How often have we witnessed an adorable, inquisitive and charming toddler and wondered what does the future hold? What happens to that child in adolescence? Why do some of these children fail in school, choose unhealthy lifestyle options, have children at an early age and contribute to the cycle of poverty? I often wish that I could bring these adorable children into my home and use my resources to help them succeed.
As a former pediatrician, I was always interested in treating the acute and chronic manifestations of illness. If we could just get children immunized, get vision and hearing checked, and do preschool exams, we could contribute to the development of healthy responsible adults.
I have since changed careers and am now more interested in population health at the macro level. I realize that social and educational issues are at least as important as health care in determining the future of young children.
How do we provide educational and social advantage for each child? It is very hard to study at night if there is no heat or electricity or the home environment is full of strife. If living conditions are unstable and a family is living on the floor of someone else’s apartment, school work has a low priority. If a child is assigned homework that requires a computer, how difficult is it to access a free computer at the public library. What if the walk to and from the public library is through a crime ridden neighborhood? Should that child have to decide whether or not to risk his or her life to complete the assignment?
If a family does not have access to good food options because they live in a neighborhood without a fresh grocery store, how can we expect them to eat a balanced diet? If a child lives in poverty, how can we blame them for childhood prostitution, drug dealing, etc.? How can we expect them to succeed when they are merely surviving?
I was very pleased when the head start programs were initiated. I was so delighted to observe young children learn their numbers, their letters, and begin to read. I tried to emulate that teaching with my own children. Recent data has shown that early gains are lost when the program is stopped. For our vulnerable children, we need to have adequate funding to continue the program throughout elementary school. Our young children are our most important resource.
In my work with population health and community health workers, I have met many wonderful people who just needed a second chance. They want to go back to work, become positive role models for their children and learn new skills to advance themselves. They want to break the cycle of poverty. This is their American dream.
It is our responsibility to help every child perform to his/her optimum capacity and provide opportunities for this to occur. It is our responsibility to identify young adults who need and deserve a second chance. It is our responsibility to encourage them and at least give them the option to become contributing members of society. Our nation is depending on us. We cannot afford to slack on these core responsibilities.
Of course, providing affordable excellent health care is critical, but the social determinants of health and illness are just as important.