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Surviving or Thriving: Health Equity for Children and Families

This November, Genesis Health Consulting is focusing on health equity. What it is. Why it matters. And what we can do to improve it. We chose this topic because it is a critical issue facing American children today that ultimately impacts all of us. Disparities in the health and well-being of children are growing, fed by the unchecked inequities in social and environmental determinants of health. The experience of poverty, racism, violence, environmental toxins, isolation, and transience shape the childhood of millions of American children and are often co-associated. Where one exists, it is likely that others will follow. In the absence of deliberate intervention, these experiences are cyclical and self-sustaining. And they have a devastating effect on our children.

The America a child is born into can be vastly different depending on that child’s race, financial resources, social support and home environment. In one America, the concerns of parents and community leaders focus on terms of survival: living to a first birthday, avoiding lead poisoning, drinking clean water, accessing basic health care, managing hunger, securing housing, and the like. In another America, these basic survival needs are assumed, and parents and leaders instead focus their attention on matters of thriving: evaluating quality of schools, providing enriching experiences for their children, encouraging healthy food habits and exercise.

These disparities between the societal factors that affect childhood have a direct, measurable and generational impact on health. If all children were born and raised with the same resources as the second America, researchers estimate that the prevalence of poor health outcomes for children (e.g., low birth weight, intellectual disabilities, psychological problems, abuse) would fall by 60 to 70 percent. Inequities have a particularly devastating effect on children when experienced during pregnancy and in the first few years of life. A child’s quickly developing brain and body are critically vulnerable to these stressors, exposure to which can permanently affect health, quality of life and expected life span.

These differences in lived experience are shaped significantly – sometimes invisibly – by the decisions we make about how our society functions. Some aspects of our society are almost universal, but many more are multidimensional, intensely local and interpersonal. For example, the overwhelming majority of children in America ages five through eighteen attend school. The quality of the instruction and resources at that school, the safety of the neighborhood in which it is located, the expectations and assumptions that guide policies and interactions, however, may be vastly different between two schools, even one mile apart. The implications of these differences, in this one dimension, for one child can have profound consequences. When calculated for millions of children across generations, it is easy to understand the urgency for change.

The remarkable thing about it is: change is not only possible, it is within our control. Achieving greater health equity starts with public policies that articulate a basic standard for childhood in America. When that standard is not, or cannot be met, public policy explains how we will close the gap. Health care providers and child health advocates are critical leaders of this effort. As we have discussed in previous posts, children need our help when it comes to ensuring policies consider potential impact on kids. And, when we invest in children’s health, the whole nation benefits – economically, physically, and culturally. Unsure where to start? Consider these existing programs and policies that improve health equity for our children:

In future posts, we’ll discuss in more detail just how matters of health equity show up in our society, why it should matter to our medical leaders, and how to measure progress along the way. We’ll also highlight some of the great work and discussions occurring at American Public Health Association’s annual conference November 10th-14th, which will focus on how to improve health equity in our communities.

In the meantime, we want to hear from you. What are the most successful strategies being used in your community to improve health equity? Tell us at @GHC_Ideas on Twitter, or email us at


Genesis Health Consulting has significant experience designing strategies, programs and policies that address the root causes of health inequity for children and families. Learn more about how Genesis can help your organization advance its work to achieve a more equitable world for kids by emailing us at

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