts are not
biodegradable. 3 Because of this, tobacco-free park
policies save city staff from picking up this toxic litter
and benefit the environment. Litter from tobacco
products is incredibly unattractive, expensive to
remove, and a blatant hazard to waterways and wildlife.
Additionally, parks and other outdoor public spaces,
such as ballparks, could be some community
members’ only access to a relaxing, natural
environment, which is why cities need to provide clean,
healthy outdoor spaces. Several cities in Kansas have
already passed legislation or policy to make their parks
tobacco-free, including Lawrence, Eudora, Hiawatha,
Highland, and South Hutchinson. Please advocate for
tobacco-free policies in your city’s parks and outdoor
settings and let’s provide clean and healthy outdoor
spaces for all Kansas families to enjoy. n
Chris Thiel is a Public Health Sciences
student at Wichita State University,
serving as a Health Professions Senator
for Student Government, member
of Sigma Phi Epsilon, and the Greek
Relations Chair for the Interfraternity
Council. He also works on campus as
a Supplemental Instruction leader for
Anatomy and Physiology and as a Student
Project Assistant at the Community
Engagement Institute in the Center for
Public Health Initiatives. After graduation,
Chris plans to become a Physician
Assistant and get a Master’s in Public
Health. He has also served as the Youth
Advisor for Resist for a little over a year,
and is passionate about tobacco control
and youth advocacy.
1. U.S. DEPT OF HEALTH & HUMAN SERVICES, CENTERS FOR DISEASE CONTROL AND PREVENTION, The Health Consequences of Involuntary Exposure to Tobacco Smoke: Report
of the Surgeon General (2006), http://www.surgeongeneral.gov/library/secondhandsmoke/report/index.html.
2. James Repace, Benefits of Smoke-free Regulations in Outdoor Settings: Beaches, Golf Courses, Parks, Patios and in Motor Vehicles, 34 WM MITCHELL LAW REVIEW 4 (2008)
3. CigaretteLitter.org, Cigarette Litter, http://www.cigarettelitter.org.
14 Kansas Child A Publication of Child Care Aware ® of Kansas

Quit smoking for
you and them.
Get FREE help:
1-800-QUIT-NOW
KSquit.org
www.ks.childcareaware.org Kansas Child 15

MATT MESSINA
Safe Routes to School
You can do it, too!
Kansas Department of
Transportation, Bicycle &
Pedestrian Coordinator
Matt is the state of Kansas’ Bicycle and
Pedestrian Coordinator at KDOT. In this
position, he evaluates and reviews many
Safe Routes to School projects throughout
the state. As an avid walker and bicyclist,
Matt also knows what it takes to make
sure walking and biking remain routine,
even with a busy schedule.
It is difficult to deny that children need
safe routes that allow them to walk or
bike to school (and other places). For
this reason, Safe Routes to School (SRTS)
projects and programs are becoming
increasingly popular in Kansas and
around the country. The associated
benefits of promoting SRTS include an
increase of physical activity, improved
safety in communities, and reduced traffic
congestion. In fact, a 2009 assessment
showed that 10-14% of rush hour traffic
is related to parents driving kids to and
from school 1 .
While some parents can easily adjust
their daily routines and access the new
sidewalks in their neighborhoods, some
families are still beyond the limits of a
“safe route” and are not comfortable with
their children traveling the whole way to
school or walking alone. These concerns
are understandable; it’s instinctive to
be concerned for and protective of our
children. But, there are solutions worth
considering for you and your children.
Here are some tips that can help make
sure you’re able to benefit from your
community’s investments in Safe Routes to
School projects:
Split the trip – You may not want your
child to walk the whole way to school.
Instead, find a place that is within a
reasonable distance from the school that
you are comfortable with (a nearby park
or a friend’s neighborhood), drive there
and let the child walk or bike the rest of
the way. This allows the child to get some
physical activity, keeps you out of the
school-related congestion, and addresses
the “distance” problem. This tactic can
also be applied to a group carpool, which
allows kids to walk in a group for the rest
of the way.
Take a turn – If you’re uncomfortable
with your child walking alone and
unchaperoned, chances are other parents
feel the same. Organize a group of parents
who have similar concerns and create
a schedule to take turns walking with
the group. The more parents you get to
sign up, the fewer days you’ll need to be
the chaperone. If you’re already part of
a carpool group, this should be an easy
transition.
