We Must Start Investing Earlier: The Importance of Prenatal to Three

Solid Start Vision: We envision a healthcare system that integrates all aspects of care for pregnant individuals and families with young children as a national public health policy.

Solid Start Mission: Solid Start promotes health and health equity by integrating social, behavioral, and medical care for pregnant individuals and families with children 0-3.

Health care isn’t enough:

As important as medical care is, it is a relatively small contributor to the overall health status of the population. Most health problems occur long before people get to their healthcare provider or hospital. Our community’s well-being is shaped by our homes, schools, workplaces, and the neighborhoods in which we live.

In the Solid Start integrated whole person model, we “follow a family” beginning at pregnancy and continuing through age 3, integrating social and behavioral health needs to meet families where they are at and fundamentally change the way healthcare is delivered.

What the research says:

Decades of research has demonstrated that investing in pregnant individuals and children when they are young pays dividends for their future well-being and for the success of our society as a whole.

Furthermore, the research is conclusive that the first three years of a child’s life are critical. Without a strong foundation, children are at risk for a variety of behavioral, educational and health problems that lessen the quality of their lives and contribute to a number of costly problems down the line.

Prenatal Care:

Having a healthy pregnancy is one of the best ways to promote a healthy birth. Getting early and regular prenatal care improves the chances of a healthy pregnancy. This care can begin even before pregnancy with a pre-pregnancy care visit to a health care provider. Inadequate or absent prenatal care is often cited as a risk factor for low birthweight and other poor pregnancy outcomes. The positive impact of prenatal care on pregnancy outcomes has wide scientific support. The Select Panel for the Promotion of Child Health concluded that prenatal care was one of the services “for which there is such a clear consensus regarding their effectiveness and their importance to good health, that it should no longer be considered acceptable that an individual is denied access to them for any reason.”

https://www.zerotothree.org/resources/156-brain-wonders-nurturing-healthy-brain-development-from-birth

Brain Development:

Recent advances in brain research have provided great insight into how a child’s brain undergoes an amazing period of development from birth to three—producing more than a million neural connections each second.

Whereas this growth had been thought to be determined primarily by genetics, scientists now believe that it is also highly dependent upon the child’s experiences. This is not to say that individual genetic differences have no influence on how a child develops; they do. But there is mounting evidence that experiences affect the way genes are expressed (i.e., turned on and off) in the developing brain. While good early experiences help the brain to develop well, experiences of neglect and abuse can literally cause some genetically normal children to become to develop serious emotional and mental difficulties.

Children, therefore, exposed to various forms of adversity early in life are at increased risk for a broad range of developmental difficulties, affecting both cognitive and emotional adjustment. Negative early experiences can profoundly affect the development of the brain.

Maltreatment increases a child’s risk of developing depression, self-destructive behavior, eating disorders, attention deficit disorders, drug and alcohol problems, sexual promiscuity, and delinquency. Many researchers believe that these effects can be partly explained by understanding how chaotic, stressful, and traumatic experiences affect brain development in the early years.

The Economic Imperative:

James J. Heckman is the Henry Schultz Distinguished Service Professor of Economics at the University of Chicago, a Nobel Memorial Prize winner in economics and an expert in the economics of human development. In this two-page summary document, Professor Heckman argues that the best way to reduce deficits is to invest in quality early childhood development for disadvantaged children. It creates better education, health, social and economic outcomes that increase revenue and reduce the need for costly social spending.

The Social Determinants of Health 

Social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. Conditions (e.g., social, economic, and physical) in these various environments and settings (e.g., school, church, workplace, and neighborhood) have been referred to as “place.” In addition to the more material attributes of “place,” the patterns of social engagement and sense of security and well-being are also affected by where people live. Resources that enhance quality of life can have a significant influence on population health outcomes. Examples of these resources include safe and affordable housing, access to education, public safety, availability of healthy foods, local emergency/health services, and environments free of life-threatening toxins.

Equity

At Solid Start, we recognize that advancing equity begins with the individual professionals’ self-reflection and commitment to learning, but that it must continue with a 360-degree examination of program expectations, practices, and policies, as well as with working across our medical, educational, and social systems of care to challenge policies, laws, systems, and institutional practices that keep social inequities in place. We are committed to continuing to help build the capacity of our system to address biases at all of these levels and promote equitable access to care and learning opportunities for all young children and their families.