A new supplement published today in the journal Pediatrics suggests that while we’re beginning to connect the dots between events and experiences early in life and later adult health challenges, we’re not doing nearly enough to… intervene in childhood to optimize later health outcomes. At a time when the mental health and well-being of adolescents, young adults is of increasing concern, researchers find this lack of attention to building health reserves and resilience at a young age “deeply disturbing” and are calling for a renewed focus on support for positive people children’s health development and well-being.
The series of articles appears as a supplement to paediatrics from the Life Course Intervention Research Network (LCIRN), whose National Coordinating Center is housed at UCLA within the Center for Healthier Children’s Families and Communities.
The current situation is deeply worrying for both providers and families, and represents a profound failure of our healthcare systems to adapt to rapidly changing epidemiology and to respond to new scientific evidence with healthcare system reforms and improvements. Immediate action is required if we are to improve the health of children and the adults they will become.”
Neal Halfon, MD, MPH, Director of the Life Course Intervention Research Network and Professor of Pediatrics, Public Policy and Health Policy and Management, University of California-Los Angeles Health Sciences
The authors write that in the existing care system, child health care providers are constrained by short appointment times and an inability to address looming social and structural issues that are likely contributing to problems that persist into adulthood, such as mental health problems, suboptimal nutrition, and chronic stress. They write that the current system and approach to treating disease was developed at a time when there was little understanding of epigenetics – how environmental influences and the experiences children have can affect the expression of their genes. Indeed, for many children, it can be a “mismatch” between an “ideal” environment and experience for them early in life and the reality of those environments and experiences that drives many of our later health challenges.
The 17 articles in the special supplement focus on several areas where new intervention approaches have the potential to improve health throughout life and even across generations. The topics of the articles range from a framework for researchers to establish best practices for intervention work across the life course, to a case for positioning adolescents to work directly with researchers at all stages of intervention development and testing, to early childhood mental health interventions and interventions in physical and physical and mental illness virtual spaces such as schools and telemedicine. Researchers consistently emphasize that engaging the role of family and community is key to improving a child’s well-being.
The series states that despite an awareness of the potential for early interventions to improve health later in life, the shift to a healthcare system designed to keep people healthy throughout their lives has been slow.
“This message is important for everyone, but especially for individuals and institutions that fund health research, child health providers and researchers, and for policymakers who need to understand that later in life it will be very difficult and expensive to achieve health equity without equality from the start to achieve,” said Dr. Halon. “We need to intervene early on in the pathways that connect events and experiences in early life to later life health, and find ways to optimize key outcomes.”
LCIRN is a collaborative network of more than 75 researchers from 25 institutions, service providers, family and community representatives, and thought leaders dedicated to improving health trajectories and outcomes across the life course of children and families. In addition to the UCLA center, LCIRN includes two research centers that focus on the issues of family and community involvement, as well as race, location, class and gender; and nine current research nodes addressing adversity and resilience, attention-deficit/hyperactivity disorder, early childhood mental health, family health development, measuring family functioning, school health, post-prematurity success, youth justice, and youth-led participatory action research.
FUNDING: This project is supported by the Health Resources and Services Administration of the US Department of Health and Human Services under award UA6MC32492, the Life Course Intervention Research Network. The information, content and/or conclusions are those of the authors and should not be construed as the official position or policy of the Health Resources and Services Administration, Department of Health and Human Services, or, or should any recommendations be inferred therefrom, the US Government.
University of California – Los Angeles Health Sciences
Halfon, N. et al. (2022) The emergence of intervention research over the life course: Optimizing health development and child welfare. paediatrics. The emergence of intervention research over the life course: Optimizing health development and child welfare. doi.org/10.1542/peds.2021-053509C.