by Jack P. Shonkoff, M.D.
The extreme challenges of 2020 have laid bare longstanding inequities that affect the lives of children and families, as well as the health of a nation. Fully addressing these deeply embedded inequities and the inter-generational trauma of systemic racism will require transformative change at a societal level. More robust early childhood policies and programs must be part of this change because significant adversity in the lives of young children can disrupt the development of the brain and other biological systems. And these disruptions can undermine young children’s opportunities to achieve their full potential.
Our latest Working Paper—Connecting the Brain to the Rest of the Body: Early Childhood Development and Lifelong Health Are Deeply Intertwined—explains how disparities begin. This understanding can stimulate a new conversation about early childhood investment in a post-pandemic world. Drawing on the rapidly growing science of adversity and resilience—including continuing advances in brain research—this conversation can inform more effective strategies for protecting all developing organs and systems. By intervening early, we can prevent the physiological disruptions that lead to problems in early learning, social-emotional development, and both physical and mental health.
To begin this conversation, we present two fundamental concepts based on 21st-century science:
- All biological systems (e.g., neural, immune, cardiometabolic) interact with each other and adapt to the contexts in which a child is developing—for better or for worse.
- Early experiences and exposures during the prenatal period and first 2-3 years after birth are likely to have as much or greater influence on later health as on school achievement.
The policy implications are clear—supporting expectant mothers during pregnancy and families with young children will build a strong foundation for lifelong health as much as for school readiness. Childcare and early education affect both health and learning. Social services and home visiting for families affect both health and learning. Family income supports affect both health and learning. Health care, which also affects both health and learning, currently constitutes the most substantially funded infrastructure focused on young children in the United States. New models of primary care practice that focus explicitly on the effects of early adversity on whole child development must be a fully integrated part of the early childhood ecosystem, not an adjacent, loosely connected sector.
The dramatic variation in COVID-19 impacts around the world has demonstrated the strengths and weaknesses of different public health responses, medical care systems, and availability of broader population-level supports. Countries that fared the best implemented strong action plans based on cutting-edge scientific knowledge from trusted sources; everyone had to confront the complex challenges of making important decisions in the face of incomplete data.
Scientific knowledge alone cannot prevent or reduce the lifelong consequences of excessive adversity in the early childhood period. But science-informed insights combined with the lived experiences of families and communities, the expertise of service providers, and a diversity of political perspectives among policymakers and civic leaders can catalyze fresh thinking and more effective action.
The time has arrived for a mindset shift for the early childhood field as part of a broader movement for social change. The brain is indeed connected to the rest of the body, but health and education are separated in policy. An integrated approach to confronting the inter-related origins of disparities in each offers a compelling path forward to greater impact at scale for both.