The Foundation for a Healthy Community is Healthy Children

By Dianne Cooney Miner, PhD, RN, FAAN, Dean, Wegmans School of Nursing, St. John Fisher College; Bob Thompson, MS, Vice President of Community Health Engagement, Excellus BlueCross BlueShield; Fran Weisberg, Community Fellow, Center for Community Engagement, St. John Fisher College; and Thomas McInerny, MD, FAAP, immediate past president of the American Academy of Pediatrics (AAP) and Professor Emeritus in the Department of Pediatrics at the University of Rochester Medical Center and Golisano Children’s Hospital.

The Children’s Agenda is celebrating its 10th anniversary with 10 blog posts from community leaders committed to making the next 10+ years a decade of dramatic change and achievement for kids. Click here to learn more. This month’s installment focuses on the importance of supporting solutions for children’s health, because their well-being impacts the well-being of our entire community and our collective future.

We are individuals from different positions in health care with a common perspective on what needs to change for the betterment of our community. From these different positions—in community health planning, health insurance, nursing education, and primary care—we have led and continue to lead local, regional, state, and national organizations.

Our experiences and expertise fuel a collective belief that advocacy for children may be the most critical factor to ensure the health of our community.

In fact, we each work with The Children’s Agenda in different capacities—on their board, in community initiatives, in partnership with them and other leading Rochester institutions—because of this belief. Advocacy and systemic change focused on children is what we need to make our Greater Rochester community healthier.

Here’s why:

  • Children’s health is the foundation of adult health, and thereby our community’s health.
  • Children’s health is poor in Rochester when compared with other similar communities.
  • Children’s health is especially influenced by determinants beyond medical care. In other words, environment and culture influence health more so than medicine or even genetics.
  • We know how to help and change many of these determinants, but as a community we need to make the choice to do that.

Reflecting back on the most important lessons of his career in an interview in Health Affairs in 2004, former Surgeon General, Dr. C. Everett Koop, stated: “In the long run, child health is about advocacy.” The American Academy of Pediatrics acknowledged in a policy statement in 2013, “Increasingly the major threats to the healthy development of America’s children stem from problems that cannot be adequately addressed by the practice model alone.”

We support and work with The Children’s Agenda because they advocate for what is needed most and works best to improve children’s health. In our community, we do not lack innovative and effective solutions. We lack the collective will to prioritize those solutions for all kids.

We have much more to do to help children and families be healthy in our nation.

“Millennial Morbidities” are the most important current diseases and causes of harm to children in the United States and in our community. They include: mental health problems, violence, child abuse, and socioeconomic disparities—including child poverty, obesity, teen pregnancy, and injury.

  • About 20 percent of our children suffer from diagnosable mental illness each year.
  • Nearly six million children are reported to be abused or neglected each year; five children die each day in the U.S. from child abuse.
  • Over one in three children and youth are overweight or obese.
  • Homicide is the leading cause of death for urban youth.

In Monroe County, our child health data are about on par with the U.S. data above. In the city of Rochester, though, our child health data are worse than Monroe County or the nation as a whole.

Beyond these palpable concerns for the health of our children, there is abundant evidence that adult health is significantly tied to childhood health. We know, for example, that an adolescent who is overweight or obese is more likely to be overweight or obese as an adult. As a further illustration, most behavior and mental health problems have their origins in childhood. Child abuse and neglect have ramifications not just during childhood, but for a lifetime.

The issues we see for children are just “the tip of the iceberg” for adult health issues, which we don’t yet see and that will cause suffering, real expenses, and decreased productivity.

It is becoming increasingly clear that economic, social, and educational policies are, in fact, all health policy for children. High school graduation, an outcome traditionally thought to be an educational issue, has exceptionally important health impacts: Youth who drop out of high school have shorter life expectancies, less access to medical care, and poorer adult health status. Education is a crucial path to health. Evidence suggests that children who have high-quality early education experiences reduce their risk for adult cardiovascular risk conditions like hypertension and the metabolic syndrome—a constellation of symptoms that include high blood sugar and excess abdominal fat.

Conversely, childhood experiences like violence in the home, mental illness in a parent, emotional neglect, and parental separation or divorce (known as “adverse childhood experiences” or ACES) lead to toxic stress, which has a devastating link to infant mortality and increases the risk for a whole spectrum of adult health problems. These include heart disease, liver disease, depression, smoking, and unintended and teen pregnancies, in a strong and graded fashion. Overlay poverty and kids’ health trajectory further deteriorates.

In fact, toxic stress and its link to premature births and subsequent infant mortality was featured in a recent episode of the new documentary series from PBS, America By the Numbers. You can learn more about this kind of stress, which impacts many Rochester mothers and is passed down to their children, by watching WXXI’s Need To Know with Dr. Jeff Kaczorowski, joined by America By the Numbers’ host Maria Hinojosa shortly before the airing of the episode.

So what can we do? As our own Frederick Douglass once said, “It is better to build strong children than to repair broken men.” Now is our time. Our children are only children for a short while. A three-year-old is only three for one year.

The Children’s Agenda advocates for programs and policies that offer every child a fair chance to live a healthy life.

Here are some right-now solutions we can all champion through support of The Children’s Agenda:

  • Expand access to evidence-based home visitation and effective parenting programs for young families.
  • Make high-quality early childhood education experiences, like three- and four-year-old pre-K, available for all kids.
  • Increase child care subsidy funding to lift children and families out of poverty and increase affordability of high-quality child care for working parents.
  • Enact and really implement school policies and approaches that help children to be healthy and promote positive behaviors, especially for children who have experienced trauma and violence in their homes and neighborhoods.

We have joined with The Children’s Agenda and its leadership to improve the health of our children and our community. There are answers to the health problems facing our community and our children. They are needed now—your advocacy and help can get us there.

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