By David Willis, MD, and Joe Waters, Co-Founder and CEO, Capita
How much of a difference can public policy make in improving Early Relational Health (ERH) and family health and well-being? We know that social, racial, and economic injustices and challenges are significant obstacles that can overload families and communities, and in turn, negatively affect parents, caregivers, young children, and their relational health.
Nurture Connection’s network brings together and elevates organizations and individuals working to promote ERH in their various fields. One of the network’s central strategies is focusing on how public policy can mitigate these barriers and create a more supportive ecosystem for parents. Capita, an independent, nonpartisan think tank that focuses on the problems and injustices that prevent societies from meeting the needs of young children and families, highlights the real impacts that policy can have on relational health.
Earlier this year, Joe Waters, co-founder and CEO of Capita, held an insightful conversation with Anu Partanen, author of 2016’s The Nordic Theory of Everything: In search of a Better Life, in Helsinki. Partanen, a journalist from Finland and a naturalized U.S. citizen, compares life in the United States with life in the Nordic region, focusing on four key relationships: parents and children, men and women, employees and employers, government and citizens. Her book articulates the family and community policies that define Finland and contrasts those with U.S. policies.
Partanen describes how after moving from Finland to the United States in 2008, she quickly went from a confident, successful professional to an anxious new parent worried about the basics of everyday life. Even in a two-income professional household in New York, Partanen felt that “it took immense energy to find the right child care, find the right school, find the right doctor, then figure out the right insurance plan and how you’re going to pay for everything.”
In contrast to the United States, Finland is a country that provides extensive social support for families and mitigates some of these social and financial challenges. We can see some evidence of how changes to public policy in the United States could support more families to experience ERH and healthy emotional connection.
Finland provides supports and services for families in three main areas: financial supports, which include a child benefit, housing allowance, and housing loans; child services, including healthcare, day care, preschool, public school, and free school meals; and 14 months of paid maternal and paternal leave. Paternal leave, which is less common in the United States, is used by more than 80 percent of Finnish fathers to take some amount of parental leave. Local governments are required to provide day care, and while day care is not always free, its costs are on a sliding scale and free for families with the lowest incomes, resulting in 70 percent of preschool children attending full-day day care and 98 percent of 6-year-olds attending public preschool.
When we look specifically at parental leave, research shows that longer paid parental leave, which provides more time and opportunity for parents and children to spend time together and develop strong, positive, and nurturing relationships, is associated with better mental health. For example, a review of 45 studies investigating parental leave in high-income countries shows that parental leave decreases depressive symptoms in postpartum mothers and results in decreased stress, reduced mental healthcare use, and lower rates of hospitalizations for mental disorders.
In addition, Finland’s policy promotes the importance of supporting opportunities for ERH for both parents; the 2022 Finland family leave reform was revised to distribute family leave time and childcare responsibilities more equally between parents.
At a high level, there are several compelling indicators that public policy improves a family’s quality of life and well-being. Finland ranks first on the Organization for Economic Co-operation and Development (OECD) “life satisfaction” survey: Finns rated their life satisfaction 7.9 out of 10, significantly higher than the world average of 6.7. Finland also has ranked first in the United Nation’s World Happiness Report for the past six years. (The United States ranks 15th.) Additionally, UNICEF ranks Finland fourth in child well-being, and 90 percent of children in Finland reported they were highly satisfied with life in 2009–10. Also interesting, the Finnish government disclosed that during the pandemic, a majority of Finnish families reported no disruption to their well-being as parents.
Partanen’s personal story in The Nordic Theory of Everything reflects this experience. While living in the United States, Partanen realized that returning to Finland and experiencing more support and economic security would lead to a less stressful family life where she could focus on her family’s happiness, connection, and joy.
The data from Finland and Partanen’s book indicate a powerful story for how public policy that supports parents, children, and families lays a foundation for well-being and happiness. One of Nurture Connection’s core strategies is focused on shifting U.S. policy to promote early relational health, including with existing programs and pending legislation in Congress. Leveraging current policy work in the United States, as well as innovations in countries like Finland, provides opportunities to redesign our health, economic, housing, social, and educational systems to advance equity and strengthen families and communities.
David Willis, MD, FAAP, is a senior fellow at the Center for the Study of Social Policy and founder of Nurture Connection. He was the executive director of the Perigee Fund, promoting Early Relational Health, and prior to that, Dr. Willis served as director of the Division of Home Visiting and Early Childhood Services at the U.S. Health Resources & Services Administration (HRSA) Maternal and Child Health Bureau.
Joe Waters is the co-founder and CEO of Capita, an independent, nonpartisan think tank with a global focus. Since starting Capita in 2018, Waters has developed forward-leaning initiatives exploring how the great cultural, planetary, and social transformations of our day affect our youngest children (0–8 years old) and our communities.