Improving the Nation’s Health

Step One: Reduce Toxic Stress in Early Childhood

Thompson argues for changes in child care practices—such as ending the customary transitioning of young children into new classrooms when they reach certain ages and improving the training and professionalism of child care providers. “Such changes could help to make quality of relationships one of the most significant markers of the quality of child care,” says Thompson. Doing this, he believes, would improve the community’s role in shaping healthy brain development, and would reduce later pressures on clinical care systems and the wider society.

• Orient Communities Around Health. Better urban design could also address some of the circumstances and conditions facing children that lead to long-term health problems. Howard Frumkin, director of the National Center for Environmental Health, Centers for Disease Control and Prevention, recommends that public health experts expand their definition of environmental health to encompass how the environment can explicitly improve child well-being. He suggests that environmental health research be conducted in collaboration with architects, urban planners, park designers, and landscape architects.

Several recent studies, including major investigations by the Centers for Disease Control and Prevention and the Robert Wood Johnson Foundation, have linked poor urban planning to child obesity. “There is extensive research pointing to the benefits of living in communities with more walkable neighborhoods, more playgrounds, better visibility to prevent crime, more stores that sell healthy products like fruits and vegetables and fewer that sell unhealthy items like alcohol and tobacco,” according to Tom Farley, chairman of Tulane University’s department of community health sciences. Farley, who lives in New Orleans, suggests that the rebuilding of his city could provide a laboratory for connecting urban design with the promotion of health and development. Our nation is struggling to improve a health care system that is widely perceived to be plagued by uneven access and runaway costs at both the state and national levels. While numerous “remedies” have been proposed—from rationing resources, to expanding insurance deductibles and co-pays, to strengthening health education programs, and guaranteeing universal access to medical care through combinations of government- and employer-financed solutions—the science of early childhood and brain development suggests that these remedies are focused in the wrong place and on the wrong period in life.

The building blocks of a healthy society are grounded in the ecology of human health and development. The foundations for sound physical and mental health over the life course are laid down in the architecture of the developing brain, the functioning of the immune system, and the physiology of a host of stress-regulating mechanisms—all of which are highly influenced by the environment in which people live, beginning in the earliest years of life.

Richard Louv is the author of several books about the future of the family and community, including Last Child in the Woods.

For information about commonly used terms in Council publications, see Definitions.