Diana Fishbein, PhD

Scholar Project 

Similar to the roll-out of the “Decade of the Brain” (1990-1999), this four-pronged Nova Scholar project involves:

1. An approach to the incoming administration to officially proclaim the next ten years to be the “Decade of the Child”;
2. With the National Institutes of Health (NIH), prioritization of a corresponding program of research;
3. Support from congressional appropriations; and
4. Propulsion by public opinion in response to a public education campaign.

By marshalling support from the administration, congress, and the public, this project is intended to signal a shift toward a much-needed national strategy that prioritizes the health and well-being of our children, founded on an accumulation of evidence, knowledge, and best practices generated largely by NIH. We are working collectively at all levels to create the political and public will to elevate whole child health and wellbeing in our discourse, practices, systems, and policies. 

The NIH funds a wide range of health issues, with investments in biomedical research across nearly all the 27 institutes. Although called the National Institutes of Health, the focus has predominantly been on disease—its causes, manifestations, and treatments. What is less prominent in its research agenda is a specialized focus on conditions that impact children and youth, and even less so on the holistic nature of health issues and well-being; an explicit statement to this effect is in the strategic plans of only a handful of institutes despite the critical role of early experience for the prevention and treatment of every health condition. Moreover, health promotion and the prevention of problems have not yet been the primary emphasis.

A substantial body of knowledge has been accumulated regarding the detrimental effects of adverse social conditions (e.g., poverty, trauma, maltreatment, racism, community violence) on brain and body development in infants, children, adolescents, and young adults that increase risk for mental and behavioral health problems and their cascading impacts on chronic disease. Hundreds of randomized controlled trials showing the benefits of family, school, and community environments, interventions, and public policies on whole child health and well-being suggest prevailing risk conditions are amenable to intentional change and that malleable developmental processes can be improved with greater investments in whole child health promotion and the well-being of all children. The population-level benefits to be derived from a large-scale initiative that builds on these recent advances can be achieved by furthering whole child research, clinical application, prevention practices, and public health policies.

To exert a meaningful impact on the conditions that holistically influence child health and well-being, investments are needed in the development, evaluation, implementation, and scaling of evidence-based interventions and public health policies. Objectives of NIH research that this project advocates for includes determination of:

• The impacts on these outcomes when services are appropriately delivered, adapted and scaled;
• Whether population level disparities are narrowed; and
• The extent to which child health and wellbeing measurably improve.

It is imperative that this line of research experimentally evaluates policy strategies for altering the root causes—the adverse social determinants of health and well-being—including poverty, discrimination, and opportunity inequality. Results of this research will provide a blueprint for development of a comprehensive national plan that supports children’s needs through legislation, agency level practices, and proximal environmental change (e.g., households, schools, clinics, communities). For children to flourish, key principles and elements identified in research to be essential to their health and well-being need to be in place, regardless of the setting.