Children‘s National Hospital’s Work with the Child Opportunity Index

February 7, 2024 by Chaya Merrill, DrPH

At Children’s National Hospital, our commitment to the well-being of children extends beyond medical care to encompass the broader socio-economic factors that shape their lives. One of the key tools we employ in this endeavor is the Child Opportunity Index (COI), a composite metric that helps us assess the levels of opportunity available to children in the neighborhoods that they call home.

Child opportunity is defined as neighborhood-level resources and conditions that impact a child’s ability to develop to their full potential, such as the quality of schools and access to healthy food.

By using the COI, we gain invaluable insights into the specific neighborhood-level factors that influence the healthy development of children in our community. We define “community” as the children and families living in our hospital’s primary service area (PSA) which includes all of D.C. and parts of Maryland (Montgomery County and Prince George’s County).

In June 2022, we released our Community Health Needs Assessment (CHNA) that was framed around the concept of child opportunity, using the COI 2.0. This report served as a foundational document, offering a detailed snapshot of the opportunities and challenges faced by children in neighborhoods within our PSA.  This work helped to identify areas where opportunity abounds as well as those where it is alarmingly scarce. Recognizing that neighborhoods play a pivotal role in shaping the trajectories of children’s lives, we understood the urgency of pinpointing and addressing the specific factors contributing to disparities in opportunity. The CHNA identified four priority areas that were lowering child opportunity levels in our community: early childhood education, healthy food, health insurance, and employment. In November 2022, we released our Community Health Improvement Plan (CHIP) that summarizes how we plan to address the needs identified in the CHNA. Click on the report covers to access our CHNA and CHIP reports.

We will be issuing our next pediatric CHNA in June 2025. With the rollout of COI 3.0 on the horizon, we look forward to delving deeper into the nuanced neighborhood-level factors that influence child opportunity. Our work is never limited to identifying areas of high and low opportunity but also to collaborate with the community in addressing the underlying factors perpetuating these disparities. We look forward to working with local stakeholders to implement programmatic and policy changes that foster equitable access to opportunities crucial for the healthy development of all children. At Children’s National Hospital, we believe that every child deserves the chance to thrive, irrespective of their ZIP code, and the COI serves as our compass in navigating the path toward a brighter, more equitable future for all.

Header photo by Paris Lopez on Unsplash

About the author

Chaya Merrill, DrPH

Director of Child Health Data Lab within the Child Health Advocacy Institute at Children's National Hospital