A New Framework for Childhood Health Promotion: The Role of Policies and Programs in Building Capacity and Foundations of Early Childhood Health

摘要

Although the connection between early life experiences and later health is becoming increasingly clear, what is needed, now, is a new organizing framework for childhood health promotion, grounded in the latest science. We review the evidence base to identify the steps in the overall pathway to ensuring better health for all children. A key factor in optimizing health in early childhood is building capacities of parents and communities. Although often overlooked, capacities are integral to building the foundations of lifelong health in early childhood. We outline a framework for policymakers and practitioners to guide future decision-making and investments in early childhood health promotion. There is a growing recognition that health in the earliest years lays the groundwork for lifelong well-being. This life-course view is particularly valuable for understanding the roots of health disparities and the potential role of early childhood policies and programs in producing benefits well into the adult years. 1–5 Focusing health promotion and disease prevention efforts on children in the first 5 years of life can provide important strategies for reducing the population-level burden of disease. Several recent reports thoughtfully consider the factors that place young children at risk for poor outcomes and list recommendations for effective interventions. 1,6 What is now needed, to advance the field of early childhood health promotion, is an underlying, organizing framework to illustrate the intermediate steps linking policies and programs to outcomes. Such a conceptualization will allow stakeholders to develop, apply, and sustain policies and programs that promote public health goals across early childhood settings. The framework presented here, introduced by the Harvard Center on the Developing Child in collaboration with the Women’s and Children’s Health Policy Center at Johns Hopkins University, illustrates the key pathway that policymakers and practitioners can follow to promote children’s health in the preschool years. 5 This framework advances previous efforts to link policies to intended health outcomes by embedding the capacities of parents and communities within the pathway; these capacities are integral to ensuring optimal environments and experiences for young children. Our objectives are to (1) describe a framework linking early childhood policies and programs to subsequent health outcomes, (2) outline key action steps within the framework and the underlying scientific evidence, and (3) demonstrate how the framework can be applied to evaluate current policies and programs and spur innovative, evidence-based strategies to improve children’s health.