Healthy Start Stories |
Vincent Jaddoe

Research into opportunity inequality: ‘A large part of the opportunities and possibilities in our lives are already determined in the womb’

A loving family, healthy food, a nice neighborhood with plenty of friends. Just a few ingredients that determine the development of children and their possibilities later in life. Unfortunately, not every child grows up safe, happy and healthy. With all its consequences. But what do we really know about childhood opportunity inequality? How can we ensure that many more children experience better development? And as a scientist, how do you work with all kinds of different target groups such as parents, teachers and caregivers? Vincent Jaddoe, Professor of Pediatrics and one of the initiators of Healthy Start, talks about this.

“We may not realize it every day, but much of the opportunities and possibilities in our lives are already determined in the womb. For example, one child comes into the world healthy, while another may be born with a brain disorder. The family and environment in which the child grows up also determine the rest of its development. As a result, large differences arise at a very young age, so that not every child can develop optimally. That hits me. Especially because some differences could have been prevented. As a doctor and scientist within Healthy Start, I am concerned with the question of what we can do to reduce inequality of opportunity in children from the very first phase of life.”

It hits me that opportunity inequality occurs at a very young age

First years of life crucial

“For as long as I can remember, I have been interested in child development. Especially the very first, so-called “embryonic phase”, fascinates me. It remains extraordinary that from the fusion of a sperm cell and an egg cell a new human being can arise. How can nature arrange that so well? But also: why does it sometimes go wrong? In the Erasmus Medical Center, as a pediatrician, I mainly see the children where something has gone wrong in that early development. Young children with visible disorders, but also children with less visible disorders, such as a brain or heart defect. These are often serious conditions that have a great impact on the rest of the child’s life, parents and environment.

The embryonic phase is also followed by a crucial period: the first years of life. Is the child growing up in a loving family? Is it getting enough healthy food? Is the air quality in the environment good, or is there a lot of smoking, for example? In recent years we have followed the development of thousands of children in Rotterdam with a huge group of scientists within the so-called “Generation R” project. Based on this, we know that unfavorable early development increases the risks of health problems such as obesity, and mental or behavioral problems.

Not only in my work as a physician and scientist do I deal with differences in children’s development. Even as a father of young children, I realize how great an influence circumstances have on their development. The town or village where children live, the neighborhood they grow up in, the elementary school they attend. All these factors affect children’s abilities and their opportunities later in life. The question now is what can we do to reduce opportunity inequality among young children as much as possible?”

There are many initiatives to reduce opportunity inequality among children, but there is still a world to be won

New ways to prevent opportunity inequality

“In recent years, many scientific and societal initiatives have been launched to promote equity among children. Yet there is still a world to be won. That’s why I set up Healthy Start together with Eveline Crone and Maaike Kleinsmann. With Healthy Start we join forces. Eveline is an expert in the field of psychosocial and brain development in children, Maaike is an expert in the field of technology and health. My expertise lies in the early stages of child development, from conception to the second year of life. I also deal with the care of chronically ill children. Because of their illness, these children are often hospitalized repeatedly and for long periods of time. As a result, they have less contact with friends and family, and often miss school, sports and other social activities. This can significantly disrupt their physical and mental development. Therefore, it is important that we know how to arrange care for chronically ill children so that they can continue to develop as normally as possible.

With Healthy Start, we bring together existing knowledge and initiate new research projects to ultimately bring about social change. We are developing new ways to prevent inequality of opportunity or to correct it in time. This should ultimately enable many more children to experience a better development. To this end, we work together with scientists at Erasmus MC, Erasmus University Rotterdam and TU Delft, but also with policy makers, parents, teachers, young people, caregivers and other stakeholders. Their ideas, wishes and needs ensure that scientific knowledge can be translated into practical applications that are meaningful and work.

Such an intensive way of working with others is certainly not common in science. So I learn a lot from it myself. As a scientist, I sometimes organize meetings with parents, children and health care providers, but within Healthy Start we always work together. For example, a midwife recently told me that it is difficult to help an expectant mother to quit smoking when she is experiencing a lot of stress and has a partner who smokes. This kind of practical knowledge helps us as scientists think about what approach might work to give the unborn child a healthy start.”

If you want research to lead to new ways to help expectant mothers and fathers, for example, you have to be able to listen to their experiences and ideas

Great diversity makes Healthy Start so interesting

“A large collaborative project like Healthy Start also brings challenges. We have now grown into a network with more than a hundred people. We are in different locations, have different backgrounds, think differently and sometimes have different interests. This great diversity makes Healthy Start so interesting, but also leads to things not going as fast as you might want.

Finally, I noticed how important it is to really listen to others. Many scientists are used to mainly transferring information. But if you want research to lead to new ways of helping expectant mothers and fathers, for example, you have to be able to listen to their experiences and ideas. This also means attracting a new generation of scientists; scientists who are willing and able want to and can connect research with practice. Who can listen and who know how to collaborate with other audiences.”

Vincent Jaddoe’s Healthy Start perspective
“For me, Healthy Start is successful when we see concrete results in society. By that I mean better health, more equal opportunities and a higher level of well-being for new generations. I would like to make Healthy Start a central place where scientists, policy makers, parents, young people, health care providers and other stakeholders know how to find each other and work together on new ways to promote opportunity equality for children. I would also love for scientists around the world to come and learn from our approach. I think the Massachusetts Institute of Technology (MIT, Cambridge, USA) is an inspiring example. That’s a place with global prestige and high-quality research. Scientists from all over the world come here to gain knowledge and then apply it in their own context. I would like something similar for our Healthy Start Program.”

Vincent Jaddoe is Professor of Pediatrics Erasmus MC Sophia Children’s Hospital. He is Academic Lead of Healthy Start and involved in the ambitions ‘The first 1000 days and a resilient life course’ and ‘Pediatric hospital of the future’. 

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