Hertzman – developmental health

Well, developmental health then is basically this concept that arose out of looking at the early childhood aspects of population health. In other words, it’s got to do with a state of doing well across those three broad domains of child development I mentioned earlier on: the language and cognitive, the social and emotional and the physical development. Now people divide it up in different ways but that’s the way I like to do it and so developmental health basically means, you know, doing well across those three different domains, right, and of course, then in turn, what’s important are the factors that influence that, you know, and those factors begin obviously prebirth and carry forth. Some of them are socio-economic in nature and clearly the more resources that families have and the more control they have makes a difference for how kids do.    

But things like parenting style make a huge difference. Being an interactive, flexible parent leads to better developmental health than say being an authoritarian or apathetic parent. Similarly providing a rich language environment in the home makes a lot of difference. And then factors at the neighborhood level make a lot of difference as well. Neighborhood safety, cohesion, having mixed neighborhoods rather than poor ghettos all make a difference. And then the quality and accessibility of services make a difference as well. Quality child care makes a difference. Having timely access to things which will pick up vision, hearing, dental problems and so forth, all make a difference. And so those things all layer on top of each other. What it means is that in a society like Canada, where we haven’t done a particularly good job of actually delivering universal access, if I can say, to the conditions for healthy child development, that by kindergarten age you can already see large socio-economic differences emerging in how kids do on those three broad domains of development. And you know those differences are largely preventable. And so developmental health, I think, is about addressing those things.    

The real question though is whether or not the gap between kids at the top and the bottom of the socio-economic spectrum in terms of their development has been widening or not over time. And we just don’t know. What we do know is the gap is wide now. And it is certainly true that now we’re in more and more of a knowledge-based kind of an economy that differences, for instance, in kid’s ability to cope with language and cognitive concepts and also on the social and emotional side, people being able to operate in a workforce where you have to be very interactive, presumably is going to bite pretty hard for people who don’t have those skills. And so the cost of differences in developmental health is definitely going up.