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Health Aff (Millwood). 2014 Dec;33(12):2116-24. doi: 10.1377/hlthaff.2014.0944.

The changing nature of children's health development: new challenges require major policy solutions.

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Neal Halfon ( is a professor of pediatrics at the Geffen School of Medicine; a professor of health policy and management at the Fielding School of Public Health; and a professor of public policy at the Luskin School of Public Affairs, all at the University of California, Los Angeles (UCLA), and is director of the UCLA Center for Healthier Children, Families, and Communities.
Paul H. Wise is the Richard E. Behrman Professor in Child Health in the Department of Pediatrics, Stanford University School of Medicine, in California.
Christopher B. Forrest is a professor of pediatrics at the Children's Hospital of Philadelphia and the University of Pennsylvania, in Philadelphia.


The epidemiology and social context of American childhood are rapidly changing. Adverse social, economic, and child-rearing conditions are loading children down with preventable illness, physical and behavioral disability, and dysfunction. This new epidemiology of childhood is swamping the capacity of the nation's health care system, schools, juvenile justice facilities, and child protective services to respond to the needs of those they serve. This low-performing system not only jeopardizes the health of children, it also jeopardizes the health of the adults they will become. In this article we review the science of life-course health development, a new field that provides a powerful explanatory framework for understanding how poor health and social adversity during childhood can affect lifelong health. We then present five ambitious policy recommendations to integrate educational, health, social, and economic initiatives designed to enhance health. Our bold but pragmatic goal is that by 2025, US children will have the highest levels of health among industrialized nations, instead of where US children currently rank-among the worst.


Children’s Health; Determinants Of Health; Disparities; Epidemiology; Health Reform

[Indexed for MEDLINE]

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