In this report, the Trust for America’s Health (TFAH) examines how to increase the public health approachto child development by looking at national, State and local strategies, policies and programs that have a high impact for improving health and well-being across a range of sectors, and how to better bring those sectors together to develop partnerships that have a better chance of achieving common goals. It begins by reviewing the impact of negative experiences on the physical health and brain development of a child, and the need to reduce risks and build protective factors that help individual children and their families while also reducing the burden on the nation’s social service, healthcare, education, and public health systems and costs. The cost effectiveness of focusing on upstream prevention of adverse experiences in the early years is emphasized. Following sections of the report review 40 years of research showing positive results for early childhood programs, the impact of trauma and toxic stress, and the shifting demographics of children in America. Recommendations are then made for a public health approach to early childhood. The recommendations include: building beyond traditional healthcare by integrating health and other social support, including accountable health communities for children; promoting protective, healthy communities and establishing expert and technical assistance backbone support to help spread and scale programs in every State; and increasing investments on core, effective early childhood policies and programs. Specific strategies for implementing each of the recommendations are discussed. 660 references.
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