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October 19, 2020

Equity Is the Foundation of Adolescent-Friendly Health Care

Author Affiliations
  • 1Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York
  • 2Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
  • 3Department of Pediatrics, Uniformed Services University, Bethesda, Maryland
  • 4The Wade Alliance, LLC
JAMA Pediatr. 2021;175(3):227-228. doi:10.1001/jamapediatrics.2020.3220

Two recent reports, The Promise of Adolescence: Realizing Opportunity for All Youth (Promise)1 and Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century (Promoting),2 from the National Academies of Sciences, Engineering, and Medicine (National Academies) conclude that adolescence is a developmental period full of opportunity for extraordinary learning and growth. The dramatic plasticity and malleability during this period prime adolescents to explore new environments, practice decision-making skills, and develop the healthy behaviors that are foundational for long-term well-being.

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    1 Comment for this article
    Children's Health Sadly Seems Considered In Terms of Societal Budget Dollars
    Frank Sterle |
    A 2007 study (its published report is titled The Science of Early Childhood Development), which was implemented to identify facets of child development science accepted broadly by the scientific community, forthrightly and accurately articulates the matter: “The future of any society depends on its ability to foster the health and well-being of the next generation. Stated simply, today’s children will become tomorrow’s citizens, workers, and parents. When we invest wisely in children and families, the next generation will pay that back through a lifetime of productivity and responsible citizenship. When we fail to provide children with what they need to build a strong foundation for healthy and productive lives, we put our future prosperity and security at risk … All aspects of adult human capital, from work force skills to cooperative and lawful behavior, build on capacities that are developed during childhood, beginning at birth … The basic principles of neuroscience and the process of human skill formation indicate that early intervention for the most vulnerable children will generate the greatest payback.”

    Although I appreciate the study’s initiative, it’s still for me a disappointing revelation as to our collective humanity when the report’s author feels compelled to repeatedly refer to living, breathing and often enough suffering human beings as a well-returning 'investment' and 'human capital' in an attempt to convince money-minded society that it’s indeed in our best fiscal interest to fund early-life programs that result in lowered incidence of unhealthy, dysfunctional child development.

    While some may justify it as a normal thus moral human evolutionary function, the general self-serving Only If It’s In My Own Back Yard mentality can debilitate social progress, even when it’s most needed; and it seems that distinct form of societal ‘penny wisdom but pound foolishness’ is a very unfortunate human characteristic that’s likely with us to stay.


    1. National Scientific Council on the Developing Child. "The science of early childhood development: Closing the gap between what we know and what we do." 2007