Healthy Children Become Healthy Adults
Healthy Children Become Healthy Adults
Investing in child health is the single most powerful lever to ensure a healthy population and a strong economy: If we want a healthier American population, we need to prioritize early childhood. Two newly published studies — one authored by a 91ÖÆƬ³§ÔÚÏß¿´ Children's-led team — offer striking examples of how important childhood habits are for lifelong health. When viewed together, the studies provide evidence that a decline in cardiovascular health starts much earlier than most people realize, and that serious problems like hypertension are often downplayed by clinicians and parents alike when they occur in children.
While it is true that most children are relatively healthy, they are also establishing lifelong habits that have serious consequences. In JAMA Cardiology, a team of researchers led by Dr. Izzuddin Aris from Harvard Medical School found that , setting them on a trajectory toward heart disease as adults, the leading cause of death in America.
In the 1,523 children studied, the decline in cardiovascular health was associated with behaviors like diet, physical activity and sleep, rather than the medical metrics we typically use as proxies for heart health: BMI, blood pressure, blood glucose and cholesterol levels. Most pediatricians collect data on both the biological and behavioral factors that influence health, but our training has taught us to focus more on biologic test results when making decisions. Clinicians in this country are reluctant to intervene with asymptomatic kids.
That needs to change. We know that most of health is due to factors outside of medical care. If we want to put kids on the path to a healthy future, clinicians need to partner with community stakeholders to influence the nonmedical drivers of health. It’s not just about treating symptoms, it’s about acting proactively regarding the whole picture of a child’s health, including social drivers like access to nutritious food, safe places to exercise and healthy sleep habits. These social drivers are inextricably tied to socioeconomic factors as well, making health equity an important piece of the puzzle. At 91ÖÆƬ³§ÔÚÏß¿´, we are committed to addressing Whole Child Health: the medical and nonmedical factors in children’s lives that combine to establish their overall wellness.
In , the researchers examined why more than 75% of children with hypertension (commonly known as high blood pressure) go undiagnosed, and the majority of those diagnosed go untreated. They interviewed a diverse array of parents whose children had been recorded at least twice as having stage 2 hypertension, but who had not received follow up treatment within a year. Pediatric hypertension, a condition affecting approximately 3% of children, can lead to kidney failure and heart disease in adulthood.
They found that most of the parents understood the serious consequences of high blood pressure and heart disease, often due to their own personal experiences. Yet they were skeptical of the blood pressure readings and concerned about medication side effects. Clinicians often downplayed the seriousness of the findings, attributing high readings to a child’s anxiety about being at the doctor, which can be a real phenomenon. Parents, in turn, took their cues from the physician’s lack of concern. Both parents and clinicians preferred to enact lifestyle changes over medication, even when they did not work. There is an innate tendency to think of kids as healthy — especially for a child who is not showing any symptoms and a clinician who is not overly concerned. This is a recipe for inaction.
Perhaps we are all colored by a bias that kids are healthy and resilient, and that even if their health is not perfect, there’s plenty of time to turn the ship around. But the poor health of American adults clearly tells us that kicking that can down the road isn’t working.
The implications of Whole Child Health extend far beyond childhood. It is important for clinicians, families, and the community organizations that support them to recognize that building a healthy foundation before the onset of disease is the easiest and most effective way to build healthy adults.
Ìý
About Dr. Moss
R. Lawrence Moss, MD, FACS, FAAP is president and CEO of 91ÖÆƬ³§ÔÚÏß¿´ Children’s Health. Dr. Moss will write monthly in this space about how children’s hospitals can address the social determinants of health and create the healthiest generations of children.