Robinson Lara R, Bitsko Rebecca H, Thompson Ross A, Dworkin Paul H, McCabe Mary Ann, Peacock Georgina, Thorpe Phoebe G
MMWR Morb Mortal Wkly Rep. 2017 Jul 28;66(29):769-772. doi: 10.15585/mmwr.mm6629a1.
Research suggests that many disparities in overall health and well-being are rooted in early childhood (1,2). Stressors in early childhood can disrupt neurologic, metabolic, and immunologic systems, leading to poorer developmental outcomes (1). However, consistent, responsive caregiving relationships and supportive community and health care environments promote an optimal trajectory (3,4). The first 8 years of a child's life build a foundation for future health and life success (5-7). Thus, the cumulative and lifelong impact of early experiences, both positive and negative, on a child's development can be profound. Although the health, social service, and education systems that serve young children and their families and communities provide opportunities to support responsive relationships and environments, efforts by these systems are often fragmented because of restrictions that limit the age groups they can serve and types of services they can provide. Integrating relationship-based prevention and intervention services for children early in life, when the brain is developing most rapidly, can optimize developmental trajectories (4,7). By promoting collaboration and data-driven intervention activities, public health can play a critical role in both the identification of at-risk children and the integration of systems that can support healthy development. These efforts can address disparities by reducing barriers that might prevent children from reaching their full potential.
研究表明，整体健康和幸福方面的许多差异都源于幼儿期（1,2）。幼儿期的压力源会扰乱神经、代谢和免疫系统，导致发育结果更差（1）。然而，持续、有回应的照料关系以及支持性的社区和医疗环境能促进最佳发展轨迹（3,4）。孩子生命的头8年为未来的健康和人生成功奠定基础（5 - 7）。因此，早期经历，无论积极还是消极，对孩子发展的累积和终身影响可能是深远的。尽管为幼儿及其家庭和社区服务的健康、社会服务和教育系统提供了支持有回应关系和环境的机会，但由于限制其服务年龄组和可提供服务类型的规定，这些系统的努力往往分散。在大脑发育最迅速的生命早期，为儿童整合基于关系的预防和干预服务，可以优化发展轨迹（4,7）。通过促进合作和数据驱动的干预活动，公共卫生在识别高危儿童以及整合能够支持健康发展的系统方面都可以发挥关键作用。这些努力可以通过减少可能阻碍儿童充分发挥潜力的障碍来解决差异问题。
