The earned income tax credit provides incentives to work because it phases out tax credits gradually as the worker’s income rises. In 2002 it lifted 4.9 million people (2.7 million children) out of poverty (Francis, 2009).

The impact of these policies and programs on family economic well-being, family functioning, and mental, emotional, and behavioral outcomes could be evaluated in randomized controlled trials. Such studies would require theory-based hypotheses about the impact of poverty and economic hardship on parental stress, depression, and parenting skills and children’s internalizing and externalizing disorders. Developing studies to test these hypotheses empirically should be a public health priority.

PREVENTION THROUGH SCHOOLS

Schools are second only to families in their potential to affect children’s mental health. They can contribute to young people’s successful development by providing nurturance and the opportunity to develop cooperative social relations and social and psychological skills. Thus, it is natural that a considerable number of preventive interventions have been developed for delivery in schools, including preschool settings.

Most of these interventions have focused on preventing behavioral problems and externalizing disorders or promoting positive child behavior in school, although some positive results have been demonstrated on internalizing disorders, such as depression. Other programs have focused on school structural factors, such as the reward structure for prosocial behavior or school–family relations. Preventive interventions begun early in life may have comparatively stronger effects because of the malleability of several developmentally central risk factors, such as family relationships, peer interactions, cognitive development, and emotional regulation.

Early Childhood Interventions
Early Head Start

Early Head Start, launched in 1995, is a federally funded extension of the Head Start Program (see below) targeting low-income pregnant women and families with infants and toddlers.1 Early Head Start programs vary in the services provided but are designed to respond to local needs, with a focus on supporting healthy child development through parenting and family support.

A randomized controlled study (Love, Kisker, et al., 2002) involving 3,001 families at 17 sites nationwide indicated that at age 3, children



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