How Are the Kids Doing? The Well-Being of Children and the Nation's Potential

commentary

(Health Affairs Blog)

Teacher Emma Rossi works with her first grade students at the Sokolowski School in Chelsea, Massachusetts, September 15, 2021, photo by Brian Snyder/Reuters

Teacher Emma Rossi works with her first grade students at the Sokolowski School in Chelsea, Massachusetts, September 15, 2021

Photo by Brian Snyder/Reuters

by Anita Chandra, Neal Halfon, Jill S. Cannon, William Gardner, Christopher Forrest

October 22, 2021

The pandemic has forced concerns about children's health to the front and center: Is enough attention being paid to their well-being, including education and mental health? Have reopening plans taken children's needs into consideration and have their potential losses been adequately measured? Could better preparation be put in place to help prepare children for the next pandemic? The COVID-19 pandemic is just another example of a stress that is forming today's youngest cohort of children and challenging how well children are supported to manage overlapping disasters and maintain relationships. They are “Gen C,” a generation growing up amid extraordinary challenges that could shape their health, development, and well-being for years to come.

Discussions of a “human infrastructure” bill to invest more in children and families could represent a shift in the social contract, with significant health implications. New investments and expansions in paid family leave, preschool, and a child allowance suggest a recognition that early childhood is critical for healthy development. Investing in children can promote national well-being in the long term. And at a time when the nation is recognizing how unprepared its data systems are to track pandemic impacts, greater attention and scrutiny about what is measured and how it informs real action may be even more resonant. This may provide an opportunity to revisit national indicators of progress and improve measures of developmental potential.

There are two options: Continuing to use gross domestic product (GDP) to guide economic policy or expanding that to include a measure of the future potential of U.S. society. GDP does not reveal anything about social inequities or the next generation's creativity, innovation, and agility—all essential issues revealed during the pandemic. This blog post briefly describes the importance of pivoting to human potential and why a developmental approach matters.

Why Focus on a Measure of Human Potential?

By not measuring the capabilities they need to succeed and thrive, children may be undervalued. Various national and local data sets exist to measure child mortality and morbidity, educational outcomes, and a few social and emotional indicators. However, there is no coherent and comprehensive system for measuring children's health, mental health, and social and cognitive development: in short, their potential to flourish as children and mature into healthy and capable adults. There could be a need for these indicators to gauge whether enough is being invested in developing the capabilities that Gen C will need to stay healthy and advance the economy and society overall in future decades.

Our goal was to develop a framework for sentinel indicators of human potential that could assist communities in helping children thrive and flourish.

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Over the past three years, researchers from the University of California, Los Angeles, the RAND Corporation, and the University of Pennsylvania have worked to develop the initial conceptual framework for a new measure—the GDP2 or “Gross Developmental Potential.” Funded by the Robert Wood Johnson Foundation, this work is motivated by the concern that both the nation and individual communities have limited information to guide investments in capabilities necessary for a healthy future. Our goal was to develop a framework for sentinel indicators of human potential that could assist communities in helping children thrive and flourish.

Intended as a companion measure to the GDP, the GDP2 aims to measure the development of human potential in communities, rather than focusing solely on economic production. The GDP2 employs the innovative Developmental Capabilities Framework to describe those capabilities needed to thrive in the U.S. both today and in the future. GDP2, when fully implemented, could be a sentinel measure to capture the potential of a nation by assessing the promise of its youngest cohort.

The GDP2 framework was co-developed with a set of pilot communities and national experts and includes indicators for seven core human capabilities that develop over the life course and are centered in concepts of equity and dignity. These include the capability for meeting basic needs, living a healthy life, communicating thoughts and feelings, lifelong learning, adapting to change, connecting with others (including the natural environment), and engaging in the community. This approach to human potential goes beyond measuring traditional basic needs (for example, food and housing quality) and inputs such as education, employment, and income. It also reframes what basic needs are by considering social and emotional development factors, sense of purpose, social connections, and belonging that create a meaningful life and way of contributing to a consequentially fulfilling future.

The COVID-19 pandemic demonstrated that these kinds of capabilities and skills matter, requiring individuals to continuously adapt and flourish in an increasingly interdependent world. For instance, determining ways to learn in new settings (for example, from a home computer) is an example of the new requirements testing resilience. Existing limited measures of health or educational outcomes may not be satisfactory to measure this effect. Novel developmental indicators of human potential are needed to pinpoint where these challenges are likely to be more acute.

Why Add a Developmental Approach?

The GDP2 acknowledges that well-being is not a fixed entity but develops over time in response to a range of risk and protective factors operating over the lifespan.

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The Developmental Capabilities Framework makes the GDP2 distinct from the many other indices and measures of well-being and happiness that have emerged recently. The GDP2 acknowledges that well-being is not a fixed entity but develops over time in response to a range of risk and protective factors operating over the lifespan. During human development, some stages, such as early childhood, are particularly sensitive to environmental effects. This developmental orientation distinguishes the GDP2, making it particularly useful as a measure of human potential and as a guide to human capital development.

In addition to the possibility of providing an essential measure of national well-being, the GDP2 could provide motivating and actionable data. Low scores on capabilities point to areas of development that need to be addressed. Widespread adoption of the GDP2 could also advance the goal of “Equity from the Start” with capability inequalities across communities, pointing to changes that could support individual and community resilience and well-being. While investments in early childhood hold perhaps the greatest potential for improving America's profile of health and well-being, there are many opportunities for investments to enhance developmental capabilities in later childhood and adolescence.

The pandemic and accompanying economic hardships have revealed the inadequacies of some social measures. While more work is needed to develop and test the GDP2, we offer the Gross Developmental Potential as an approach for charting a new way forward, by concentrating attention on the developmental capabilities that enable everyone to thrive.


Anita Chandra is vice president and director of RAND Social and Economic Well-Being and a senior policy researcher at the nonprofit, nonpartisan RAND Corporation. Neal Halfon is founding director of the UCLA Center for Healthier Children, Families, and Communities. Jill Cannon is a senior policy researcher at RAND and a member of the Pardee RAND Graduate School faculty. William Gardner is a child psychologist and mental health services researcher at University of Waterloo in Canada. Christopher Forrest is the director of the Center for Applied Research at Children's Hospital of Philadelphia.

This commentary was first published on October 22, 2021 on Health Affairs Blog. Copyright ©2021 Health Affairs by Project HOPE — The People-to-People Health Foundation, Inc.

Commentary gives RAND researchers a platform to convey insights based on their professional expertise and often on their peer-reviewed research and analysis.