By MAKIYA SEMINERA

SAN ANTONIO (AP) — Sandra Mosqueda watched with an amused smile as her 2-year-old son, Atreus, began sweeping the floor with a miniature mop.

Atreus is part of the inaugural class of infants and toddlers receiving free preschool in a citywide program in San Antonio, Texas. It’s something his mother doesn’t take for granted. As a child, she herself wasn’t able to start preschool this young. In the case of her two older boys — now in first grade and kindergarten — the free preschool set them up for success in elementary school.

The first five years of a child’s life are among the most critical for their development. Those years lay a foundation and prepare them for kindergarten, often setting them up for success throughout school and beyond. But immense disparities exist in whether parents across the country report their child as ready for kindergarten, new data from the National Survey for Children’s Health shows.

Nationally, nearly two-thirds of children were reported in the survey as on track for kindergarten, regardless of their families’ income. However, the gap in kindergarten readiness is substantial when comparing reports from the poorest families and the wealthiest — approximately a 20% difference.

Administered by the U.S. Census Bureau, the federal survey offers a glimpse into school readiness by collecting responses annually from thousands of parents and guardians on their children’s early learning, social-emotional development, self-regulation, motor development and health. The latest results were released in December.

Low-income children often have less access to experiences that boost school readiness, such as high-quality early learning opportunities. That isn’t to say those kids haven’t made gains. Over the past few years, the survey’s portion of on-track children from families earning less than the federal poverty line — just under $32,000 for a family of four in 2024 — has trended upward nationwide by a few percentage points.

Some city and state programs are working to boost that improvement by expanding preschool opportunities for children from low-income families. The mission is even more urgent as parents juggle soaring child care costs and a widening affordability gap.

San Antonio’s program, called Pre-K 4 SA, is a prime example. It’s designed to serve low-income and working-class families throughout the city, offering 2,000 preschool seats for 3- and 4-year-olds — 80% of them free to families who qualify. The program, which opened in 2013, is funded through the city’s sales tax and expanded last year to include four infant and toddler classrooms in its new South Education Center. The preschools also offer an unusually broad mix of services, in recognition that poverty raises a complex blend of obstacles to kindergarten readiness.

Citywide early childhood programs have also emerged in recent years in Denver, New York, Boston, and Chicago, among others.

Pre-K 4 SA teacher Deziree Arce, center, plays a game with her students, Oct. 9, 2025, in San Antonio. (AP Photo/Eric Gay)

Students who have completed Pre-K 4 SA have scored higher than the state average on third grade math and reading, according to the Urban Education Institute at the University of Texas at San Antonio. Those outcomes contribute to what Sarah Baray, CEO of Pre-K 4 SA, views as a key success of the program: Children with the greatest needs receive the same quality education as kids from wealthier families.

“The quality is so high that even families who could afford to go anywhere try to get into our schools,” Baray said.

High-quality education as a solution for all families, regardless of income

Many experts agree that one of the best ways to boost school readiness is to ensure programs meet high-quality standards, such as smaller class sizes and child-to-staff ratios.

Pre-K 4 SA has implemented a “whole child” approach that develops a range of skills, including socioemotional learning. Baray said the program prepares children “not just (for) academic success, but life success.”

Kids in Deziree Arce’s class learn to count and recognize shapes just like other preschoolers. But the children also receive guidance from Arce on social-emotional skills to test out all day, whether it’s consoling a crying classmate or resolving a conflict on who sits where at their classroom table.

Pre-K 4 SA students play on the playground, Oct. 9, 2025, in San Antonio. (AP Photo/Eric Gay)

“When I see kids that come from, like, where I came from, I’m giving them something that I never got,” said Arce, who grew up in a low-income family and has taught at Pre-K 4 SA for nine years.

Pre-K 4 SA also intentionally incorporates opportunities for children to refine their motor skills. For lunch, the children in Arce’s class pinched turkey burgers — provided by a local food bank — with tongs out of aluminum trays and onto their plates. Exploding ketchup packets were met with celebration, as some students opened them by themselves for the first time.

