Six months ago, I blogged about a child health research conference I attended and concluded that “we know enough right now to predict that doing nothing will result in poor adult health outcomes of babies being born today. Aside from the obvious moral dimensions, my main argument for expediency is pragmatic: the health and economic competitiveness of our nation over the next 50-100 years is at stake. Surely investing in maternal and early childhood health should be a priority.”
This perspective is rooted in idea that upstream social and economic factors such as income and education are critical drivers of health. Interventions in these areas are often assumed to be the purview of the public and non-profit sectors, but this is a limited view. For-profit activity in economic development and job creation are just as important as anti-poverty public policies and programs such as the Earned Income Tax Credit (EITC). I believe that measurable and comprehensive population health improvement requires a long-term commitment of resources – we need to focus on creating and sustaining funding streams for the long haul.
While the editorial didn’t specifically mention the health effects of early childhood programs, they are well-documented and account for a major part of the long-term impact on a productive future workforce. I applaud the growing numbers of employers promoting employee wellness and fitness and rewarding healthy behavior choices. But the healthy choice is not often easy to make, particularly among lower SES populations. We need to cultivate business sector buy-in to the notion of shared responsibility for education; strategic investments now will pay off in the form of a healthy and productive workforce in years to come.
In a 2010 MATCH essay, the head of the National Business Coalition on Health said it this way: “a compelling business case can and should be made for business leaders to look beyond the worksite to the communities where their organizations do business and their employees reside. Business leaders must understand that an employer can do everything right to influence the health and productivity of its workforce at the worksite, but if that same workforce lives in unhealthy communities, employer investments can be seriously compromised.”
Improving community health is a complex enterprise needing involvement and collaboration across many sectors. While no clear organizing entity has yet emerged, we will not get there without robust private sector support and financing that goes beyond job creation to upstream investments in education, particularly for early childhood.
David A. Kindig, MD, PhD is Emeritus Professor of Population Health Sciences and Emeritus Vice-Chancellor for Health Sciences at the University of Wisconsin School of Medicine and Public Health.
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