Get in gear – There is a saying, “There
is no such thing as bad weather, just bad
gear.” You don’t need to cancel a walking
or cycling trip to school because of
some rain or snow. There are plenty of
successful SRTS programs around the
country that manage in less-desirable
weather conditions—think Alaska, or New
Hampshire. With the right gear, like an
umbrella, galoshes, and a raincoat, you’ll
realize that a little rain or snow is not the
end of the world.
Plan for what works – You don’t have
to commit to having your child walk or
bike every day. Start by picking a day
of the week (or even month) that you
know will work for you and your family’s
schedule. You can make adjustments later
as you become more familiar with the new
routine, adding a day or altering the route.
Being involved with your community’s
SRTS program is the best way to take
advantage of the benefits. By following
these tips and adjusting them to meet your
needs, you can start to develop a routine
that increases your child’s physical activity
levels, improves traffic safety in your
community, and helps you avoid the chaos
and congestion at the school’s student
drop-off zone. n
1 McDonald N, Brown A, Marchetti L, et al. “U.S. School
Travel, 2009: An Assessment of Trends.” American Journal
of Preventive Medicine, 41(2): 146-151, 2011.
16 Kansas Child A Publication of Child Care Aware ® of Kansas

Healthy Habits for a Healthy Future
Every child deserves the chance to grow
up healthy and strong. When children have
a lifestyle that includes nutritious food
and plenty of time for active play, they are
more likely to reach their full potential.
In the U.S., nearly one in four
preschoolers (ages 2 to 5) is overweight
or obese, an alarmingly high number.
Children who are overweight as
kindergarteners are four times more
likely to be obese as eighth-graders. With
obesity comes a high risk for other health
conditions, even in childhood, such as
asthma or Type 2 diabetes.
While childhood obesity rates (ages 2
to 19) have remained stable for the last
decade, they are still three times as high as
they were in 1980. During this same time
period, our food and fitness environment
has shifted, making it more difficult to eat
healthy and be active.
Some of our most vulnerable children
have limited access to healthy food, and
many are bombarded with unhealthy
food offerings. The food and beverage
industry spends $2 billion each year
marketing specifically to children. In
addition, for young children, screen time
may be replacing physical activity time.
The good news is that, together, there is
much we can do to help children grow up
healthy and active. One of the best ways
to prevent childhood obesity is to start
young!
Healthy Habits in Early Childhood:
Why they’re so important!
When children are preschool age, they’re
still learning and forming their health
habits and tastes.
Studies suggest that children’s
experiences in early care and education
(ECE) programs have an important
influence on weight status in childhood.
Regular physical activity and good
nutrition help children grow up healthy
and strong. Children learn better in
healthy environments.
Early care and education programs in
Kansas and Missouri have been working
to create this healthy start for children by
changing policies. They are serving more
nutritious foods and drinks and ensuring
that kids are physically active every day.
At Children’s Mercy, we are excited
to partner with organizations such as
the American Heart Association, The
Family Conservancy, Child Care Aware®
of Kansas, local health departments and
many others to support these efforts.
One of the ways we work together is to
share a consistent message about health
-- 12345 Fit-Tastic! This message promotes
five specific habits for kids (ages 2 and up)
to engage in every day:
1
2
3
4
5
hour or more
of physical activity
hours maximum
of screen time
servings of low or
nonfat milk or yogurt
servings of water
-- not sugary drinks
servings or more
of fruits & vegetables
At Children’s Mercy, we’ve worked with
partners to create the Healthy Lifestyles
Initiative in Early Childhood toolkit.
The toolkit helps guide early care and
education programs on how to share
the 12345 Fit-Tastic! message, tips and
EMILY MEISSEN-
SEBELIUS, M.S.W.
Project Coordinator,
Weighing In Program,
Children’s Mercy Hospital
Emily Meissen-Sebelius, M.S.W., is project
coordinator for the Weighing In program
with Children’s Mercy Hospital. Emily
works with community partners on
policy and environmental changes that
support healthy lifestyles. Before joining
Children’s Mercy, Emily was an analyst at
the Kansas Health Institute, where she
worked to conduct research, evaluate
programs and inform policy in the fields
of early childhood, mental health and
public health.
resources with families. It also connects
the 12345 Fit-Tastic! message with those
important wellness policy changes that
make it easier for children to practice
healthy habits.
What’s in this toolkit?
