Although there are some data on health risks, there are very few data on positive health measures and other health and developmental assets, including characteristics that help to ward off threats to ill health. Similarly, there are no coordinated or linkable data regarding states of “resilience,” such as physical fitness and nutritional status. While many communities throughout the United States have engaged in the measurement of positive youth behaviors and developmental assets as part of their own local interest or projects, it is important to consider how measuring the developmental assets of young people can be encouraged in all communities and the data made available to public and private entities interested in fostering positive health development in their youth.
In March 2003, Child Trends convened a national conference of leading researchers to review the state of the art in measurement of positive development. The conference concluded (Child Trends, 2003) that a theory of positive development was still lacking, and that many if not most of the measures that have been developed still lack demonstration of validity. Two areas were included under the broad rubric of positive development: (1) positive feelings, attitudes, and beliefs and (2) skills, behaviors, and competencies. The role of culture in the first of these two categories was recognized as a major consideration in interpreting the value of the measures. Other major issues were related to data collection and to the choice of type of respondent. Further work on theory development and research on positive measures was recommended, a direction with which the committee concurs.
In the near future, it may be possible to determine the early origins for many significant adult health conditions, such as adult-onset diabetes mellitus, coronary heart disease, and hypertension, as well as to have information about the risk of developing common childhood diseases such as asthma, attention deficit hyperactivity disorder, and some metabolic and diet-related conditions. There is already success in predicting the likelihood of rare Mendelian diseases. Whether there will be similar success in predicting many common adult conditions remains to be seen. At present there is no mechanism for assessing the distribution of genetic risk profiles in the population or relating them to the environmental influences that are likely to determine the actual likelihood of ensuing disease and disability as well as resilience. Developing better data collection mechanisms to array environmental influences in relation to biological or genetic factors is an area in which greater gaps in measurement are likely to be felt in just a few years.
Although there are data that indicate that children are not thriving, many current measures cannot capture either their successes or their failures. The committee’s view is that the nation must move ahead in developing a more comprehensive measurement strategy that captures the dynamic nature of childhood, assesses all the domains of health, and tracks composite trajectories of children’s