What is it going to take? How much more evidence is needed before we – society, policy-makers and governments, too – act on what we know: Strategic public investment in early years, including prenatal support and care, can make dramatic, even life-changing differences in the lives of young parents and their children. The late Dr. Fraser Mustard knew this, and made it his life’s work to get that message out, with only limited success. And if you’ve been following The Spectator’s second Code Red series, BORN, you know this as well. The evidence is irrefutable.
That, arguably, is one of the most important things about work like Code Red overall, and BORN specifically. Looking at the striking evidence about the relationship between low birth weights and health, and at the concentration of that specific problem in areas saddled with high poverty rates, the reaction of some people has been: “Of course – this isn’t surprising. Who didn’t know that?” But seeing the evidence amassed and quantified in this way should drive social policy and public health decisions. It’s as close to hard science as we are likely to get on this subject, and on measuring the social determinants of health. And it is the most concrete proof yet that our choice is simple: Invest something now, or invest a lot more later.
Hamilton is home to a powerful example of what we can do about this. The Nurse-Family Partnership is a pilot program that matches high-risk, low-income, first-time mothers with a nurse who conducts intensive home visits until the child reaches the age of two.
The goal is to provide support and counselling to make wise choices and get families moving in the right direction. Evidence in other jurisdictions where similar programs have been established shows dramatic improvement in rates of child abuse, parental substance abuse and emergency room visits, as well as a much improved prognosis for children as they move forward after the program. School outcomes are better, mothers tend to return to continue education more often, get better jobs, make better decisions.
BORN points out the average cost to the health care system of a low-birth-weight baby during the first year of life is $88,000. Suppose the provincial objective of reducing the percentage of low birth-weight babies from 6.5 per cent to 4 per cent could be met. That translates into 3,370 fewer low-birth-weight babies, and a saving of $293 million. In one year. And we know that low birth weights also often translate into a lifetime of problems, medical and social. Knowing that, and knowing that health care currently eats 43 per cent of the provincial budget, how can we not acknowledge and respond to the message of BORN? What is it going to take for us to learn these lessons?
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