Duke Endowment 2018 Annual Report | Zero to Eight



President Rhett N. Mabry and Board Chair Minor M. Shaw

Letter From Our Leaders

In the document that established The Duke Endowment in 1924, our founder charged his Trustees to attend to the needs of North Carolina and South Carolina “along physical, mental and spiritual lines.” The critical issues that Mr. Duke identified nine decades ago remain the focus of our Child Care, Health Care, Higher Education and Rural Church program areas. But as we strive to honor his intent and follow his mandate, we must continuously adapt to today’s world to make the greatest impact with our resources. The complex challenges of our society require it.

In this Annual Report, we invite you to learn about the Endowment’s new strategic emphasis on early childhood. With modern advances in brain science showing us the importance of a strong start, we believe our new emphasis on prenatal to age 8 promises a more effective approach to addressing the issues that confront today’s families and communities. We are convinced that prevention and early intervention will help us produce greater impact across our grantmaking and pave the way for better outcomes for children and their families.

As you will discover, this attention to early childhood amplifies the existing strategies and initiatives in our four program areas. Our approach honors program area priorities and grantees, building upon each area’s expertise. While the Endowment has long made early childhood grants, now we are working more systematically and collaboratively across the program areas to incorporate this emphasis into our work. In addition, our emphasis on early childhood moves us into place-based work in several communities, giving us greater opportunity to effect systems change.

We believe that a good beginning for children bodes well both for their lives as adults and for their communities, thus fulfilling Mr. Duke’s vision for the Carolinas. We are excited about exploring this important path and sharing what we learn along the way.

In closing, we want to pay tribute to a colleague who played a major role in developing our early childhood emphasis and served as an exceptional leader across our organization. Arthur Morehead, the Endowment’s vice president and general counsel, passed away on February 8, 2019. From the time he joined our staff in 2007, Arthur’s wisdom, tireless commitment and good-natured guidance made him indispensable. All of us miss him deeply.



  • We believe that a good beginning for children bodes well for their lives as adults and for their communities.

  • Modern advances in brain science show the importance of having a strong start in life...

  • Research shows value of intervening early, in order to address issues hindering today’s families and communities...

  • We’re working systematically and collaboratively to pave the way for better outcomes.

A Powerful Lever

By focusing on child care, health care, higher education and rural churches, James B. Duke wanted his philanthropy to enrich lives across the Carolinas.

Our new strategic emphasis on early childhood issues is rooted in that vision. By helping families become emotionally tight-knit, physically healthy, educationally prepared and spiritually strong, we believe this can be a powerful lever to help us honor Mr. Duke’s intent.

Why now?

As Dr. Jack Shonkoff, director of Harvard’s Center on the Developing Child, said during a speech at Duke University, an “exploding revolution in biology” is before us. New discoveries and techniques in neuroscience are leaving little doubt about the value of intervening early. Thanks to cutting-edge imaging, we can see how the brain develops in real time.

We now know that in the earliest years of life, the brain is developing rapidly and is especially sensitive to all kinds of experiences. Constant, unrelenting negative experiences in the absence of supportive relationships with adults can trigger excessive stress system activation — termed “toxic stress” — which can disrupt the development of brain circuitry and increase the risk for a lifetime of academic challenges, alcoholism, depression and even heart disease. Conversely, we know that stable, nurturing environments stimulate the development of neural connections critical to getting along with others and developing the executive function skills needed for effective learning and problem-solving.

“The exceptionally strong influence of early experience on brain architecture makes the early years of life a period of both great opportunity and great vulnerability for brain development.” National Scientific Council on the Developing Child

Biological evidence increasingly demonstrates that chaotic or traumatic childhood experiences unbuffered by responsive adult relationships undermine brain development in young children. Positive early experiences set the foundation for learning, good health and resilience. By mitigating or preventing negative experiences and maximizing positive ones, we pave the way for better adult outcomes.

Research also points to a clear return on investment in moving to upstream solutions. James Heckman, a Nobel Prize-winning economics professor at the University of Chicago, shows that high quality birth-to-five programs for disadvantaged children can deliver a 13 percent per year return on investment. Those gains are realized through better outcomes in education, health, social behaviors and employment.

As the Center on the Developing Child puts it, getting things right the first time is easier and more effective than trying to fix them later.

Get Ready Guilford

In North Carolina, the Duke Endowment is supporting an ambitious strategy that uses large, targeted investments in early childhood to break the cycle of intergenerational poverty in Guilford County, a major population center of the Triad.
More About This Initiative +

Two Avenues

The Duke Endowment is using two avenues to carry out its emphasis on early childhood: through its four program areas and through select “place-based” initiatives. With both, our goal is to work collaboratively to make early childhood a greater focus within our broader mission.

Program Areas

In each of our program areas — Child Care, Health Care, Higher Education and Rural Church — program officers are exploring ways to increase our emphasis on early childhood. In many cases, that has meant building on grantmaking already underway.

Child Care, for example, sees replicating evidence-based models as an effective way to support this age group. The program area has focused on expanding evidence-based programs — such as The Incredible Years, Parent-Child Interaction Therapy and the Strengthening Families Program — since 2008. Rural Church’s primary focus is in church-based outreach programs such as the summer literacy initiative, which began in 2012.

