InBrief: The Foundations of Lifelong Health

Uploaded by HarvardCenter on 11.01.2011

>> 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.