Hertzman – population health

Well, population health is the study of why some groups of people in society, in regions, etc., etc., are healthier than others. And so in a society like Canada, one could ask, you know, why are non-aboriginal people healthier than Aboriginal people? Or why are people, as you go up the socio-economic spectrum, increasingly healthier than those as you go down the socio-economic spectrum.  

It turns out when you actually delve into the question of population health that a lot of the factors that determine whether or not people live healthy lives as well as have a high sense of well-being and competence, really emerge from the early years of life. That’s one of the things that’s come out of our study of population health. In particular, early language and cognitive development, early social and emotional development and early physical development all contribute to health across the life course. And so people who are interested in early child development need to understand that what they’re doing can have a life-long impact on health. 

I think there’s good reasons to believe that what goes on very, very early on does have a long-lasting effect. Now, one has to be very careful when one says that because some people think that means you’re saying it’s all over by age X. And it’s difficult to get people to understand certain kinds of population context. What we’re really saying is if you take 1000 children who are not doing well on one or more of their domains of development by the time they reach school; you take another 1000 who are doing well; and then you watch to see where they are 10 years, 20 years from now. On average, what you will see is the 1000 who are doing well will be doing better than the 1000 who weren’t. However, within each of those groups there will be huge variations. There will be kids who are doing great going into school who are doing terribly 10 and 20 years later. More importantly, there are kids who will not have been doing very well who will be doing great 10 or 20 years later. Right. But on average, those are the differences that you will see, right. And so it is difficult to get people to understand how to think in these population terms and understand what we’re saying.