•§
12345 Fit-Tastic! materials and parent
handouts available to ECE providers
•§
Ideas for how to use 12345 Fit-Tastic!
messaging within ECE programs and
in communication with families
•§
Examples of 12345 Fit-Tastic! wellness
policies and practices for ECE
programs
•§
Sample 12345 Fit-Tastic! family letters
that connect wellness policies with the
12345 Fit-Tastic! behaviors
We hope this toolkit can give you
ideas for how you might be a Fit-Tastic!
champion within your family, program or
community! Together we can help young
children thrive through the healthy habits
of 12345 Fit-Tastic! For more information,
contact us at weighingin@cmh.edu or visit
www.FitTastic.org . n
www.ks.childcareaware.org Kansas Child 17

Protecting and Securing Healthier
HESTER PAUL, M.S.
National Director,
Eco-Healthy Child Care ® ; Children’s
Environmental Health Network (CEHN)
Hester Paul, National Director of Children’s
Environmental Health Network’s (CEHN)
Eco-Healthy Child Care® (EHCC) program,
works to ensure that children throughout the
nation benefit from the reduction of harmful
environmental toxins within child care facilities.
EHCC offers comprehensive training, technical
assistance, resources and an endorsement to
child care professionals. CEHN is a national multidisciplinary
organization whose mission is to
protect the developing child from environmental
health hazards and promote a healthier
environment. Hester can be reached at 585-307-
7170, or hesterp@ecohealthychildcare.org
The chemicals a child encounters
daily—at home, in the early learning
setting, and even in the womb—can play
a greater role than previously imagined
in a child’s health and development. In
the United States, an estimated 13 million
children spend at least 35 hours a week
in some form of child care; therefore,
child care providers represent a cadre
of professionals uniquely positioned to
influence children’s cumulative exposures
to harmful substances.
Fortunately, parents and early learning
leaders can benefit from a variety of
resources that will assist them in making
healthier choices for their children,
including the free checklist and fact sheets
available from the Eco-Healthy Child
Care® (EHCC) program that offer simple
steps to reduce harmful exposures.
Advances in science have dramatically
changed our understanding of how our
bodies interact with our environment, and
how these interactions affect our health,
especially the health of young children.
Scientists are identifying more and more
substances in products that we use every
day that have the ability to suppress or
mimic hormones. These hormone mimics,
often called endocrine disruptors, can
impact not only sex-related hormones that
influence reproduction and fertility, but
also thyroid hormones that are related to
the ability to learn. 1
Baby bottles, sippy cups, teething
rings, dolls, rubber duckies, beach balls
and inflatable pools are often made
with phthalates and Bisphenol A (BPA).
These two toxic ingredients in plastics
are of particular concern, as research
increasingly shows that these chemicals
mimic or suppress hormones (e.g.,
1 De Coster S and van Larebeke N, “Endocrine-
Disrupting Chemicals: Associated Disorders and
Mechanisms of Action: Review article,” J Environ Public
Health. 2012; 2012: 713696.
Published online 2012 September 6. doi:
10.1155/2012/713696 PMCID: PMC3443608
18 Kansas Child A Publication of Child Care Aware ® of Kansas

Early Learning Environments
estrogen and testosterone) and disrupt
normal development and growth.
Unfortunately, this is just one example
of a growing body of evidence about
worrisome health effects resulting from
exposure to a number of chemical
categories, such as fragrances, flame
retardants, and compounds in building
materials. Despite this knowledge,
children are still being exposed, whether
it is through their drinking water, poorly
maintained lead-based paint in their
homes, schools or child care facilities,
consumer products, food, or air pollution.
Of the 85,000+ synthetic chemicals
in commercial use today, only a
small fraction has been tested for
their impact on children’s health.
For example, a wide variety of toxic or
hazardous chemicals are routinely used
as ingredients for cleaning products.
Household chemicals can make indoor
air unhealthy to breathe, irritate the
skin and eyes, harm the respiratory
tract and hormone system, and pollute
the natural environment. Children are
especially vulnerable to toxic chemicals,
because their bodies and organs are still
developing.
It is essential that parents and caretakers
understand the differences in products
when cleaning, versus sanitizing and/
or disinfecting. Routinely cleaning with
detergent and water is the most useful
method for removing germs from surfaces
in the child care setting or home. There
are times that a sanitizer or disinfectant
is needed however, such as after a diaper
change, but it is important not to overuse
sanitizers and disinfectants. EHCC
supports child care professionals in
understanding how to effectively follow
their state’s licensing regulations for
cleaning, sanitizing and disinfecting,
while still being careful to protect a child’s
environmental health. Key available
resources are highlighted by EHCC when
appropriate, such as Appendix J of Caring
For Our Children, 3rd Edition, which
provides helpful guidance in selecting an
appropriate sanitizer or disinfectant.
