The United States has long been a global leader in medical research and innovation, yet we rank lower than 38 other countries on measurements of children's survival, health, education and nutrition, according to a recent report from the World Health Organization and the United Nations Children's Fund, published in The Lancet.
We urgently need to shift our country's focus to improving children's lives to build a healthier nation and protect the human capital and economic health of the U.S. In a new white paper, How Children Can Transform the Economy…and Health Care, I call attention to the direct connection between healthy children and long-term U.S. economic growth and security.
As leaders in medical research, the U.S. has made unparalleled advances in treating complex medical conditions. Yet we know that 85 percent of health comes from factors beyond the hospital walls — including education, food security, employment, freedom from violence, avoidance of childhood trauma, access to transportation and much more.
Evidence shows that addressing these social issues in childhood can have a major impact on the long-term workforce productivity of the next generation of adults. A dramatic example is the Abecedarian preschool project, led by James Heckman, PhD, the Nobel prize-winning economist from University of Chicago. Researchers divided children from birth to age 5 into two groups. The study group received two meals per day and a healthy snack, along with periodic medical checkups and basic education on healthy behaviors and lifestyles appropriate for a 5-year-old. The control group went to the same preschool as everyone else.
Thirty years later, the health outcomes of the study group were compared to the controls and demonstrated that the intervention group was significantly less likely to have high blood pressure, had no incidence of deadly metabolic syndrome and had a markedly lower incidence of obesity. But more jarring, in my view, were the economic outcomes. Children in the study group had an increased high school graduation rate, were less likely to be convicted of a crime or incarcerated and had higher median annual income compared to the control group.
Children's hospitals and health systems across the U.S. have taken the lead in piloting and testing interventions like these to connect their patients to resources that go far beyond medical treatment. At Nemours, we are accomplishing this through intentional collaboration with our community partners in early childhood education, adult care, food pantries and more. Beyond this, there are a few key strategies that are crucial to success:
- Creating a value-based services organization to prepare Nemours to be at full risk for the health of our patients.
- Adopting a population mindset to assume accountability for children in the service area, whether they seek medical care or not; and
- Partnering with organizations in addressing social determinants of health by applying each other's areas of expertise — generating the cross-sector reward of improved child health and well-being.
Children's hospitals and health systems are uniquely positioned to change the way we define health and to pave the way with strategic investments in our children's future. Our organizations serve as community pillars with the expertise, trusted relationships and infrastructure to serve as the stewards of children's health. They are strongly equipped to systematically assess gaps and barriers to improved health, working in partnership within their communities, states and even regions, creating the potential of expanding this model to scale nationwide.
At Nemours, we want to get more from the care we provide, and we see children's health and well-being as a smart, significant investment in our country's future. Children account for about 7 percent of total medical care spending, but before long, this generation will constitute 100 percent of the adult population.
The benefits of intervention in childhood are seen across a lifetime and will impact subsequent generations. By making evidence-based changes in the way we "create" healthy children, we not only improve the quality of life for families, we also improve workforce productivity and reduce health care- related costs to individuals, companies, governments and communities. We must engage with a broader set of private and public sector leaders to work together with us to take action to secure a healthier future.
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