I began practicing pediatrics more than 60 years ago. Since then, health care has taken enormous strides, including this summer's Supreme Court decision to uphold the Affordable Care Act. This landmark ruling comes after decades of progress in how we care for our children in this country.
We know so much more now than back when I started: Science has shown that deprivation in the womb has lifelong negative effects on health. So does severe adversity during early childhood. We know now that access to quality health care -- at the beginning of life and during pregnancy -- can help prevent both. Investing in prevention can help transform our healthcare system by keeping people healthy and reducing health care costs. A healthier workforce and a sustainable healthcare system mean a stronger nation.
But we can and must do more to act on what we know. There's more to do if we are to ensure that all children grow up to become adults who can cope with adversity, strengthen their communities, engage as active participants in civic life, steward our fragile planet's limited resources and nurture the next generation to be prepared to do the same.
One place to start is preventive health care, which can do more to strengthen our nation when linked with education. In addition to good health, our workforce needs to be highly educated, and the two go hand in hand. Nearly 50 years ago, I collaborated with Head Start's founding fathers, educator Ed Zigler and pediatrician Julius Richmond, to help build a comprehensive child health, early education and family support program for children living in poverty. Since then, science has shown that children are more likely to enter college, be healthier in adulthood, join a globally competitive workforce and serve as contributive members of society if they get a strong education -- starting in their earliest years.
Today, thanks to Obama administration investments, more children than ever are participating in Head Start, fulfilling the bipartisan vision backed by Republican and Democratic administrations alike. Econometric studies have shown that such investments pay off -- up to $17 per $1 spent. Yet despite all we now know, too many Head Start-eligible children still aren't funded for a chance to participate in this critical program. One of the Obama administration's great accomplishments has been to galvanize public will to open Head Start doors to 61,000 additional children, but we need to fund twice as many Head Start slots for babies and young children, and we need to start right now.
The recent Supreme Court decision to uphold the Affordable Care Act leaves many protections for children and families intact, at least for now. Thanks to this law, millions of children have already received preventive well-child routine care; more than 3 million young adults have received coverage through their parents' health insurance plans and children with pre-existing conditions, including asthma, diabetes and others, have been guaranteed rather than denied coverage when their parents have had to switch insurance plans due to job changes or out-of-state moves. The broader coverage afforded by this bill will make our nation healthier, and stronger.
But threats to our children's health are afoot on Capitol Hill. Fall deadlines for funding the federal government loom. Nearly every proposal before Congress would make dramatic cuts to investments in preventive and primary health care for children, investments that pay off and save taxpayers' money. If Congress chooses cuts and avoids sequestration -- the automatic cuts set by the Budget Control Act of last summer -- Medicaid is at risk. If Congress doesn't, then the automatic ones would also slash federally-funded children's health programs and educational ones. Either way, without the funding for relatively inexpensive medication and outpatient treatment, we will spend much, much more for children who end up in very costly emergency rooms and intensive care units unnecessarily. We know how to do better -- for our children's health and our economy, too.
I may be 94 years old, but I'm not done. We health care professionals have a duty to advocate for what we now know children need and to empower their families and federal legislators to do the same. We must go beyond our offices and prescription pads and into the halls of Congress and the pages of publications like this one to speak up for the children we care for who so often are unable to speak for themselves.
T. Berry Brazelton, MD, beloved as "America's pediatrician" has advised Republican and Democratic administrations on children's health. Clinical professor emeritus of Pediatrics at Harvard Medical School, and founder of the Brazelton Touchpoints Center at Boston Children's Hospital, Brazelton is internationally renowned for his pioneering research on newborns and his common sense wisdom for parents. The Brazelton Neonatal Behavioral Assessment Scale (NBAS) is used in major hospitals around the world, and the bestseller, Touchpoints: Your Child's Behavioral and Emotional Development, has been translated into more than 20 languages.
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I will never ever forget standing in my kitchen with his kind, gentle voice reassuring me from the other end of the phone line. His willingness to personally help a concerned mother was simultaneously overwhelming and such a comfort. I am forever grateful to him. Thank you, Dr. Brazelton.