Safer cleaning products are not only less
toxic and environmentally safe, but they
also often cost the same or less compared
to conventional cleaners. Green Seal
and EcoLogo are nonprofit companies
that research and certify products that
are biodegradable and environmentally
friendly. Visit www.greenseal.org and/
or www.ecologo.org to verify whether
the products you and/or your child’s
provider use are safe, healthy and effective.
Additionally, the US Environmental
Protection Agency
(EPA) has created
Safer Choice. This label
verifies that the product
ingredients have been
thoroughly reviewed
by the EPA review.
EPA also has Safer
Choice Fragrance-Free,
a label for products
without fragrance. Visit
http://www.epa.gov/
saferchoice.
If we as a society
want to ensure that
children’s opportunities
to learn and to grow
are not stunted, our
goals should include
preventing children’s
exposures to chemicals
of concern that are
commonly found in the
early learning environments.
Get empowered! Access the low-cost
practical steps and healthier purchasing
policies that have already been adopted
in thousands of child care facilities
across the nation. Download the free
checklist offered by Eco-Healthy Child
Care® (EHCC) at www.cehn.org/ehcc to
About Eco-Healthy Child Care ®
Eco-Healthy Child Care ® is a sciencebased,
award-winning program managed
by the Children’s Environmental
Health Network, a national nonprofit
organization created to protect the
developing child from environmental
health hazards and to promote a
healthier environment. The best
practices promoted through EHCC are
guided not only by EHCC’s Science
Task Force, a committee made up of
nationally recognized researchers,
pediatricians and toxicologists, but
also by EHCC’s 30-member National
Advisory Committee, which includes
representatives of the National Resource
Center for Health and Safety in Child
Care and Early Education, Child Care
Aware® of America and other early
learning and environmental health
professional organizations.
get started on making healthier choices
right away. Read the tips and resources
offered within EHCC’s 16 fact sheets, also
free to download at www.cehn.org/ehcc/
factsheets.
How does the Eco-Healthy Child Care®
program work? The 30-item Eco-Healthy
Child Care® checklist offers practical,
free or low-cost steps in 11 areas: Air
Quality, Household Chemicals, Lead,
Mercury, Radon, Art Supplies, Furniture
and Carpets, Plastics and Plastic Toys,
Pesticides, Arsenic: Treated Wood and
Water, Recycling and Garbage Storage
and Education and Awareness. Child care
facilities that participate in the EHCC
endorsement program receive a certificate
and poster announcing their two-year
endorsement. They are also recognized
on the EHCC website, where their efforts
are recognized and where parents can
go to search for providers who are going
above and beyond child care licensing
regulations to incorporate environmental
health best practices into their daily
routines. n
www.ks.childcareaware.org Kansas Child 19

KATIE SCHOENHOFF
Program Officer,
United Methodist
Health Ministry Fund
Katie Schoenhoff is a program officer
for the United Methodist Health Ministry
Fund focusing on strategic initiatives in
breastfeeding support and early childhood
social-emotional health. Additionally, she leads
Healthy Congregations, a Health Fund program
supporting targeted, outcomes-oriented
wholistic health ministries in United Methodist
churches throughout Kansas and Nebraska.
She is a graduate of Sterling College with a
double major in Health/Physical Education
and Athletic Training. Previously, she
worked as an athletic trainer and then in
health education at the Reno County Health
Department. She joined UMHMF in 2013.
Project NeuroNurture
Investment across 35 Kansas counties
leverages proven, short-term,
cortisol-regulating intervention for
families facing adversity
Providing a nurturing environment
does not come naturally to all parents.
When a family faces extreme financial and
emotional adversity, parents can struggle
to offer the comfort and care their babies
and toddlers require.
A growing body of research on brain
development is connecting these adverse
childhood experiences to toxic levels
of the “stress hormone” cortisol, which
can have devastating effects on a young
child’s growth and development. This
includes cycles of behavior challenges,
school struggles, and troubled adulthood.
