• creation of improved measures of functioning and health potential;

  • the relative importance of and interactions among the range of influences;

  • biopsychosocial pathways of development;

  • assessment of children’s exposures to environmental toxins and other environmental health hazards;

  • reasons and remedies for health disparities;

  • longitudinal methods that can identify causal relationships between developmental and functional levels and the health status of children;

  • development of profiles and integrative measures of children’s health; and

  • construction of trajectories for each domain of children’s health.

In sum, health extends beyond traditional notions of disease and disability and is influenced by myriad factors external to the individual. Conceptualizations of health have generally not considered development as part of health. The committee has proposed both a definition of health and a framework that portrays these interactions. New measures need to be developed that capture the multidimensional nature of children’s health.

Although numerous data collection efforts capture data on children’s health and health influences, none has kept pace with the evolving understanding of health, and none provides a complete understanding of the interactions between and across influences. Comprehensive, longitudinal surveys are essential to filling critical gaps in data collection. More immediate, short-term approaches could include modifications to existing surveys and better use of extensive administrative data at the state and local levels. Regardless, efforts to improve collection of data need to be supported by additional research that will address key gaps in knowledge (such as limited understanding of disparities in health) and advancing children’s health research by embracing new methodologies (such as use of biomarkers and improved health measures).

Finally, federal, state, and local governments need to establish a shared vision to focus on children, the nation’s most valuable resource. It is time to develop comprehensive ways of assessing the health of children that will foster the nation’s ability to nurture and develop its children with all their inherent richness and potential.



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