When mothers arrive at Ruth Slocum’s parenting classes, she encourages them to sit on the floor and play with their babies as they talk about first foods or coping with sleep deprivation. She and her co-instructor offer bubbles to blow, and they snap pictures that the women can later turn into scrapbooks with materials they provide. During mothers-only sessions, the women talk about how to recognize and respond to a baby’s cues and how to manage “big feelings” of their own. Slocum’s immediate goal is to help them build a strong attachment with their child. But there’s another, longer-term idea at work here: Research suggests that forging these bonds will ultimately prevent problems for these children that may seem a long, long way off, deep in their adulthood, problems like heart disease, stroke and depression.
Slocum’s parenting class on the Tulsa campus of Oklahoma State University isn’t meant just to help mothers weather the first uncertain weeks with a baby. It could be considered a novel form of inoculation.Medical professionals can vaccinate children against pathogens like polio or pertussis, but they have few tools to prevent the chronic illnesses that wreak havoc with so many adult lives and that cost the health care system so much to treat. What would it look like if we could somehow protect small children against those illnesses the way we vaccinate for tetanus or chicken pox? It might look something like the Legacy for Children parenting class Slocum teaches.
Public health experts know that much of what makes adults unhealthy has roots in childhood, in the adversities that children experience as they are growing up — the absence of a parent, unstable housing, or a family member’s problems with drugs or alcohol can show up later as diabetes, drug and alcohol use, obesity, cancer and anxiety. The connection between childhood and later health cuts across society: While low-income children like the ones Slocum works with may on balance experience higher levels of adversity, few people are born into families or circumstances without the kinds of challenges that can have long-lasting effects on their health.
A growing body of research has looked at people who face adversities in childhood yet somehow grow up without serious problems or illnesses. A number of factors seem to help those children thrive, but some researchers say one factor stands out as the best possible protection against poor health: the presence of a consistent, caring relationship early in life.
Of course, a loving relationship can’t be prescribed in a doctor’s office, but experts say there are proven means of making those connections more likely to develop in families and across a community. And if, as a society, we really want to promote better health and uproot the causes of social ills like addiction and chronic illnesses like diabetes, the research suggests we must go back—way back, to the very start of the lives we want to improve.
A baby’s connection with its mother is “the architecture for all future relationships, including self-esteem and one’s own relationship to oneself,” said Slocum, mental health manager for the Tulsa Children’s Project. “It’s big.”
SCIENTISTS ARE STILL figuring out exactly how early childhood stress influences health years later, but the evidence suggests that even the tiniest bodies—especially the tiniest bodies, it turns out—internalize stress, causing debilitating effects on organ and tissue function.
“The only thing that we know that mitigates those physiological effects on the physical body is maternal warmth,” said Jennifer Hays-Grudo, director of the Center for Integrative Research on Childhood Adversity at Oklahoma State University.
Researchers suspect that childhood stress essentially embeds in immune cells, prompting long-lasting changes to how genes are expressed and causing the body to go into a chronic inflammatory state. That is exacerbated by behavioral and hormonal effects that make it harder for people to regulate their emotions, increasing the likelihood that, as adults, they’ll find themselves in stressful situations and engaging in unhealthy behaviors. And we’re not just talking about social problems, we’re talking about diseases adults get decades later.
In fact, people who are exposed to adverse experiences in childhood—things like physical, emotional or sexual abuse, problem drinking, food insecurity, divorce or mental illness within the household—are far more likely to have serious health problems later in life, at a certain level doubling their risk of cancer, heart disease and stroke, quadrupling rates of depression, and increasing their likelihood of attempting suicide 12-fold.
The correlation between these events and health problems later in life is so direct that researchers now count them, using a scoring questionnaire. Life expectancy for people who report six or more adverse childhood experiences, often shortened to ACEs, is estimated to be as much as 20 years shorter than for people who report none. Notably, while a lot of public health rightly focuses on racial and ethnic disparities, the study that first established a dosing relationship between ACEs and health—the more bad experiences you have in childhood, the worse off you are later in life—was based on a study of more than 9,500 people who were mostly white and largely college-educated. No one is born immune to these problems.
But there are mitigating factors. A 2011 study found that among adults who grew up in poverty, those who experienced high levels of maternal warmth as children had lower systemic inflammation and reduced immune -ell response to challenges. They suggested that having that kind of relationship may actually biologically protect people from health consequences, including depression, later in life.
That’s some of the research that’s motivating the Legacy program and others like it. Programs that provide structured social support for parents and increase positive parent-child interactions could significantly improve the long-term health of participants, particularly for children living in poverty, according to an article published last year by researchers at the Centers for Disease Control and Prevention, Hays-Grudo, and others at Oklahoma State University. One key to such programs, the authors write, is that they…