Surprisingly, the answer to infant
and toddler cortisol regulation is not
medication, but nurturance. Now, a pilot
program called Project NeuroNurture
is implementing a proven
early intervention to help
regulate elevated levels
of cortisol in infants
and toddlers in just 10
weekly home visits.
Aimed at new
parents and caregivers of 6-to-24-
month-old children in adverse family
circumstances, the Attachment and Biobehavioral
Catch-up (ABC) intervention
method consists of home visits by a parent
coach. Throughout each of the ten sessions,
the parent coach observes interactions
between parent and child and provides
feedback on behaviors that relate to the
intervention targets. Sessions are captured
on video, so coaches can highlight parents’
strengths, weaknesses, and behavioral
changes. These sessions help parents learn
play-based strategies that build attachment
— and in turn, regulate cortisol levels in
infants and toddlers. Evidence shows that
caring and responsive relationships with
adults early in life can help develop positive
coping skills and reduce the likelihood
of chronic health concerns caused by
continuously elevated cortisol levels.
Developed by researchers at the
University of Delaware, the ABC
intervention is approved by
Health and Human
Services and received
a 1 rating on
the California
Evidence-Based
Clearinghouse
for Child
20 Kansas Child A Publication of Child Care Aware ® of Kansas

to serve 850 families
Welfare scientific rating scale, indicating
that ABC has one of the strongest bodies
of research evidence among those rated.
“We’ve known for years that very early
interventions pay dividends in the long
term,” said Kim Moore, President of
United Methodist Health Ministry Fund
(UMHMF), a funding partner for the
pilot. “Our challenge now is to find the
most effective way to achieve the greatest
outcome, and ABC is an excellent example
of a science-based, proven program that is
very short in duration, yet very powerful
in results.”
Project NeuroNurture aims to serve
850 families over a three-year period
across 35 Kansas counties. The $2.4
million investment is underwritten by
United Methodist Health Ministry Fund
(UMHMF), Kansas Health Foundation,
Wyandotte Health Foundation, REACH
Healthcare Foundation, and Hutchinson
Community Foundation. The University
of Delaware and Kansas University
Endowment Association are conducting
program training and evaluation with
grant support.
Grants are directed to five sites, which
are incorporating
the ABC method
into existing infant/
toddler home
visit programs as
a means to speed
implementation
and create synergy
with existing staff
and resources. Those sites are:
Horizons Mental Health Center: Reno
County
Northwest Kansas Council on
Substance Abuse: Cheyenne, Rawlins,
Decatur, Norton, Sherman, Thomas,
Sheridan, Graham, Wallace, Logan, Gove,
and Trego counties.
Project Eagle – University of Kansas
Medical Center: Wyandotte County
Rainbows United: Sedgwick and Butler
counties
Russell Child Development Center
(Southwest Kansas): Greeley, Wichita,
Scott, Lane, Ness, Hamilton, Kearny,
Finney, Hodgeman, Stanton, Haskell, Gray,
Ford, Morton, Stevens, Seward, Meade,
and Clark counties
A unique component of this program
is the testing of cortisol levels via saliva
samples collected from the children at the
start and end of the program. Researchers
at the University of Kansas will evaluate
the samples, which are expected to
demonstrate the same cortisol regulating
effects seen in prior ABC implementations
across the country.
“We’re able to prove this program is
helping with cortisol regulation. Anytime
you can back up the work you’re doing
with scientific evidence, it’s very exciting,”
said Moore.
Return on Infants (ROI): A Smart
Investment for Kansas: Science-based,
short-term early interventions have the
potential for large, long-term savings
for Kansas taxpayers. Research by the
Heckman Institute reports that highquality,
birth-to-five programs for
disadvantaged children can deliver a 13%
per year return on investment. These gains
are realized through better outcomes in
education, health, social behaviors, and
employment.
“Most people understand and value
the investment in
early childhood
programs,” said
Moore. “But if we
can be even more
strategic with our
funds, the savings
for Kansans
longterm could
be incredible. We have an opportunity to
make a major shift in the lives of these
children and ultimately in our future
workforce and tax base.”
Project NeuroNurture program leaders
will be contacting Kansas legislators,
business leaders, and leaders of the mental
health and early education communities
over the coming months to advocate
for investment in short-term, early
interventions programs as a means for
improving the Kansas economy and the
lives of our youngest citizens.
