Putting the Needs of the Next Generation Front and Center

By David Willis 

The best metric for a society’s future, writes New York Times columnist Nicholas Kristof, is how well it nurtures its next generation. We couldn’t agree more. Kristof raises valid and urgent concerns for the plight of this country’s youth in his February 7 opinion piece, “We Americans Neglect Our Children.” He maintains that in this election year, the well-being of children should be front and center at the local, state, and national levels. Further, he argues that it’s vital that a pro-child/pro-family agenda be part of every politician’s platform and that voters should quiz candidates on their policy recommendations to address the well-being of the nation’s children and families, particularly those disproportionately affected by systemic inequities. 

What exactly does a pro-child/pro-family agenda look like?  

Kristof outlines a few suggestions, including an early child care program and improvements in childhood education. Such a plan, though, needs to go further to ensure that children in the United States blossom. 

A crucial component to any pro-child/pro-family agenda missing from Kristof’s list: a child, family, and community health program that promotes Early Relational Health.

Fostering an environment that supports Early Relational Health (ERH) — defined by strong, positive, and nurturing emotional connections between caregivers and children — is essential for the next generation of flourishing children, healthy families, and thriving communities. The building blocks for ERH include the responsive, protective, supportive, and nurturing early interactions with parents and caregivers that help children feel safe, connected, confident, and competent. 

Here at the Nurture Connection national network we champion Early Relational Health across all communities and early childhood systems. Our network seeks to mitigate the many ways in which inequities — perpetuated by discrimination, racism, and poverty — have harmed families and disrupted their ability to thrive. Our mission is made possible by the collaboration of healthcare providers, community leaders, policy advocates, and parents and caregivers from all walks of life. We honor “family wisdom” shaped by lived experiences, cultural identities, and generations of tradition.

ERH is an emerging and rapidly expanding framework that recognizes the components central to building the health, educational capacities, and social well-being of the next generation. Children face so much uncertainty today; it’s essential to establish positive early relationships to ensure a bright future for all our children.

We come to this perspective boldly: A growing body of research makes clear that the early years have a profound impact on lifelong health and well-being.

Nurture Connection amplifies organizations and champions, including parent leaders in the Family Network Collaborative, who are supporting parents across the United States as they work with providers to feel confident in their parenting role and form strong, resilient attachments with their children. Our partners in this work are responsive to parent expertise, knowledgeable about child development, and eager for every parent to succeed in their own family goals.

This approach, backed by science, intuition, parent and community expertise, and lived experience, drives the group’s goal to make sure every family — regardless of where they live or their race, ethnicity, economic circumstances, or education — can provide stable and nurturing relationships, which are the foundation of every child’s healthy development.

What does Early Relational Health even mean? 

At its core, Early Relational Health is a simple yet profound concept. It refers to the everyday interactions and daily rituals of caregiving between parents and caregivers with infants, toddlers, and young children. The power of this work lies in simple, everyday interactions and those daily rituals of caregiving. ERH includes holding, feeding, diapering, singing, reading, playing, and just “hang-around time” with an infant or a young child. Positive relational experiences for children, studies show, promote physical, emotional, and cognitive development; avoid future health and behavioral concerns; and buffer the harmful effects of childhood adversity and trauma. 

It’s not just the young ones who benefit. Early Relational Health has ripple effects simultaneously to parents and caregivers. These intimate interactions enrich parent-infant bonding; decrease parental anxiety and depression; improve stress resilience; bolster physical health; and enhance neurological and other markers of well-being.

Cumulative findings from research in the fields of infant and early childhood mental health, child development, social-emotional development, neurobiology, and physiology confirm what many practitioners and parents have long understood — the capacity for and impact of early relationships are reciprocal, according to Early Relational Health: A Review of Research, Principles, and Perspectives, a September 2023 report authored by Harvard early childhood researchers Junlei Li and Thelma Ramirez.

So to strengthen relational health, supports and resources must be in place for both caregivers and children.

The United States urgently needs to weave together early childhood systems to improve early relational experiences for children, early relational and material supports for families, and early relational ecosystems in communities. This is especially true, as Li and Ramirez note, in communities plagued by historical legacies and present conditions of inequity. The resources available to support positive childhood experiences are key for physical, behavioral, and mental health; connection; resilience; and well-being.

In order to do this work at the practice, program, and policy levels, it’s crucial that the guiding principles around ERH are well understood, respected, upheld, and supported. These include embedding equity; trusting parents; focusing on simple, everyday interactions; appreciating that it takes a village to raise a child; meeting families where they are; and building parallel relationships.

In the years of life when the foundation for lifelong health and learning are being established, positive early relationships really matter. Any pro-child policy platform ignores that at the next generation’s — and the nation’s — peril. Early Relational Health should be at the forefront of all conversations and efforts around a truly pro-child agenda.

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, 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.