When we asked Americans which five-year-old child is more likely to be successful—one with access to a good education but no healthcare or one who had access to a great doctor but poor schools—people overwhelming choose education by a margin of 4 to 1.
On face value this makes sense. We know more successful people who are educated, but unhealthy, and fewer who are uneducated but healthy.
Dig a little deeper though and you quickly realize how interwoven these two aspects of our development are. Better health makes learning easier.
Consider the following:
If a child is sick with untreated asthma, he or she will miss school and opportunities to learn.
If a child is exposed to early trauma in the home, for example, if she knows someone who was shot on her block, she will have more difficulty focusing in school.
If a child’s early diet includes more salty and fatty foods, he is likely to not only gain weight as a child, but also continue unhealthy weight gain as an adult.
If a baby is breastfed for at least the first six months of life, the child is likely to see gains in IQ of up to 10 points.
Better health provides a stronger foundation on which to build an education. It shouldn’t come down to forcing parents, a community or society to have to choose between health and education—especially for our children. Yet we make these choices every day. In terms of where we place our resources, time and energy.
We can overcome everything. So the American story goes. As a result, we fail to give much credit to things we’re told will impact us down the road. If the impact isn’t proximal, the belief is that we’ll have time at some point to work around any issue that may have been caused by our early years.
So it is with what happens within the first thousand days of a child's life. Science shows us that this period of time is an absolutely critical juncture in a person's development. From the moment a baby is conceived through its first two years of life, its brain and body is literally being built from scratch. The foundations for health and education are being laid down through the nutrition and care the child receives in this window. What mom eats while she's pregnant, how long and how often she is able to breastfeed, whether she will patiently allow her children to adjust to foods that take getting used to (think peas) or whether it will be dismissed by the adage, "Well, my baby just doesn’t like peas." These are all critical decisions that gain too little attention because frankly, we don’t really believe they are all that important. Nice to have's versus have to have's. In fact, moms get this sense too. In research we conducted for the organization 1,000 Days that focuses on this issue, almost three out of four moms said they don’t feel as if people appreciate how important the bond between a mother and her baby is when it comes to nutrition.
We can all point to great thinkers and doers who weren’t breastfed, or whose moms didn’t eat well or couldn’t serve fresh fruits and vegetables as often as they’d recommended. We see them as exceptions that disprove the rule. Instead of understanding the definition of exceptions.
When it comes to our health, taking personal responsibility is key. We all could do a better job of eating the right things, being more physically active, and just taking better care of ourselves. But being healthy doesn’t happen in a vacuum. All around us there are people, places and rules that either make it easier or harder to get and stay healthy. How these things connect and interact is called a system.
We’ve all heard the adage, "If you give a man a fish, he will eat today. But if you teach him how to fish, he can feed himself forever." Sounds nice, right? Unfortunately, it’s not quite that easy. Where does the man fish? Who else is allowed to fish there? How many fish should one person be allowed to catch? Are the fish safe to eat? Who oversees all of this to make sure that everyone who is "taught to fish" has a fair shot at catching good healthy fish to feed himself and his family?
Again, all of the people, places and rules in this process and how they interact form a system.
Some systems work really, really well. Think the Apple Genius Bar. And with others, there is room for improvement. Think the Veterans Affairs administration. At its best, a good system works to make sure that good things are flowing freely and fairly to the greatest benefit of those involved. At its worst, a bad system consists of misguided rules, inaccessible places and people who, for one reason or another, block change that could. While often hard to define, we seem to know a good system when we see one and, similarly, recognize when one needs to be changed.
Some systems are personal and limited, like the systems we create for ourselves to pick up and drop off our children to various activities. Other systems are impersonal and massive. In fact, they are usually comprised of so many people, places, and rules it is almost impossible to understand how exactly they work. Our health care system is a good example of the latter.
How do we think our systems for helping people make progress actually work?