For more information on Project
NeuroNurture, the ABC program,
or how to get involved, visit www.
neuronurtureks.org. n
Building
Resiliency
Through
Community
Supports
By Kami Cohorst, Director
Child Care Aware ® of Kansas
Research has demonstrated that
abuse, neglect and other household
stressors can increase the risk of health
problems throughout a child’s lifespan.
Promoting
resilience—the
capacity to face
and overcome
adversity, to
bounce back
from difficulties
or challenges, to
cope and adapt
Did you know?
Only 25% of children
receive the mental
health care they need.
– childhoodresilience.org
to change—in children can contribute
to better health outcomes.
Resilience is not learned through a
one-and-done activity, but can be built
over time. Families and communities
can actively support and enhance
children’s resiliency by providing safe
and supportive environments, and by
ensuring access to community supports
and services.
Get to know supports in your
community. Who are the mental
health providers, pediatricians, school
counselors, faith-based personnel, etc.?
Get involved. Are there active civic
groups, community clubs, play groups,
or family activities you and your child can
participate in?
Be informed. Attend a training on
trauma-informed practices. Knowledge is
power!
At the end of the day, understanding
what resources exist in your community
and leveraging community support are
key to strengthening resilience. For a
detailed list of resources available in
communities around Kansas, check
out the Parent & Community Resource
Sheets on the Child Care Aware® of
Kansas website, under the helpful
resources section. n
www.ks.childcareaware.org Kansas Child 21

Creating a Village
for Successful Living
By Alice Eberhart-Wright, Child and Family Specialist
I scratched my head as I thought about how to engage children in thinking about community
health, then headed to the shelves of new books in the library. There I found titles that dealt
with community health issues such as self-care, dealing with conflict, illness and possible
hospitalization.
My Good Morning
For toddlers, community health starts with helping them learn and master all the self-help
rituals that begin with pulling their diapers off and moving up the developmental scale to
being able to get ready to go to school well-groomed. My Good Morning, by Kim Crockett
Corson and Jelena Brezovec, is delightful for children and also reminds
grownups how young children slowly master their world. Things get
messy, clothes are buttoned in ways that grownups probably want to fix,
toilet paper somehow drifts across the entire bathroom floor, and parents
sweat trying to get clothes on a jack-in-the-box child. For a while there
may be tears at child care, but then one day the tears are gone, and, in
an organized way, the child is well on her way to being ready for the
increasingly complex rituals involved with growing to adulthood. As
a bonus, this book helps our society see diversity as perfectly normal, with a light-skinned
mother and dark-skinned father. We are all beautiful.
Kid Amazing vs. the Blob
Next comes Kid Amazing vs. the Blob by Josh Schneider, a Theodor Seuss Geisel
Award Winner. This story deals with sibling issues where everyone tries to help brothers
and sisters love and care for one another. The Blob is the stinky, shrieking baby sister
who, for a time, creates havoc in a family that has been accustomed to just one child
who played center stage. The little boy handles his feelings by seeing the baby as an
uninvited intruder who must be reckoned with. He creatively makes a super hero
costume out of all kinds of ordinary things and heads out on an adventure to deal with
the stinking blob. The stinking blob of a baby is conquered by the super hero, who finds
her pacifier and plugs her up. For parents, the story introduces a strategy to engage
children in a different way to tame their annoyance. We want children to grow up to be
peace makers and problem solvers in their community.
Bear Feels Sick
Bear Feels Sick, by Karma Wilson and Jane Chapman, is an adorable book about a sick bear
and how all its friends rally around to care for him when he feels crummy. In the end they
get sick, too, and the bear gives back the love and caring he experienced. This is a great book
to read when some type of bug sweeps through a group of children. It has very few words but
wonderful illustrations to talk about. A follow-up activity might be to draw and tell a story
about when someone gets sick in your own family. What happens? What do people do about it?
How does a parent take care of you and how do you help take care of a sick parent who may not
be able to do all the things he or she usually does? The story helps us foster empathy for others.
Harry Goes to the Hospital
Harry Goes to the Hospital, by Howard J. Bennett, M.D. and illustrated by M.S. Weber, is a
book to use when a child has to go to the hospital and experience the scary IV, blood tests, and
x-rays. It includes tips about how to prepare a child, stay with him, help him relax, and use play
as therapy. The author practices pediatrics in Washington, D.C., and has written several books
that help parents deal with common issues. He also has a website that helps with bedwetting
(www.wakingupdry.com). n
22 Kansas Child A Publication of Child Care Aware ® of Kansas

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