This early childhood emphasis is not a fifth program area for us. Nor does it affect current grantmaking commitments or diminish our interest in funding projects with other populations. The work of our Child Care program area — including its efforts to help teens who are aging out of the foster care system — continues. Other program areas will keep funding programs supporting adults and seniors.

We’re also developing newer initiatives to target early childhood. The Endowment’s oral health initiative, for instance, seeks to support system reform and policy change, integration of oral health into general health care, and school-based oral health services.


Through our place-based work, we are partnering with communities that are expanding and aligning services for children prenatal to age 8. Our Special Initiatives team is focused on developing this strategy.

Placed-based grantmaking is a philanthropic concept that pursues lasting social change at the community level by weaving local resources and programs into a cohesive system. This concept is especially appealing for the prenatal to pre-K population, for whom services are often fragmented.

The Endowment continues to fund the Northside Initiative in Spartanburg, S.C., and the Renaissance West Community Initiative in Charlotte, N.C. These two place-based efforts follow the Purpose-Built Communities model, which strives to revitalize urban neighborhoods by supplying high quality affordable housing, a cradle-to-college education pipeline and community wellness programs.

In Guilford County, N.C., we are supporting the Get Ready Guilford Initiative, a joint effort of the Endowment and Ready for School, Ready for Life, a community- based organization focused on Guilford County’s youngest children and their families. By expanding proven programs, improving service quality and bringing disjointed early childhood resources into a seamless system of care, Get Ready Guilford aims to ensure that critical developmental needs are identified and met.

This work represents the Endowment’s largest and boldest foray into place-based grantmaking.

Keeping Young Scholars Engaged

The Duke Endowment is working with rural United Methodist churches in North Carolina to combat learning loss in their communities through evidence-informed summer literacy programs. The goals are to improve literacy outcomes for students who are at risk for reading failure and encourage churches to play an effective role in helping children and families.
More About This Initiative +

Promoting Learning

As interest in early childhood issues continues to build throughout the Carolinas and the country, the Endowment is also investing in ways to promote learning in the field.

Both the Northside Initiative and the Renaissance West Community Initiative are giving us valuable insights into successful community-level efforts.

In addition, we awarded a $90,000 grant to The Hunt Institute in Durham to help state leaders in North Carolina and South Carolina understand the importance of child development and the need for creating robust early childhood systems. The Institute hosted a summit in June 2018 that brought together education policy advisors, agency and department heads, community, business and philanthropic leaders and legislators from eight states. National funders included the BUILD Initiative, the Pritzker Children’s Initiative, the Bill and Melinda Gates Foundation and the Bezos Family Foundation.

Other support, to the Institute for Emerging Issues housed at N.C. State University in Raleigh, is aimed at strengthening early childhood outcomes in four North Carolina counties.

Building a Strong Foundation

Child development experts tell us that the first years of life matter because early experiences affect the architecture of the maturing brain. For healthy development, children need nurturing relationships with caregivers. The Incredible Years is an evidence-based parenting program designed to help build that strong foundation.
More About This Initiative +

At the Table

As this work unfolds, an internal Zero to Eight team continues to shape our early childhood strategy and develop recommendations for our Board.

Using expertise from Duke University’s Center for Child and Family Policy, the team created a list of shared outcomes to steer our grantmaking toward programs with the highest potential for impact. The outcomes reflect our “whole child” approach, encompassing domains of physical, cognitive and social-emotional well-being, and they are strong predictors of later success in school, the workplace and the community.

The team’s long-term goal is to identify “signature initiatives” that reach high standards for impact, scalability and sustainability.

Our Zero to Eight team includes Special Initiatives, Communications, Evaluation and the program areas, and each representative brings expertise to the group. Collaborating has helped us learn more about each other’s work and share challenges across departments. We’re also learning how important it is to make the most of our time together at the table, and we’ve adopted Endowment-wide guidelines for holding effective meetings.

As we build a culture that emphasizes trust, accountability, clarity of purpose, respectful dialogue and a strong commitment to learning and outcomes, Zero to Eight is another avenue for engaging constructively.

Breaking Barriers to Care

Many children and families face legal barriers when it comes to health care. In South Carolina, a new statewide effort aims to improve health outcomes by eliminating those daunting challenges.
More About This Initiative +

Lasting Impact

We believe this new emphasis on early childhood issues will be an important part of Mr. Duke’s legacy. By attacking childhood challenges before they grow into adult-sized social problems, we can improve learning, behavior and health — and enhance life for families and communities.

Investing in a strong start for children and their families won’t make problems vanish overnight, but we are convinced it will give us a broader reach and greater impact. We ease the strain on our child welfare systems. We send our educational institutions better-prepared students. We strengthen the families who fortify our rural churches so that the churches can meaningfully engage their communities. And, we boost the health of the Carolinas by improving wellness outcomes for children.

We are seeking evolutionary, not revolutionary change, and will strive to implement this new strategic focus with the same thoughtful, results-oriented approach we have championed for many years.

We’ve made a strong start. By moving upstream, investing strategically in effective programs and research, we are advancing our commitment to the Carolinas and furthering our founder’s dream.