The National Academies of Sciences, Engineering, and Medicine (NASEM) recently published the consensus study report Early Relational Health: Building Foundations for Child, Family, and Community Well-Being. This is an exciting moment for our field — it’s an acknowledgment of the hard work that’s been done to date, and also a stake in the ground for what we hope is an accelerated and more universal shift from “transactional” healthcare to relational healthcare, supporting more families and communities to flourish and thrive. Further, the report includes the first-ever published recognition that Early Relational Health (ERH) is comprised of a multitude of constructs, such as safe attachments, emotional availability, and family resilience and connection. This recognition is a direct appeal for more cross-sector collaboration and research to understand how these constructs individually and synergistically map onto life-course outcomes.
In addition, NASEM’s landmark recognition of ERH is a clear validation of — and a major boost to — the work so many are leading in early childhood ecosystems across communities, including members of the Nurture Connection’s National ERH Network. The work of centering Early Relational Health in systems, communities, and families is reshaping the health and well-being of children across the country.
The report, which emphasizes asset-based approaches and family and community leadership, signifies NASEM’s growing recognition of the importance of community knowledge in addition to science. “National Academies studies have been moving toward having more youth and family voices at the table,” says Natacha Blain, JD, PhD, Director of the National Academies’ Social and Economic Systems and Board on Children, Youth and Families (BCYF). “People with lived experience bring insights that deepen and enrich the science. Incorporating a broad range of perspectives helps ensure that our consensus reflects the full breadth of experiences and realities.”
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This is an exciting moment for our field — it’s an acknowledgment of the hard work that’s been done to date, and also a stake in the ground for what we hope is an accelerated and more universal shift from “transactional” healthcare to relational healthcare. |
Report Highlights
The ERH consensus study report supports the NASEM Board on Children, Youth, and Families’ continuing work to advance the health, learning, development, resilience, and well-being of all children, youth, and families. NASEM serves as an independent, objective advisor to the nation to bring the latest scientific evidence to bear to inform policy and practice.
Importantly, the ERH report highlights cross-sector collaboration and connects expertise from multiple disciplines, including child development, pediatrics, infant/early childhood mental health, child and family policy, trauma-informed care, developmental neuroscience, family psychology and therapy, parenting, and cross-cultural studies.
The report focuses on:
- Key findings and influences on Early Relational Health that can be used to inform policy and program interventions
- Asset-based approaches and five key principles to embed ERH in early childhood programs, initiatives, and health systems
- Opportunities for policies, investments, and workforce supports to advance ERH
- Future directions for research
Dani Dumitriu, MD, PhD, an associate professor of pediatrics (in psychiatry) at Columbia University Center for Early Relational Health, Nurture Connect Steering Committee member, and one of the report committee participants and authors, emphasizes that “among many important concepts, the report establishes a strong stance that relationships aren’t just a ‘nice-to-have’ — they’re a biological need.”
Dr. Dumitriu also notes that the report highlights the concept of a sensitive early-life period for developing relational capacity in the 0–3 years, and provides an overview of research needed in order to promote long-term child and family physical and socioemotional outcomes.
Report committee participant and author Barbara Rogoff, PhD, UCSC Foundation Distinguished Professor of Psychology at the University of California at Santa Cruz, comments that for her, “it was striking how much the available research assumes that relations with babies and young children are dyadic, although in many cultural communities, babies’ and young children’s relations often or usually include more than two people at a time.” In addition, she feels that the most interesting thing she learned while working on the report was that although committee members agreed that interpersonal synchrony is a key aspect of Early Relational Health, there is surprisingly little research on it.
As report committee member and parent partnership expert Charlyn Harper Browne, PhD also shared, one valuable component of the report is clarifying how early relational health (ERH) differs from related experiences: “ERH is a universal biological and psychological need but can be understood and manifested in culturally-specific, family-specific, and behavior-specific ways.” She noted that “ERH emphasizes factors which impact child health and well-being, and must be considered to extend beyond reciprocal dyadic relationships to include community, economic, policy, and ideological factors.”
A Call to Action
David Willis, MD, FAAP, Nurture Connection’s founder and director and a professor of pediatrics at Georgetown University, is an author of the report and chair of the NASEM Committee on the Early Relational Health Determinants of Future Health and Well-Being. He invites everyone in the Nurture Connection community to reflect on how the report’s strategies can impact their work.
“With the new National Academies report and the AAP’s earlier statement about relational health, we’re seeing an exciting paradigm shift in health systems, public policy, and community services,” says Dr. Willis. “There’s a recognition of the importance of partnering with families and communities to reimagine child and community services — with ERH at the core.”
Because it synthesizes the most advanced thinking in the field, the report can be a powerful tool and road map to build confidence in ERH science and help move policy change forward. The report also establishes a shared way of talking about ERH and sets the stage for future innovation.
As the report authors emphasized: “Ensuring ERH for every child demands an expansion from focusing on preventing harm to investing in strengthening relationships and the contexts within which children and families thrive. It demands a reorientation from assessing a wide array of risks toward recognizing, uplifting, and supporting the strengths of families and communities … every system and sector has a responsibility to invest in its promotion. This collective commitment will require system-level change, targeted investment, mindset shifts, and new ways of measuring and supporting human flourishing.”
For more information read the full ERH report and report highlights, and watch NASEM’s report release webinar.