Getting to the Moon was Easy

In Health Affairs (December 2014) were multiple articles on children’s health, including The Changing Nature of Children’s Health Development: New Challenges Require New Policy Solutions.  The authors, Neal Halfon et al., suggest that the current health care system is poorly designed to ensure optimal lasting health of children into their adult years.   Using the science of life-course health development to support their view, they assert that factors present in early during childhood impact health throughout life more so than we appreciate, and that our current approach to health in the U.S. doesn’t address these early influences.

This new science provides an explanatory framework for understanding how poor health and social adversity during childhood can affect lifelong health. Early interventions, especially in early childhood, have been shown to lessen the impact of these social and environmental influences. The authors contend: “Studying life-course health development has left little doubt that a nurturing and materially sufficient early life is an essential component of a healthy society.”

The authors call for a national action plan, with involvement of public, private, philanthropic, and faith-based sectors, where local and regional partnerships would link child health care providers, city and county governments, payers, employers, and schools. They suggest that most health creating interventions need to have its roots at the local and regional level. They propose the child health care community drive the creation of community accountable health development systems designed as integrated networks of medical homes, early childhood programs, school health centers, children’s hospitals, and other community health services.

What the article doesn’t do is reveal the secret to achieving this vision. Those communities that have made some progress all have one thing in common: funding.   And the funding typically comes from a mix of local, regional and national sources, many of whom consider themselves partners in fulfilling the vision, which generally leads to the funding being somewhat sustainable over a long period of time, enough to discover how to make a difference, and demonstrating some results.   In addition to funding, perseverance may be a critical ingredient to the formula.

If We Can Put a Man on the Moon is a book by William Eggers.  Mr. Eggers provides some thoughts on why we are failing to solve our biggest social problems.   Lots of great insights except for perhaps one when it comes to children: the social transformation that needs to take place to improve the health and wellbeing of our children will take a lot more people believing in it and participating in it than what it took to put someone on the moon.  It will require the public thinking more long-term than ever before and more about the children than themselves.   The Moon was easy.