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Refocus Lisa F. Berkman Harvard School of Public Health To characterize the morning’s presentations, Dr. Berkman pointed out some of the things they shared, such as strong science. “A decade ago, we would have said that [ours] is a weaker science, with hints at important things but not really reporting very conclusive findings.” When you look back at the results that John Cacioppo and Robert Sampson presented, however, you see really incredible strength emerging, she said. You also see, with regard to the intervention issues laid out by Jack Shonkoff and Margaret Chesney, a great deal of progress. “On a small scale and in lots of ways,” Dr. Berkman said, “we know a lot about what we are doing, though scaling up [presents problems] of enormous magnitude.” Another point that the morning’s presentations shared, she said, is that our society is undergoing rapid and often fundamental changes, most of them demographic. For example, the community hyper-segregation mentioned in Dr. Sampson’s talk—both in terms of racial and ethnic segregation as well as socioeconomic segregation—is really quite a new phenomenon. “In some ways, we are not talking about the same thing just getting a little bit worse,” she said. We are talking about something dramatically changing, and it has wide-ranging implications for what we are going to do.” Similarly, speakers discussed a growing inequality—particularly the spread over time in wages for different kinds of groups—that has “quite dramatic” implications, Dr. Berkman said. And also “very staggering” was Raynard Kington’s point about acculturation. “Considering the magnitude
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of patterns of migration coming into the United States, we could be in for some very important surprises,” she said. “People could be doing very well, and then suddenly take a big turn for the worse” in succeeding generations. Dr. Berkman said she was particularly taken with Jack Shonkoff’s comment about the need for realistic social models when designing early-childhood interventions. “He didn’t say this, but I’ll say it—we can’t pretend that women are at home all the time and don’t work,” she said. If you assume “that families look the way they did in the 1950s, you are in for a very rude awakening.” Dr. Berkman called these speakers’ points “important wake-up calls” that give us no choice but to change. “They really call upon us to think about things in a different way.” Thus the symposium will focus this afternoon on “a new way of doing business in order to make future progress in this area,” she said. That will involve some struggles, beginning with the challenges of doing multidisciplinary work. But that is to be expected, as Dr. Kington so aptly reminded the audience with his quote of Martin Luther King.
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