Outdoor play is another critical component to improving motor skills. Students spend an hour outside every day unless weather conditions are severe. In an era of much screen time and time indoors, Pre-K 4 SA students are encouraged to engage in “risky play.” That could mean racing tricycles around the perimeter of the playground, climbing up the slide or spraying water from a pump. Those experiences teach students their physical limits early, said Pre-K 4 SA Chief of Schools Tonda Brown.

Finding solutions to get families off the waitlist

A major challenge for San Antonio’s program, as well as in citywide efforts around the country, is meeting the demand.

More than 1,600 families were on Pre-K 4 SA’s waitlist this school year, Baray said. To help wait-listed families, the program’s enrollment team connects them with other local options, such as school district-run preschools or private centers partnered with Pre-K 4 SA.

Pre-K 4 SA students eat a provided lunch, Oct. 9, 2025, in San Antonio. (AP Photo/Eric Gay)

Other cities distribute the demand across a wide variety of high-quality preschool programs by offering financial assistance to families.

Denver Preschool Program offers tuition credits to all families with 4-year-olds. Selected families can then put that money toward any licensed public or private preschool participating in the sales tax-funded program, said Priscilla Hopkins, executive director of Denver Public Schools’ early education office. About 80% of DPP’s providers were rated four- or five-star in Colorado’s quality rating system, according to the program’s 2024 impact report.

The level of financial support given to a family is determined by income. In 2024, nearly 1,800 4-year-olds who received DPP’s tuition support were in the lowest income tier — up to 135% of the federal poverty line. More than $21 million in tuition credits were dispersed in the 2023-2024 school year, according to program leaders.

Sandra Mosqueda and her 2-year-old son make a visit to Pre-K 4 SA, Oct. 9, 2025, in San Antonio. (AP Photo/Eric Gay)

However, in large swathes of the country, especially rural areas, private preschools are the only high-quality option but often come with a hefty price tag and little financial assistance. That leaves low-income families with fewer preschool options than their wealthier peers, said Kelly Purtell, a human development and family science professor at Ohio State University.

“There’s all sorts of challenges that then really limit what preschools are even kind of on the table for them,” Purtell said.

Helping families outside the classroom, too

Reliable transportation can be another obstacle for low-income families, especially for parents who work outside normal business hours, Purtell said.

Pre-K 4 SA students arrive to catch the school bus, Oct. 9, 2025, in San Antonio. (AP Photo/Eric Gay)

Pre-K 4 SA’s South Education Center offers free bus transportation to fill that gap.

As children boarded the bus at a designated pickup spot near Southside Lions Park, cheerful bus monitors greeted them and strapped each one into their seat with a safety harness. Their bus driver offered each child a cartoon sticker for their school-provided backpacks.

The stress of poverty can hinder a parent’s ability to give their child enriching experiences key to school readiness, which is why services that promote family stability are important, said Katie Paschall, a researcher at Child Trends. At Pre-K 4 SA, that means healthy cooking classes, mobile vaccination clinics and even “family cafes” where parents can get help from staff to apply for jobs. By eliminating those at-home issues, parents can focus more on setting their children up for a better future.

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In Mosqueda’s case, having her kids in preschool allowed her to return to school after Atreus’ birth halted her studies to become a respiratory therapist. She completed a dental assistant degree and got a job at a nearby dental office. No one has cheered on Mosqueda more than her boys — her oldest son proudly took videos of his mom at her graduation last year.

“It’s showing them you can still do anything, no matter what comes in your way, and having the help to do it makes it possible,” she said.

Data journalist Todd Feathers contributed reporting.

The Associated Press’ education coverage receives financial support from multiple private foundations. AP is solely responsible for all content. Find AP’s standards for working with philanthropies, a list of supporters and funded coverage areas at AP.org.

By ALEX VEIGA, AP Business Writer

The average long-term U.S. mortgage rate barely budged this week, staying close to 6% as the spring homebuying season nears.

