Community & Environment-Children

Why does this matter?

Adverse childhood experiences (ACEs) are stressful or traumatic events that may have a lasting impact on children’s health and well-being. Early experiences have a broad and profound impact on an individual’s development and subsequent emotional, cognitive, social and biological functioning. 

The relationship between ACEs and health behaviors and outcomes in adulthood was first described in a 1998 study, which found a higher number of adverse childhood exposures was associated with a higher number of risk factors for leading causes of death in adults. A recent study found that having four or more ACEs (compared with none) is associated with a number of adverse health outcomes including:

• Drug abuse and interpersonal and self-directed violence (very strong associations).
• Sexual risk taking behaviors, poor mental health and alcohol abuse (strong associations).
• Smoking, heavy alcohol use, poor self-rated health, cancer, heart disease and respiratory disease (moderate associations).
• Physical inactivity, overweight or obesity and diabetes (weak or modest associations). 

There are also socioeconomic challenges, associated with ACEs including not graduating from high school, being unemployed and lacking health insurance. These negative experiences place a great economic burden on families, communities and the society, costing an estimated $748 billion in North America.

Why does this matter?

The health of individuals and communities is closely tied to the built environment. Neighborhood amenities such as recreational facilities, libraries, playgrounds and sidewalks offer individuals opportunities to socialize, play, exercise and enjoy the neighborhood in which they live. There is some evidence to support these forms of community engagement contributing to physical health, mental health and human development. For example, people who live in communities close to parks or beaches, have a beautiful neighborhood or have a safe neighborhood, on average, spend more time walking outside. The evidence indicates that improving multiple aspects of neighborhood roads and walkways for pedestrians and cyclists, and installing play equipment in parks may increase physical activity levels in adults and children.

Why does this matter?

The home environment has long-term effects on early childhood development and is an essential factor in adolescent growth as youth prepare to leave home and enter young adulthood. While there are many factors that go into creating an environment that can foster development, these are often things that can be controlled by parents and influenced by society. Helping parents understand the importance of creating a protective home environment can improve the health and economic future of their children.

Protective family routines and habits is a summary measure that describes family environmental elements that promote optimal health in children and includes the following age-specific criteria:

• All children 0-17 experience no household tobacco smoke exposure, share family meals on four or more days per week, and watch television or spend time on computers less than 2 hours per day
• Children 0-5 are read to everyday and were breastfed ever
• Children 6-17 do all required homework and have parents participate in their events or activities

Each factor has a different and important impact on a child’s continued physical and personal growth and is not highly dependent upon household income or other resources.

Environmental tobacco smoke exposure on children’s health has been widely documented and acknowledged adverse effects. Secondhand smoke exposure is linked to increased incidence of:

• Respiratory illness
• Asthma that is likely to continue into adulthood
• Ear infections in young children
• Sudden Infant Death Syndrome (SIDS)
• Behavioral problems
• Neurocognitive deficits
• Metabolic syndrome in adolescents
• Adolescent’s likelihood of taking up smoking themselves

Shared family meals are important in helping young children establish regular eating habits, and serve as a foundation for both the physical and psychosocial health of adolescents with influences that persist into young adulthood.

Child and adolescent participation in family meals are associated with:

• Lower risk of:
  • Skipping breakfast
  • Developing disordered eating behaviors
  • Using tobacco, alcohol or marijuana
  • Having a low grade point average
  • Experiencing depression, suicidal ideation or suicide attempts
• Higher likelihood of:
  • Eating more fruits, vegetables, fiber, protein, grains and calcium-rich foods
  • Being in a healthy weight range
  • Having positive psychosocial outcomes even after controlling for demographic variables and family connectedness

Time spent watching television or using computers influences both the physical and psychosocial health of children and adolescents with effects extending well into adulthood.

Watching more than two hours of television per day affects children and adolescents by:

• Negatively impacting early language and cognitive development
• Increasing sedentary behavior which is associated with increased risk of obesity
• Increasing exposure to food advertisements — which is associated with heightened alertness to food-related cues and increased amount of food intake
• Increasing the likelihood of:
  • Engaging in aggressive and violent behaviors
  • Earlier initiation of sexual activity among teens
  • Poor self-esteem and body image issues especially among young women

Reading aloud to young children is important for early cognitive development including:

• Language function
• Early reading habits followed by increased interest in reading
• Positive social interaction followed by improved parent-child interaction

Breastfeeding provides both nutrition and protection against viruses and bacteria. Breastfeeding has a range of benefits including:

• Decreasing the risk of:
  • Infant mortality
  • Sudden Infant Death Syndrome
  • Childhood obesity, asthma, type 1 and type 2 diabetes and childhood leukemia
  • Chronic disease in adolescence and adulthood
• Improving physical and emotional development
• Improving maternal health

Completing homework is key to a child’s education. Strategies for ensuring homework completion generally fall into two categories, 1) self-monitoring by the child and 2) parental monitoring. Both strategies for homework completion may yield benefits including:

• Significant positive impacts on a child’s educational success and behavior, relative to having no strategy to ensure homework completion
• Higher likelihood of greater educational attainment which in turn is associated with better economic and physical health into adulthood

Parent participation in their children's events or activities benefit children and the programs they participate in. These opportunities allow parents to better understand their child’s development and interests and help promote healthy growth by:

• Reducing risky behaviors (e.g. violent or sexual behavior; tobacco, drug or alcohol use)
• Building stronger parent-child relationships
• Improving academic performance

Why does this matter?

Supportive neighborhoods are ones in which the residents feel as though they can trust their neighbors, that everyone is watching out for the neighborhood kids and that should something happen there will be an adult nearby that will help. The concept of supportive neighborhoods, also referred to as neighborhood cohesion and social capital, describe communities that work together to create safe and orderly environments. Positive relationships and social connectedness within neighborhoods are important for both social development and physical health of children and teens. Among women the stress of living in an unsupportive neighborhood is associated with poor self-reported health. 

Living in a neighborhood that is not supportive can have a variety of effects on health. In children it is associated with obesity, developmental, and behavioral issues. Children living in such neighborhoods are also chronically exposed to stress, which has long term consequences including increased risk of developing disorders such as alcoholism, substance use disorders, anxiety, depression, and even heart disease. How and why neighborhood support is linked to children’s health is an area of ongoing research and is complicated by mothers of children with poor health moving to more supportive neighborhoods.