InBrief: The Foundations of Lifelong Health

InBrief: The Foundations of Lifelong Health


>>SHONKOFF: The foundations of a successful society
rest on the health and competence of its population. It’s just common sense to conclude that what happens early
in life sets the foundation for everything that follows. What’s exciting about the revolution that we’re living through
right now in biological science is that we’re beginning to
understand at the molecular level why that’s true.>>BOYCE: The biology of health and development is really the
link that is formed between the experiences that we have, both positive and negative, within our families, within our
relationships, communities, neighborhoods, and so on, and the kinds of health experiences and developmental
experiences that we sustain over a lifetime. >>SHONKOFF: Advances in neuroscience, molecular biology, and
genomics have a very simple message that has tremendous impact
for thinking about policies for young children. That message is that early experience literally is built
into our bodies, for better or for worse. >>BOYCE: If as young children, we encounter recurrent or
chronic stressors that are within this category of toxic stress we begin to sustain a kind of cumulative wear and tear on the
biological systems of the body, on the cardiovascular system
on the neuroendocrine system, on the systems of the brain. And over months and years of time, this cumulative exposure
begins to break or change the functioning of those systems,
in ways that can lead to disease and disorder. >>MCEWEN: People who have had these adverse events in their
lives and have not had consistent parenting,
have been abused or neglected, will lack this ability to show good emotional control, will have difficulty learning,
and will show problems in health-increased risk for obsesity,
diabetes, cardiovascular disease and even a shorter life span.>>GUYER: So the question then becomes how do we influence
the health of those young children? And there we know that there’s a strong interaction between
the underlying biology, the genetic makeup, and the environment. >>SHONKOFF: So extensive research from multiple
perspectives leads us to identify three basic foundations
of lifelong health that are laid down in early childhood. The first is the environment of relationships
in which a child is living.>>GUYER: We know that warm, responsive relationships are
part of brain development. They are part of the developing feelings of security and
close attachment, and those translate into better health
because they allow infants to develop all those other systems. including neuroendocrine and inflammatory responses in brain
development that lead to better health. >>SHONKOFF: The second foundation of healthy development is a safe physical environment that promotes good health and protects children from harm. GUYER: Creating safe environments for children in both built
environments, play environments, protecting them from hazards
in those environments, whether it’s lead or some other toxin, whether it’s tobacco smoke in the home, all
of those are things that relate to, again, the development of the
child’s systems. And then finally a third foundation is good nutrition. And there we’re thinking not only of micronutrition, all the micronutrients, vitamins, minerals and so forth, but also macronutrition, a good composition of the diet in terms of fat, in terms of protein and so forth, but also the availability of food in the community. >>WILLIAMS: One of the things we have learned, and the
scientific evidence on this is quite clear: the way we live, learn, work, and play have a bigger impact on our
health than going to the doctor. Now, please don’t misunderstand me. Going for medical care is important, but what other factors that determine whether we are sick or healthy in the first place have to do with the opportunities for health in the places where we spend most of our time: our homes, our communities, our schools, our workplaces,
and the policies in those places can make it easy
or harder for us to live healthy lives. >>SHONKOFF: And in policy terms, that really points
us in two directions. One is the extent to which we fortify the first line of
support for children, which is in their families. But the second message is very clear that it’s not just the
family that provides the sense of protection for children. This
is a much broaderissue that’s really a community responsibility. >>WILLIAMS: There are many ways in which communities
can influence the health and well being of our children. Opportunities for social interaction within communities that
brings parents and other community residents together, that is beneficial for the kids. There actually is some
research that suggests it’s beneficial for the adults
as well, the engagement with young people. We can think of other ways and other institutions in the
communities that can play a role. Churches and religious institutions can play a role;
certainly libraries can play a role. What we’re talking about is the entire community being a
village that provides the support and the nurturing for
the development of our children. >>SHONKOFF: There are very few social policies that do
not have an impact on the health and the well-being
of young children. Some are obvious: childcare, early education,
provision of healthcare. Some are less obvious, but clear to most people, like how
we deal with maternal employment, and how we provide
services through a child welfare system. Some of them may not be obvious at all, like the extent to
which zoning regulations make it easier or more difficult for a community to provide grocery stores with
fresh vegetables, as opposed to liquor stores
and fast-food outlets. The question is much more how is any of these or all of
these policy streams addressing the fundamental challenge,
which is how we can reduce the sources of adversity in children’s lives, so that we
can reduce the toxic stress they experience. >>WILLIAMS: There have been recent analyses to document
that the costs to society of disparities are enormous. If all Americans had the health of the college-educated, the
U.S. economy would save a trillion dollars each year.
So those are enormous disparities. People like to say that children’s health is our nation’s wealth. But until we really start to act on these ideas of how do we
promote health in the earliest part of life, we will not get
to being a healthier population and a more prosperous society.

Daniel Yohans

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