While Dr. Brazelton explicitly references the Head Start program, I would mention that there are early care and learning environments that rely on the same understanding of the necessity of: "comprehensive child health, early education and family support program for [economically disadvantaged] children." Surely both government and private $$$ could have no more critical purpose than this.
Recently, I recently discovered a school in Georgia, http://cdakids.org - with outstanding Early Care & Learning programs. We may have examples in our communities of how to get these first critical years right, but be unaware that we are doing so. God knows we have a crying need for many, many more. I can only wish we would see this quality in *all* our schools, for all our children.
Why isn't this common sense?
More on how one community makes this happen:
http://www.youtube.com/watch?v=HzxKrN7AlYI
A recent study by the DHHS showed that any modest benefits achieved through the Head Start program "are largely absent by 1st grade".
We are clearly failing our children at many levels, but we need to make sure the resources we have are spent more productively
http://bluecravat.blogspot.com/2012/04/dont-confuse-me-with-facts.html
Head Start children are significantly more likely to complete high school and attend college than their siblings who did not attend Head Start.
Young women who have experienced a quality early childhood program are one-third less likely to have out-of-wedlock births.
At-risk children not afforded the opportunity to participate in a quality early childhood program are five times more likely to be arrested repeatedly by age 27.
Could you point me to recent statistically significant data that supports each of these claims?
Thank you
Head Starters’ first grade standardized test results may look similar to their non-Head Start peers. But first grade testing does not provide evidence for or against impacts on adult outcomes and return on investment. The studies below do.
Anderson K, Foster J, Frisvold D. (2004). Investing in Health: The Long-Term Impact of Head Start. Working Paper No. 04-W26. Nashville, TN: Department of Economics, Vanderbilt University. www.vanderbilt.edu/econ.
Deming, D. (2009). Early childhood intervention and life-cycle skill development: Evidence from Head Start. American Economic Journal: Applied Economics, 1(3), 111-134.
http://www.aeaweb.org/articles.php?doi=10.1257/app.1.3.111
Garces, E., Thomas, D., & Currie, J. (2002). Longer-term effects of Head Start, American Economic Association, 92 (4), 999-1012.
http://www.aeaweb.org/articles.php?doi=10.1257/00028280260344560
Ludwig, J., & Miller, D.L. (2007). Does Head Start improve children’s life changes: Evidence from a regression discontinuity design, The Quarterly Journal of Economics, 159-208.
http://ideas.repec.org/p/iza/izadps/dp2111.html
I have reviewed these studies and have to say they are not compelling and certainly not enough to support $10 billion in funding. For example one of the studies you provided argues that Head Start reduces mortality rates in 5 - 7 year olds. Really? Even the author of the study states is only able to claim this questionable conclusion "could" be as a result of Head Start
The frustration is that we spend an enormous amounts of money on education with very mediocre outcomes. Our kids deserve more. I am not saying cut spending, but I am saying we should expect better results and unfortunately Head Start is unable to document its efficacy
They don't make them like this anymore.
Seeing the positive, acting on it and honoring it.
Blessed to have known your work Dr.
I have three great kids in college, and it is largely because you were my guide.
None of the blather from the in-laws was allowed to supersede your guidance.
Thank you, and good health to you.
I often speak about him when certain subjects come into my conversation.
I remember a TV series of his called 'What Every Baby Knows'. He would have something like a very large play pen. Into it would go a bunch of very young children. The parents would sit in the 'peanut gallery'. Then, Dr. Brazelton would explain to mothers what was going on with these babies interacting with each other.
These babies spoke to each other. They did things to each other that would have distressed them if done to them by an older child. It was an amazing show.
I'm sure many mothers learned a lot from Dr. Brazelton regarding their baby's body language, their needs and desires, and innate abilities at a very early age.
I loved watching this program. And, I am a single male.
Thank you, Dr. Brazelton. You are a true jewel regarding babies. You should bring back repeats of your TV show - it will always be valid and valuable.
I loved to watch the interaction between Dr. Brazelton and the children.