Early childhood health promotion and its life course health consequences

To explore whether health promotion efforts targeted at preschool-age children can improve health across the life span and improve future economic returns to society.

We selected 4 health topics to review-tobacco exposure, unintentional injury, obesity, and mental health-because they are clinically and epidemiologically significant, and represent the complex nature of health problems in this early period of life. The peer-reviewed literature was searched to assess the level of evidence for short- and long-term health impacts of health promotion and disease prevention interventions for children from before birth to age 5. This review sought to document the monetary burden of poor child health, the cost implications of preventing and treating child health problems, and the net benefit of the interventions.

The evidence is compelling that these 4 topics-tobacco exposure, unintentional injury, obesity, and mental health-constitute a significant burden on the health of children and are the early antecedents of significant health problems across the life span. The evidence for the cost consequences of these problems is strong, although more uneven than the epidemiological data. The available evidence for the effectiveness of interventions in this age group was strongest in the case of preventing tobacco exposure and injuries, was limited to smaller-scale clinical interventions in the case of mental health, and was least available for efforts to prevent obesity among preschoolers.

Currently available research justifies the implementation of health interventions in the prenatal to preschool period-especially to reduce tobacco exposure and prevent injuries. There is an urgent need for carefully targeted, rigorous research to examine the longitudinal causal relationships and provide stronger economic data to help policy makers make the case that the entire society will benefit from wise investment in improving the health of preschool-age children and their families.