Using data that already exists for children and families, the Strong Start Index summarizes, in a standardized way, the conditions into which children are born. It comprises a total of 12 variables that fall into four domains. A birth asset score is calculated by simply counting the number of assets present (0-12).
The California Strong Start indicators include:
Family
- Legal parentage established at birth
- Born to non-teen parents
- Born to parents with at least a high school diploma
Health
- Healthy birthweight
- Absence of congenital anomalies, abnormalities, or complications at birth
- Absence of transmissible (mother-to-child) infections
Service
- Access to and receipt of timely prenatal care
- Receipt of nutritional services (WIC) if eligible
- Hospital with high percentage of births with timely prenatal care
Financial
- Ability to afford and access healthcare
- Born to a parent with a college degree
- Born to parents with employment history
A thorough literature review initially helped to identify, among all indicators present on vital birth records, those that could be considered “assets” due to their robust relationship to child health and well-being outcomes. Once the theoretical evidence base for each of the 12 indicators and the resulting Strong Start Index was established, we built the empirical evidence base through community- and child-level validation.
Community-Level Validation: We used the Healthy Places Index (HPI), the Child Opportunity Index (COI), and the Human Development Index (HDI) as benchmarks for external validation. Findings demonstrate the expected relationship between the Strong Start Index and the HPI, COI, and HDI, confirm that our birth index is neither exceedingly divergent nor duplicative of these measures, and reinforce the value of generating community scores at granular levels.
Child-Level Validation: Linking individual-level birth records to both child protection system and death records reveal a strong, graded relationship with the predicted probability of child protection involvement and death before age 5. In other words, the more Strong Start assets with which a child is born, the less likely they are to become involved with the child protection system or to die in early childhood. For more information, please refer to the California Strong Start Index Documentation.
Strong Start scores are generated by summing the total number of assets (0-12) as coded from each child’s (de-identified) birth record.
The number and percentage of babies born with each individual asset (indicator) is presented at the state level in Table 1 of the California Strong Start Index Documentation for descriptive purposes, but the presence of any one discrete asset or domain should not be the focus. The Strong Start Index is unique in its ability to describe the constellation of resources available to individual children and families. Additionally, producing asset and/or domain scores alongside total scores for more local jurisdictions would result in widespread suppression in order to mitigate the risk of re-identification. For those reasons, the site highlights total Strong Start Index scores.
The Strong Start Index is unique in its sole reliance on administrative birth records. Unlike other indices, it has the ability to provide recent, specific, holistic, and asset-focused information about cohorts of children born in California. These data can develop a much more complete picture of our state’s children. And they can be easily (and efficiently) updated for each new cohort of children born.
In addition, the index’s reliance on administrative birth records allows for validation through data linkage. Specifically, linking birth records to both child protection system and death records reveal a strong, graded relationship with the predicted probability of child protection involvement and death before age 5. In other words, the more Strong Start assets with which a child is born, the less likely they are to become involved with the child protection system or to die in early childhood. For more information, please refer to the California Strong Start Index Documentation.
Child-specific scores are geocoded by the mother’s residential address, and then aggregated by census tract. Means for all census tracts in California are presented on the map and underlying data.
Per California’s Health and Human Services Agency (CHHS) Data De-identification Guidelines, data (and coloring) are suppressed for census tracts (and one county) with fewer than 11 births.
Average Strong Start scores provide a snapshot of the constellation of resources available to and demographic characteristics of babies born within a given geography and year. As such, changes in average Strong Start scores represent differences in the resources available to and the characteristics of the children born from one year to the next. These year-over-year differences are best understood as demographic shifts, and do not necessarily reflect changes in the resources available to individual children or changes that are a result of efforts implemented within communities. Changes should be considered within the context of the size of the birth population in a given geography.
This index standardizes and summarizes the conditions into which children are born. Comprising twelve indicators that are universally measured, the California Strong Start Index can be used to better, more holistically characterize children across (and within) California communities, providing a tool that can help First 5s and policy makers target resources where they are needed most.
The Strong Start Index allows us to characterize the number of assets children have at birth, including how California communities have varying distributions of children at different asset levels. In addition, it facilitates the identification of communities in which children have fewer assets at birth and where additional services and supports may be important to promote equity, and characterizes how asset levels of children in different communities have changed over time, highlighting where disparities persist.
It also can act as a standardized and cost-effective anchor for community needs assessments; guide a more strategic stewardship of public dollars, with increased accountability; and promote the adoption of a common language across communities, commissions, and other stakeholder groups for conceptualizing and discussing early childhood investments.
Please visit Use the Data for examples of how other organizations and agencies have used the Strong Start Index in their work.
It is our sincere hope that these data will be used to better characterize young children and families, streamline processes for stakeholders, and, ultimately, change the conversation around investments for children and families. As such, we welcome comments, questions, and suggestions as we iterate and improve the Strong Start Index.