GOAL 5: HEALTHY HUMAN DEVELOPMENT IN RHODE ISLAND COMMUNITIES: IMPROVING FAMILY AND COMMUNITY HEALTH OPPORTUNITIES

Medicine and Health Rhode Island, Sep 2004 by Hollinshead, William H

HEALTH'S Strategic Goal 5 is to "...implement...a plan for healthy human development-connecting physical, educational, cultural, emotional, social, and economic environments to health outcomes by 2006". This goal was adopted because health leaders recognized that the trajectory of optimal human development, from infancy to old age, is the best measure of, and a powerful force for, public health. Healthy human development depends on healthy people, in a healthy community - not just protected from toxins, violence, disease, and hunger, but promoting life, liberty, safety, and mutual support.

Health promotion is a powerful investment in human development, knowing that critical opportunities at each life stage can be lost:

* A toddler's development can be slowed by birth injuries, lead poisoning, or a lack of interactive stimuli-the result will be diminished chances in the next steps of school and life, and therefore a much greater likelihood of failure, illness, and fewer years of productive life. Research shows that educated parents, prenatal care, breastfeeding, and good preschool experiences are protective.

* A teen's development can be arrested by depression, pregnancy, drugs, incarceration, or by an absence of options for hope and success. As a result s/he misses a critical stage of expanding choices, challenges, and productivity - with much higher risks of unemployment, disabilities, and dependency in later years. A responsive school, adult mentors, physical activity/sports, and good job options are protective.

* An adult's development can be derailed by alcohol abuse, domestic violence, or unsupported responsibility for an aging frail parent. The result can be a lost career, disrupted family, or homelessness - all factors that may bring poor health for the adult, and for others dependent on her or him. A culture of faith, a strong family, and supportive neighborhood services prevent these outcomes.

* A senior's developmental trajectory can turn down abruptly from vigorous autonomy to dependency with a fall, loss of a driver's license, or toxic prescription drug interactions. Then withdrawal, irrational demands, and a nursing home become much likelier. Safe housing with caring neighbors and extended family, good transportation, and meaningful ongoing senior roles are protective.

In short, developmental risks at every life stage can diminish lifelong health dramatically. There are also protective developmental supports at each stage, which can balance risks and promote a healthier developmental trajectory.1 Public health strategies should reduce serious risks and strengthen supports for optimal human development, for the sake of individuals' health, and for safe and healthy communities.

Issues of human development are actually woven into many of Rhode Island's larger goals and challenges. 41% of RI infants are born with significant developmental risks that may threaten their long-term health and success. 19% of RI teens do not achieve a high school diplomawhich lowers their contributions to society, and shortens their healthy life span.

In partnership with RI Kids Count and a coalition of public and private leaders, we have launched Successful Start, a fivoto-eight year initiative to address the developmental needs of all Rhode Island's preschool children, with particular attention to the needs and opportunities for socio-emotional health, for early care and education, for medical homes, for parent education and family support. To address the second great developmental acceleration of adolescence, we have engaged with many others in a youth development initiative that prepares adults and schools to assure teens the services and mentors that will protect them into their young adult years.

Goal 5 is itself a Department commitment to a developmental approach to public health, in which the environmental, care quality, behavioral and other threats to healthy development across the lifespan will be documented and addressed in a more integrated way. For example, our broad approach to epidemic obesity involves breastfeeding and exercise for children, and later support of healthy workplaces for adults, community wellness campaigns, and healthy food.

At the state policy level, demographics, public interest, and budget pressures all direct us to find comprehensive community approaches to help the elderly stay out of nursing homes and other institutional care. In many ways, an integrated strategy to meet elders' developmental needs in their homes, in healthy neighborhoods, and in responsive primary care settings, will give them the choices, autonomy and health they deserve, and should also give society savings to fund the other needs of coming decades.

The three objectives for Goal 5 are:

1. to refine the concept ["framework"] of a public health agenda for healthy human development, and

2. to study the physical, educational, cultural, emotional, social and economic environments of Rhode Island for major opportunities to assure healthy development, and