Author Archives: Kristin Schubert

To Build a Culture of Health, There Is No Place Like Home

Aug 11, 2014, 3:36 PM, Posted by Kristin Schubert

Child First

A century ago, it was normal for a doctor to make a house call to tend to a patient in need. By the time I was a child growing up in New Jersey in the 1970s and 80s, the practice had become virtually obsolete.

The case for bringing health care back into the home is becoming more compelling every day. One place where we see the potential to make a big impact is with new parents and newborns.

Last month, JAMA Pediatrics published new research from on the effects of nurse-home visits on maternal and child health. The randomized, clinical trial followed a group of low-income, primarily African American mothers and children living in disadvantaged, urban neighborhoods of Memphis over a 19-year period. Specifically, they wanted to see whether home visits conducted by the Nurse-Family Partnership before and after a birth influenced whether the mothers and children died prematurely.

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Shielding Young Brains from the Effects of Toxic Stress

Nov 13, 2013, 3:45 PM, Posted by Kristin Schubert

Child First

Before the science on addiction was developed, we blamed smoking on bad choices. Once we understood how the brain worked, we were able to devise strategies to change behavior, and smoking plummeted. 

As David Bornstein points out in two outstanding recent New York Times columns, the science of toxic stress is setting the stage for another health revolution that is just as far-reaching. It is forcing us to rethink the way communities deliver services─health care, education, and more─to our most vulnerable.

Read the first column

Read the second column

Every day, there are young children who are abused. Who witness violence in their homes or neighborhoods. Who are malnourished. Or who have parents who struggle with drug or alcohol use. We now know that those adverse experiences change the way their young brains develop, and affect their mental and physical well-being later in life. These children are more likely to have heart disease, cancer, and hypertension as adults. They are more likely to use drugs, suffer from depression, and commit suicide. They are more likely to drop out of school, spend time in prison, and be homeless. 

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Ending a Childhood Disease

Jun 10, 2013, 10:48 AM, Posted by Anna Heling, Kristin Schubert

Poverty Epidemic Blog Graphic

We rarely think of poverty as a disease. It doesn’t trace back to a microbe, it doesn’t transmit through coughs or sneezes. But for children, the effects of poverty can have lifelong implications as devastating as many diseases.

As author Perri Klass, MD, noted recently in The New York Times, the stress and limitations that often accompany childhood poverty can influence children’s life trajectories, change their dispositions, blunt their brain development, and even alter their genes.

Today we’re in the midst of a poverty epidemic not seen since the Depression. We have more kids living in poverty now than we have had for generations. That’s scary, especially now that we know what poverty does to you neurologically, biologically, and socially. A child’s early development has huge implications on health for when that child is 20 years old, or even 30, 40, or 50 years old.

So what can we do about it? To start, we need to look holistically at who is around to support a child. Who is giving care to make sure a child can, as Klass puts it, “grow toward the light”? As a society, we need to ask how we can make sure families have the supports they need to give the best care to their child, even as they face the trials of poverty.

Support for lifting children and families out of poverty often gets wrapped up in asking who’s accountable for the situation, or the politics around a handout versus picking yourself up from your bootstraps. The conversation—and action—could get further if we set aside these polarizations and approached the problem, instead, as an early childhood disease. There’s a huge need for that conversation to happen. We all have a stake in this. It’s costly to pay for poor health outcomes that we know stem from trauma and adversity early in life. Whether you care from an economic perspective or you care from a moral one, recognizing poverty as a childhood disease is imperative to the future wellbeing and productivity of our society.

Early childhood is a primary focus of the 2013 Commission to Build a Healthier America, which meets June 19 in Washington, D.C. 

Learn more and register for the public meeting