Ready to Work? The Long Term Impact of Child Health on Economic Development

February 2011

Ready to Work? The Long-Term Impact of Child Health on Economic Development

Ana Cruz-Taura: Welcome to the Federal Reserve Bank of Atlanta's Economic Development podcast series. I'm Ana Cruz-Taura with the Federal Reserve Bank of Atlanta. Today, we're talking with Dr. Jay Berkelhamer, past president of the American Academy of Pediatrics, and former senior vice president for medical affairs at Children's Healthcare of Atlanta.

Our nation's health care policies have been heavily debated, but beyond these policies lay the impacts of illness on worker productivity. Chronic illnesses, including diabetes and high blood pressure, contribute to worker absenteeism, decreased productivity, and increased insurance costs to employers. Greater focus is being placed on preventative health care, including a closer look at children's health. In this podcast, we will discuss trends in child health issues and their long-term impact on economic development.

photo of Dr. Jay BerkelhamerDr. Berkelhamer served as President of the American Academy of Pediatrics from 2006–07. In addition to his work at Children's Healthcare, Dr. Berkelhamer serves as a clinical professor at Emory University School of Medicine, an adjunct professor at Morehouse College of Medicine and as a general pediatrician.

Dr. Berkelhamer, thank you for joining me today.

Dr. Jay Berkelhamer: Well, thank you for having me here.

Cruz-Taura: As a practicing pediatrician, what trends have you noticed in children's overall health in the past 10 to 20 years?

Berkelhamer: There's been both progress and concerns, and the progress really is quite amazing. There have been new immunizations that have become readily available, and have now become routine. There are new antibiotics, which allow us to treat infections more effectively. Cancer treatments have improved. Transplant immunology has made transplantation for children who have organ failure much more available. And then, management of chronic diseases, diseases like cystic fibrosis and asthma and diabetes are all diseases that we do a much more effective job of today managing those diseases. Neonatal survival rates have actually improved for premature infants. And we've seen a marked decrease in serious infections.

On the concern side, you know there's an obesity epidemic in the United States (25 percent of all the children in this country are overweight). Children are less physically active. Recess and physical education have become condiments in the schools—many schools not actually having them. There's been an increase in the number of children diagnosed with autism and autism spectrum disorders. The children are living in a very hyper-stimulated environment. They have computers, handheld devices, television sets—all kinds of things that keep them going and over-stimulate them at times. And the suicide rate remains high among teenagers (about one in 1,000).

But, overall, health and well being of children in the United States doesn't fair well when we compare ourselves to other wealthy nations. There was a UNICEF study in 2007, which ranked the United States number 20 out of 21 wealthy countries in terms of the health and well being for children. A third of our children are not graduating from high school, and this is the first generation in our nation's history where the life expectancy for this generation is less than the previous generation.

Cruz-Taura: Brain development in early childhood is now understood to be a time of great potential. What are the links between maximizing early childhood health and adult health and productivity?

Berkelhamer: Exposing children to a rich verbal environment and introducing reading at an early age can set the stage for educational success in school. We now know that children need to be able to learn to read by third grade, and then move on to read to learn. In order to read to learn you have to, not only be able to pronounce the words, you have to understand them, and that's the vocabulary part. Children reading below grade level in fourth grade, have a 50 percent chance of never graduating from high school.

Children who suffer from diseases that prevent regular school attendance are also at greater risk of not becoming productive adults.

Nutrition is very important, and that can impact their learning as well. It turns out that approximately 90 percent of the brain's growth will have been completed by six years of age. So, it's very rapid and very important that we set the pathway straight from the very beginning in terms of the child having a good, sound foundation for future success.

Cruz-Taura: Adolescents are critical to the nation's future workforce and many local economic development agencies are partnering with junior high and high schools to ensure critical job skills are being taught. Why should local communities consider healthy living skills part of their preparation efforts, and how can they best go about this?

Berkelhamer: Healthy lifestyles that are set in the childhood years can have a dramatic impact on the effectiveness of our future workforce. The seeds of adult disease—such as cardiovascular problems, hypertension, cancer, diabetes—all begin in the years prior to the child entering the workplace. Obesity, smoking, poor physical conditioning, abuse of alcohol are major problems for children in junior high and high school.

The best way to go about dealing with these issues is to give children support for healthy living with exercise and diet. It's important to expose children to role models of successful adults so they can set their sights on becoming contributing members of our society. We need to work with children to be sure they have a strong sense of self. We need to work hard so that they understand how important it is to be successful in school, and that their school performance is valued. Programs that provide tutors and extra support for learning activities will pay off later by having a healthier and better-prepared workforce.

Cruz-Taura: What about the parent's role in all of this?

Berkelhamer: The parents are extraordinarily important and we need to work with the parents. And many of our efforts, particularly in the very early childhood years should be giving the parents the tools with which to teach their child about reading (read books to your infants, to your toddlers). To give parents the skills to reinforce the child's good behaviors and desired behaviors, helping the child build a strong self-image. Parents need to take an active role in their child's work at school and need to understand how important it is.

Cruz-Taura: In addition to lacking basic skills, such as reading and math, some young people are unemployable because of inabilities to pass a drug screening. How pervasive is teen drug use compared to a few years ago, and what implications does adolescent drug use have on long-term ability of workers?

Berkelhamer: Drug use has continued to increase and remains very high among teens. By eighth grade a third of all teenagers will have used illicit drugs, and by twelfth grade it jumps to 50 percent. Underage alcohol use costs more than $60 billion a year. Marijuana is readily available and has become a multi-billion dollar industry in the United States. Cocaine, heroine, the abuse of prescription and over-the-counter drugs also contribute to the problem. Amphetamines, sedatives, tranquilizers, Ritalin, and cough medicines top the list.

Most teens think they're just having a good time and do not believe they will become hooked or addicted to drugs. We need to work with the children so they are better aware of the dangers and less likely to experiment heavily during their school years. They need a stimulating environment so they have less reason to find stimulation from drugs. Although experimentation with drugs during the teen years does not always result in lifelong problems, I can understand the difficulties this creates for employers trying to bring young adults into the workplace.

Cruz-Taura: The ages between 15 and 18 are when teens generally make decisions about employment and educational options. What are the new challenges facing young adults, and are there significant differences compared to 20 years ago?

Berkelhamer: Absolutely. Children today are entering an environment where education has become more important than ever. Jobs require skills that involve information technology and communication, and working as part of a team, and these are skills that only can be developed while they are successful in school. Our teens today are not well prepared and we have to change that if our country is to remain competitive in a worldwide marketplace. We are not keeping up with other major world powers and we cannot afford the large number of teens that enter their adult years without employable skills. We need all our children to become contributing members of our society and the business community has an important role to play by investing in programs that will better prepare children for adulthood.

Cruz-Taura: I imagine that children's health also has an impact on the family and on the parent's work life.

Berkelhamer: Parents need to know that their children are safe. They need to know their children are healthy and that they're in a good school situation where they're learning. If those things aren't happening the parents are distracted. They may have to stay out of the workplace to look after their children. So, one of the ways parents can be more effective in the workplace, it's extremely important that they know their child is healthy and well cared for.

Cruz-Taura: Dr. Berkelhamer, thank you for joining us today.

Berkelhamer: You're welcome, I was pleased to be here.

Cruz-Taura: This concludes our podcast. We've been speaking with Dr. Jay Berkelhamer, past president of the American Academy of Pediatrics.

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Thanks for listening.