Early Childhood Health Promotion and Its Life Course Health Consequences

  • Bernard Guyer
    Affiliations
    Department of Population, Family and Reproductive Health (Drs Guyer, Ma, Grason, Perry, and Sharkey), Department of Health Policy and Management (Dr Frick), Johns Hopkins Bloomberg School of Public Health, Baltimore Md; and the School of Pharmacy, Northeastern University, Boston, Mass (Dr McIntosh)
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  • Sai Ma
    Correspondence
    Address correspondence to Sai Ma, PhD, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Room E4153, Baltimore, MD 21205.
    Affiliations
    Department of Population, Family and Reproductive Health (Drs Guyer, Ma, Grason, Perry, and Sharkey), Department of Health Policy and Management (Dr Frick), Johns Hopkins Bloomberg School of Public Health, Baltimore Md; and the School of Pharmacy, Northeastern University, Boston, Mass (Dr McIntosh)
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  • Holly Grason
    Affiliations
    Department of Population, Family and Reproductive Health (Drs Guyer, Ma, Grason, Perry, and Sharkey), Department of Health Policy and Management (Dr Frick), Johns Hopkins Bloomberg School of Public Health, Baltimore Md; and the School of Pharmacy, Northeastern University, Boston, Mass (Dr McIntosh)
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  • Kevin D. Frick
    Affiliations
    Department of Population, Family and Reproductive Health (Drs Guyer, Ma, Grason, Perry, and Sharkey), Department of Health Policy and Management (Dr Frick), Johns Hopkins Bloomberg School of Public Health, Baltimore Md; and the School of Pharmacy, Northeastern University, Boston, Mass (Dr McIntosh)
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  • Deborah F. Perry
    Affiliations
    Department of Population, Family and Reproductive Health (Drs Guyer, Ma, Grason, Perry, and Sharkey), Department of Health Policy and Management (Dr Frick), Johns Hopkins Bloomberg School of Public Health, Baltimore Md; and the School of Pharmacy, Northeastern University, Boston, Mass (Dr McIntosh)
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  • Alyssa Sharkey
    Affiliations
    Department of Population, Family and Reproductive Health (Drs Guyer, Ma, Grason, Perry, and Sharkey), Department of Health Policy and Management (Dr Frick), Johns Hopkins Bloomberg School of Public Health, Baltimore Md; and the School of Pharmacy, Northeastern University, Boston, Mass (Dr McIntosh)
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  • Jennifer McIntosh
    Affiliations
    Department of Population, Family and Reproductive Health (Drs Guyer, Ma, Grason, Perry, and Sharkey), Department of Health Policy and Management (Dr Frick), Johns Hopkins Bloomberg School of Public Health, Baltimore Md; and the School of Pharmacy, Northeastern University, Boston, Mass (Dr McIntosh)
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      Objective

      To explore whether health promotion efforts targeted at preschool-age children can improve health across the life span and improve future economic returns to society.

      Methods

      We selected 4 health topics to review—tobacco exposure, unintentional injury, obesity, and mental health—because they are clinically and epidemiologically significant, and represent the complex nature of health problems in this early period of life. The peer-reviewed literature was searched to assess the level of evidence for short- and long-term health impacts of health promotion and disease prevention interventions for children from before birth to age 5. This review sought to document the monetary burden of poor child health, the cost implications of preventing and treating child health problems, and the net benefit of the interventions.

      Results

      The evidence is compelling that these 4 topics—tobacco exposure, unintentional injury, obesity, and mental health—constitute a significant burden on the health of children and are the early antecedents of significant health problems across the life span. The evidence for the cost consequences of these problems is strong, although more uneven than the epidemiological data. The available evidence for the effectiveness of interventions in this age group was strongest in the case of preventing tobacco exposure and injuries, was limited to smaller-scale clinical interventions in the case of mental health, and was least available for efforts to prevent obesity among preschoolers.

      Conclusions

      Currently available research justifies the implementation of health interventions in the prenatal to preschool period—especially to reduce tobacco exposure and prevent injuries. There is an urgent need for carefully targeted, rigorous research to examine the longitudinal causal relationships and provide stronger economic data to help policy makers make the case that the entire society will benefit from wise investment in improving the health of preschool-age children and their families.

      Key Words

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