There are many definitions of child health. First Things First (FTF) is a broad public policy
initiative; as such, the definition of child health used by FTF should reflect broad societal
goals of health. Because of this, we recommend that definition used by FTF be based upon
the definition of child health used by the World Health Organization:
Child health is a state of physical, mental, intellectual, social and
emotional well-being and not merely the absence of disease or infirmity.
Healthy children live in families, environments, and communities that
provide them with the opportunity to reach their fullest developmental
Children cannot achieve optimal health alone. They are dependent upon adults in their
family and community to provide them with an environment in which they can learn and
grow successfully. In addition, because they are continually growing physically and
mentally, measuring FTF’s success in achieving optimal child health will be challenging.
Maternal health status, habits, and environment during and even before pregnancy
profoundly impacts the health and well-being of a child. Thus, achieving optimal child
health is dependent upon optimizing the health and well-being of a child’s mother.
Child health is foundational to adult health and well-being. When children’s health is
nurtured and supported and there is an absence of physical and mental abuse or other
intentional childhood trauma; and there exists opportunities to gain habits that support
good health during childhood, the stage is set for healthy adulthood less likely to include
chronic health problems such as overweight/obesity, poor oral health, diabetes, and other
chronic physical and mental health problems.
Because of the mutable nature of childhood and the desired long-range impact of any
initiative targeting early childhood, the Board will face challenges in how to use outcomes
and indicators to measure their success in attaining optimal child health. Outcomes will
need to be viewed in both the short and long term. In addition, because kid health
indicators are indirect measures of the health of communities as well as our state it is
important that FTF choose indicators of health that measure child health status from
the perspective of not only the child but also their environment (eg. family, community)
Although FTF funds will be targeted in early childhood, the long-range impact of funded
interventions should be assessed using this definition of child health. For example, some
measures of FTF success might include the funded interventions’ impact on the community
- Economic status (eg. poverty rate)
- Educational status (eg. high school graduation rate)
- Workforce (eg. unemployment rate).
While such impact areas may seem far removed from First Things First’s target actions, we
suggest that any design elements for interventions in early childhood must logically align
with these or similar long-range goals.
In addition, the short-term impacts of interventions will need to be assessed. Potential
short-term measures of the FTF interventions in communities might include kindergarten
readiness and educational achievement in elementary and middle school.
Using such a framework, funding targeted at improving kid health must address the
definition of child health or components thereof, and lead logically toward the progression
of desired outcomes.