In 2016, the National Head Start Association (NHSA) conducted its first nationwide survey focused on understanding access to and support of health services for children and families. This 2021 report is a five-year follow-up to that study, and again examines the intersection between equity and access. The 2021 survey received 389 responses, representing approximately 20% of Head Start agencies nationwide. While participation was voluntary, the programs that responded generally reflect the national diversity of grantee auspices and sizes. The central findings that emerged from this year’s survey are organized into five categories: Providers; Screenings; Mental Health Care; Dental Care; and Social Determinants of Health. (author abstract)