The benchmark 30-year fixed rate mortgage rate edged up to 6.11%, essentially flat compared to last week when it was 6.1%, mortgage buyer Freddie Mac said Thursday. One year ago, the rate averaged 6.89%.

This is the latest increase since the average rate eased three weeks ago to 6.06%, its lowest level in more than three years.

Borrowing costs on 15-year fixed-rate mortgages, popular with homeowners refinancing their home loans, also ticked up this week. That average rate inched up to 5.5% from 5.49% last week. A year ago, it was at 6.05%, Freddie Mac said.

Mortgage rates are influenced by several factors, from the Federal Reserve’s interest rate policy decisions to bond market investors’ expectations for the economy and inflation. They generally follow the trajectory of the 10-year Treasury yield, which lenders use as a guide to pricing home loans.

The 10-year Treasury yield was at 4.21% at midday Thursday, down from 4.23% a week ago.

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By MIKE STOBBE, AP Medical Writer

NEW YORK (AP) — During the early years of the COVID-19 pandemic, experts worried that disruptions to cancer diagnosis and treatment would cost lives. A new study suggests they were right.

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The federally funded study published Thursday by the medical journal JAMA Oncology is being called the first to assess the effects of pandemic-related disruptions on the short-term survival of cancer patients.

Researchers found that people diagnosed with cancer in 2020 and 2021 had worse short-term survival than those diagnosed between 2015 and 2019. That was true across a range of cancers, and whether they were diagnosed at a late or early stage.

Of course, COVID-19 itself was especially dangerous to patients already weakened by cancer, but the researchers worked to filter out deaths mainly attributed to the coronavirus, so they could see if other factors played a role.

The researchers were not able to definitively show what drove worse survival, said Todd Burus of the University of Kentucky, the study’s lead author.

“But disruptions to the health care system were probably a key contributor,” said Burus, who specializes in medical data analysis.

COVID-19 forced many people to postpone cancer screenings — colonoscopies, mammograms and lung scans — as the coronavirus overwhelmed doctors and hospitals, especially in 2020.

Earlier research had shown that overall cancer death rates in the U.S. continued to decline throughout the pandemic, and there weren’t huge shifts in late diagnoses.

Recinda Sherman, a researcher on that earlier paper, applauded the new work.

“As this study is the first to document pandemic-related, cause-specific survival, I think it is important,” said Sherman, of the North American Association of Central Cancer Registries. “The more we understand about the impact of COVID-19, the better we will be able to prepare for the next one.”

How could overall cancer death rates decline in 2020 and 2021, while short-term survival worsen for newly diagnosed patients?

Cancer prevention, diagnosis and treatment measures that for years had been pushing cancer death rates down did not suddenly disappear during the pandemic, Burus noted.

“We didn’t forget how to do those things,” he said. “But disruptions could have changed access, could have changed how quickly people were getting treated.”

Further research will show if any impact was lasting, said Hyuna Sung, senior principal scientist and cancer epidemiologist at the American Cancer Society.

“Transient declines in survival that quickly recover may have little impact on long-term mortality trends,” she said.

The new study tapped national cancer registry data to focus more specifically on patients who had a first diagnosis of a malignant cancer in 2020 and 2021. More than 1 million people were diagnosed with cancer in those two years, and about 144,000 died within one year, according to the researchers’ data.

The researchers looked at one-year survival rates for those patients, checking for what stage they were at the time of diagnosis.

They calculated that one-year survival was lower for both early- and late-stage diagnoses, for all cancer sites combined. Most worrisome were large differences seen in colorectal, prostate and pancreatic cancers, they said.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

By NOHA ELHENNAWY

CAIRO (AP) — Famine is threatening more areas in war-torn Sudan’s western Darfur region, a global hunger monitoring group said Thursday as an attack by paramilitary forces on a military hospital in the country’s south killed 22 people, including the hospital’s director and three members of its medical staff.

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Since April 2023, Sudan has been in the throes of war after a power struggle erupted between the military and the powerful paramilitary Rapid Support Forces, or RSF. The conflict has triggered what the United Nations calls the world’s worst humanitarian crisis.

