Public health for paediatricians: promoting good health for children in the early years

The foundations that are laid through pregnancy and the first years of life have a profound influence on health both through childhood and into adult life. Public health approaches—those that seek to promote good health and prevent ill health—which, for example, effectively support poverty reduction, immunisation, good nutrition, safe sleeping and nurturing parenting—have had a considerable impact on reducing poor health outcomes. They continue to be critical to tackling preventable ill health in children and reducing inequalities. Alongside their role in treating child ill health, paediatricians can play a key role in promoting primary prevention efforts, aimed at preventing ill health from occurring in the first place, and secondary prevention or early intervention, identifying issues early on and addressing them before they have had more lasting impact. Paediatricians’ role can be as powerful advocates across the public system arguing for policy change, as local professionals working hand-in-hand with a wide range of other early childhood professionals and as clinicians recognising where prevention, both primary and secondary, can enhance the health and well-being of their patients. The strength of association between early childhood experiences and later life outcomes is shown vividly by the large number of longitudinal cohort studies which follow children from birth throughout their lives. Across different countries, a deep and persistent link has been shown between early childhood adversity and poor outcomes in adulthood. Childhood poverty is associated with poor health in adulthood; poor health in childhood is associated with poorer health and worse socioeconomic outcomes in later life.1 2 For example, lower fetal growth and low birth weight have been shown to be associated with adult coronary health outcomes and a range of related risk factors.3 ,4 Higher levels of childhood obesity and rapid infant growth are associated with later life obesity.5 The Adverse Childhood …