Improving the Nation’s Health
Step One: Reduce Toxic Stress in Early Childhood
By Richard Louv
Abstract: To reduce risk factors for adult disease in our society, we must tackle the problem of toxic stress in early childhood. This condition is associated with the excessive release of a stream of hormones whose persistent elevation can disrupt the wiring of the developing brain and the functioning of the immune system. Children who experience toxic stress in early childhood may develop a lifetime of greater susceptibility to stress-related physical illness, such as cardiovascular disease, hypertension, and diabetes, as well as mental health problems, including depression, anxiety disorders, and substance abuse. Reliable, nurturing relationships with adults buffer children from the adverse effects of toxic stress and are essential for healthy brain development. These protective influences can be provided by families, child-care facilities, libraries, schools, neighborhood support networks, and family-friendly places of employment—each of which has a role to play in supporting the healthy development of all children.
The research is clear: To achieve both personal well-being and a healthier nation, we need to start at the beginning—as individuals and as a society. As individuals, we know the mantra for improved health. Eat well, exercise, take a daily vitamin, lose a few more pounds, don’t stress out too much, get a good night’s sleep. But the longer we wait to establish those habits, the harder it is for the brain to adapt and the harder it is for the habits to stick. As a society, the challenge is even greater when we consider how to reduce the costs to the health care system and at the same time improve the health of all—even those who grew up in impoverished or dangerous environments.
“Though the effective treatment of illness depends on high-quality medical care, the prevention of disease and the promotion of health is less about doctors and hospitals, and more about the broader environment in which we live, beginning in the earliest years of life,” says Jack P. Shonkoff, pediatrician, Julius B. Richmond FAMRI Professor of Child Health and Development at Harvard University, and Chair of the National Scientific Council on the Developing Child. “Children develop in an environment of relationships that begins in their family and extends outward to their community. Starting at birth, these relationships literally shape the developing architecture of the brain. And that architecture produces either a sturdy or a weak foundation for a lifetime of physical and mental health. In a very real sense, early childhood development sets the stage for the nation’s health.”
How Toxic Stress Affects Brain Architecture
To reduce risk factors for adult disease—heart disease, diabetes, hypertension, obesity, depression, substance abuse, and other conditions, research shows unequivocally that, as a society, we must tackle the problem of toxic stress in early childhood. This is not about positive stress that builds character—like being told you have to share your toys. And it’s not about tolerable stress, which can be mastered—like experiencing the death of a loved one or a natural disaster. This is about toxic stress—like living in a violent environment or being the victim of abuse or severe neglect. Children who experience positive and tolerable stress do not suffer long-term consequences if they are protected by supportive adults who help them develop effective coping skills. But children who experience toxic stress in the absence of supportive relationships are burdened by strong, frequent, or prolonged activation of their body’s stress management systems, which can literally disrupt the architecture of their developing brains and lead to lifelong problems in both physical and mental health.
Child development is the ongoing process by which a person’s genetics and other biological factors interact with family and community experiences to lay a foundation on which body and behavior are built. Central to that developmental foundation is the architecture of the brain, which is composed of countless networks of neurons that are shaped by early nutrition, daily care, opportunities for learning, supportive relationships in the family and in the community, and other environmental factors. Optimally, children’s brains develop in a way that allows them to reach their full potential. Yet recent neuroscience and behavioral research reveal how early development can be derailed, with devastating implications for the later health of individuals and the nation.
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