FIGURE 2-1 Model used by the Healthy People 2010 report.

SOURCE: U.S. Department of Health and Human Services (2000, p. 30).

For the committee, the model falls short for use with children because it does not reflect the dynamic and developmental nature of children’s health and is too narrow in its view of determinants or influences on health; for example, it fails to articulate the importance of cultural factors or to recognize the importance of services other than health care. Health results from complex interactions of many aspects of the child’s environment, genetic endowment, and behavioral responses that constantly influence and affect one another. Several principles of this dynamism are critical to a full model of children’s health.

Health and Development

Development is important in the biological and behavioral processes that determine health capacities, optimize function, preserve health, and lead to the presence or absence of disease throughout life. Cumulative experience, inherent adaptive capacities, dynamic interactions with physical, social, and cultural environments, and genetic predisposition all interact to determine developmental trajectories (Institute of Medicine, 2001b; National Research Council and Institute of Medicine, 2000; Hertzman, 2000; Halfon and Hochstein, 2002). A growing body of scientific research specifies the biological mechanisms and physiological



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