The First 5 Years of Life, Critical to Health Equity

In May 2018, the Robert Wood Johnson Foundation released a report entitled, “Early Childhood is Critical to Health Equity.”  As defined in the report, health equity means that “everyone has a fair and just opportunity to be as healthy as possible.” As stated in this report, it says that the conditions in the first five years of life are critical to shaping health for the rest of our lives.  We all want good health for our children but then why is it that certain groups go on to live healthy, productive lives while others go down a pathway of lifelong hardship, ill health, and piles of medical bills?  The report outlines the multiple pathways that show how the effects of poverty and racism experienced in early childhood can lead to poor health in adulthood.  For example, a family of color may experience racial discrimination when it comes to housing.  They may be forced to live in low-income areas with poor living conditions.  This causes chronic stress in parent(s) and in the child leading to suboptimal cognitive development, poor academic performance, lower educational attainment and lower income in adulthood.  Ultimately, this leads to poor health in adulthood and the downward cycle perpetuates itself to the next generation.

So, how do we stop this perpetual downwards spiral of poverty, racism, and health inequity?  Fortunately, there is hope for the future but it will require us to take a broader approach that goes beyond just programs, services, and education.  As stated in this report, there is evidence that intervening in early childhood has the potential to interrupt this cycle linking childhood inequity with lifelong poor health.  Current knowledge and evidence suggests that there is a need for “multiple, mutually reinforcing efforts” and that effective solutions will require changes at the structural, institutional, and policy level.  At Healthy & Active before 5, we do just that.

At HAB45, we recognize the importance of early childhood in shaping health equity and call to this plea by focusing our efforts on two main areas of policy and environment.  HAB45’s Pledge the Practice, Pass the Policy Program works with groups to adopt healthy policies, breaking the chain of unhealthy institutional norms and practices along the way.  When employees adopt healthy habits, they become role models to their children and families who likely follow suit.  By advocating for better parks, children will have more opportunities to play and socialize with other children.  While we acknowledge that changing institutional norms and culture won’t cure epidemics like obesity overnight, we recognize the tremendous power of policy and environment level changes to influence health in the places where we live, work, and play.