The Integrated Food Security Phase Classification, or IPC, released a new report saying that acute malnutrition has reached famine levels in two more towns in Darfur. It stopped short of confirming a full famine in the towns.

Last year, the group said that people in Darfur’s major city of el-Fasher, overrun by the paramilitary forces after an 18-month siege, were enduring famine.

The attack Thursday in the town of Kouik in South Kordofan province, also left eight people wounded, the Sudan Doctors’ Network, a group of medical professionals tracking the war said. It was not immediately clear how many of the casualties were civilians.

The attack was “not an isolated incident, but rather part of a series of attacks that have plagued South Kordofan,” the network said, adding that the assaults have left “several hospitals inoperable.”

The U.N. estimates that over 40,000 people have been killed in the war in Sudan, but aid agencies consider that the true number could be many times higher. Over 14 million people have been forced to flee their homes.

This is a locator map for Sudan with its capital, Khartoum. (AP Photo)

A harrowing report

The IPC report said famine-level malnutrition has been registered in the towns of Umm Baru and Kernoi in North Darfur province. In November, the group said that along with el-Fasher, the city of Kadugli in South Kordofan was also enduring famine. At the time, it also said 20 other areas across Sudan were at risk of famine.

In Umm Baru, nearly 53% of children between aged between 6 months and nearly 5 years suffered from acute malnutrition, the IPC said — almost double the famine threshold, which stands at 30%. In Kernoi, 32% of children are suffering from malnutrition, the group said.

“These alarming rates suggest an increased risk of excess mortality and raise concern that nearby areas may be experiencing similar catastrophic conditions,” the report said.

Since the eruption of Sudan’s civil war, the IPC has confirmed famine in a total of seven areas. The group said it could not confirm a full famine in Umm Baru and Kernoi as access and lack of data makes it difficult to confirm the other two thresholds — access to food and mortality — that need to be reached for a famine to be confirmed.

The fall of el-Fasher in October 2025 to the RSF set off an exodus of people to nearby towns, straining the resources of neighboring communities and driving up food insecurity rates, the report said.

The IPC has confirmed famine only a few times, most recently in 2025 in northern Gaza during the Israel-Hamas war. It also confirmed famine in Somalia in 2011, and in South Sudan in 2017 and 2020.

In 2024, famine had struck five other areas in North Darfur and also Sudan’s Nuba Mountains region.

The IPC report also warned that more people might face extreme hunger in Kordofan, where the conflict has disrupted food production and supply lines in besieged towns and isolated areas.

“An immediate and sustained ceasefire is critical to avert further destitution, starvation, and death in the affected parts of Sudan,” pled the Rome-based group.

According to experts, famine is determined in areas where deaths from malnutrition-related causes reach at least two people, or four children under 5 years of age, per 10,000 people; at least one in five people or households severely lack food and face starvation; and at least 30% of children under age 5 suffer from acute malnutrition based on a weight-to-height measurement — or 15% based on upper-arm circumference.

Fighting rages on

Since the RSF overran el-Fasher, which had been one of the army’s last strongholds in Darfur, fighting has recently concentrated in various areas of Kordofan. Lately, the Sudanese military began making gains in Kordofan after breaking a siege in Kadugli and the neighboring town of Dilling.

On Tuesday, the Sudanese military announced that it had opened a crucial road between Dilling and Kadugli, which had been under siege by the RSF since the start of the war. The RSF launched a drone attack Tuesday that hit a medical center in Kadugli, killing 15 people including seven children, according to Sudan Doctors Network.

Also this week, the United States and the U.N. said they are seeking to rally international support for humanitarian aid to Sudan, kicking off a new Sudan Humanitarian Fund with $700 million in contributions from the United Arab Emirates and the U.S.

The Trump administration said Tuesday it would contribute $200 million to the initiative from a basket of $2 billion it set aside late last year to fund humanitarian projects around the world. The UAE said it would contribute $500 million. Saudi Arabia and several other participants promised they would make pledges but did not specify amounts.

Associated Press writer Fay Abuelgasim in Cairo contributed to this report.