across different developmental stages, so that health characteristics can be assessed across stages of development in a dimensionally consistent manner.
An earlier section of this chapter delineated the elements of ambitious new surveys that would promote research efforts in this regard. The committee also highlighted important technical and methodological gaps in the ability to measure specific dimensions of health across developmental stages in a consistent and continuous fashion. Some of these gaps require more research on appropriate measures and measurement strategies.
As basic science continues to elaborate the biological, behavioral, and environmental pathways of healthy development, new measures will become available based on how these pathways function. As more is learned about sensitivity genes, and genomic testing becomes more widespread, the value of biomarker assessment is likely to increase considerably. At the same time, the technologies for gathering biomarker data in routine surveys using noninvasive procedures are advancing rapidly. The current and future use of such biomarkers in isolation or in conjunction with other health or health influence (including genetic) measures demands increased research attention. Furthermore, given the complex interaction between genetic and multiple environmental factors, these assessment and predictive efforts should be integrated with measures of other influences and indicators of health to enable the development of composite measures of health.
Given the large number of new chemicals introduced into the environment each year, and the lack of information about their effect on human function and health, particularly their potential effect on children, there is a growing need to measure the exposures of children to these agents more systematically and to understand better their potential effect on children’s development. In addition, the levels of agents currently in the environment known to pose an appreciable risk to children need to be monitored and child populations at greater risk of environmental exposures identified.
The committee determined that, despite general awareness of the scope and nature of children’s health disparities across population subgroups, the reasons for such disparities are barely understood. A growing body of empirical literature indicates that many disparities begin early in life and increase or are compounded as a child grows. Much is to be learned from longitudinal research on the processes that lead to health disparities among specific subgroups and on the development of measures of health and health influences that are valid across population subgroups. Longitudinal studies that examine cultural processes—acculturation, daily routines, values and attitudes toward childrearing, and the effects of actual or perceived discrimination on health disparities—are needed. In addition, traditional methods for measuring health and social influences are not equally valid across subgroups. Efforts to develop reliable measures to assess the influence of culture and discrimination on children’s health need to be supported.