Health Promotion

Addressing Health Disparities Early in Life

By: Paul H. Dworkin, MD

Back in April 2016, I was honored to be selected as one of four presenters at the Centers for Disease Control and Prevention’s (CDC) Public Health Grand Rounds titled “Addressing Disparities in Early Childhood.” The information we collectively provided to our audience is now compiled in an article just published on the front page of the CDC’s Morbidity and Mortality Weekly Report (MMWR), which is circulated to an audience of millions around the world.

The article highlights powerful research that suggests many disparities in health and well-being have roots that can be traced to stressors in early childhood, such as poverty, neighborhood safety and a lack of access to early childhood education. If unaddressed, such stressors can have detrimental effects on children and lead to them being on an “at-risk or vulnerable” trajectory or even a “delayed or disordered” trajectory. However, the article also details how protective factors such as having consistent, caring relationships and access to coordinated health care can provide a buffer to offset the negative consequences of toxic stress, leading children to reach “healthy” trajectories.

The article details the importance of not only screening children in the early years to identify developmental and behavioral concerns, but also the importance of ensuring such children are connected to hospital-based or community-based programs and services that can intervene. By identifying children with concerns and connecting them to necessary supports, we can prevent them from ending up as high risk. As the article notes, the benefits of early intervention clearly exceed the costs of such initiatives.

The article mentions our Help Me Grow (HMG) model as an example of a program that enhances cross-sector coordination to transform child-serving systems around the country by reducing service gaps for children. As the article notes, HMG serves as a centralized point of entry for vulnerable children and families to access both state-funded early intervention programs and community-based services that can intervene for those with lesser needs. In 2015 alone, systems in the nationwide HMG network served 42,511 children and families, with some states embedding the model into federal initiatives including home visiting programs.

With the first eight years of life being critical to laying the foundation for future success, I applaud the CDC for bringing focus to the issue during its Public Health Grand Rounds session and through its MMWR publication. We can do more to ensure all children have the opportunity to reach their full potential. By working together to raise awareness about the value of developmental promotion, early identification and linkage to community based supports we are taking important and necessary steps to enhance children’s optimal health, development, and well-being.

Dr. Dworkin participated in the CDC’s Public Health Grand Rounds with three other presenters: Ross Thompson, PhD, of the University of California, Davis and board president of ZERO TO THREE; Georgina Peacock, MD, of the CDC; and Mary Ann McCabe, PhD, of George Washington University and past-president of the Society for Child and Family Policy and Practice.


Shown in photo left to right: Ross Thompson, PhD, Paul H. Dworkin, MD, Mary Ann McCabe, PhD, and Georgina Peacock, MD

Paul H. Dworkin, MD, is the executive vice president for community child health at Connecticut Children’s, the director of Connecticut Children’s Office for Community Child Health and the founding director of the Help Me Grow® National Center. Dr. Dworkin is also a professor of pediatrics at the UConn School of Medicine.  Learn more »

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