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Kid Friendly: Neal Halfon

By Jack Feuer

Published Apr 1, 2007 8:00 AM

Neal Halfon, director of the UCLA Center for Healthier Children, Families & Communities, is internationally recognized for his expertise in child health and human development. Halfon is a professor of pediatrics in the School of Medicine, in the Department of Health Services in the School of Public Health, and in the Department of Public Policy in the School of Public Affairs. But this good doctor is not only a champion of healthy kids. He also produced the hit 1994 documentary Crumb, about the legendary counterculture cartoonist. Copyright © Juliane Backmann

How to Help Children Thrive

The UCLA Center for Healthier Children, Families & Communities is helping to build early childhood systems initiatives in counties throughout California, with several other states, and increasingly with programs in Australia, Canada and England. To find out more about how to help families and communities support children's health and development, log on to their site. And check out Halfon's article in the March 2007 issue of Health Affairs, "Transforming the UC Child Health System."

Q. How does a leading health scientist get involved with a film about a hippie icon?

A. I was teaching at UC Berkeley and UC San Francisco, and I had many friends who were old-time string musicians. It was not uncommon for me to return home from a night on call at the hospital and find my living room filled with guys playing 1920s and 1930s string jazz and country music. One of those old friends is film director Terry Zwigoff. I jumped at the chance to help Terry by producing a documentary in 1989 about an eccentric Hawaiian family of musicians, the Moes. [That film has yet to be released.] Two years later, R. Crumb, a close friend of both Terry and myself, decided that he and his family would be decamping from Northern California to a small medieval village in Southern France. We both thought that was a great device to tell Crumb's traumatic story and to show how misaligned his values and views were with those of modern America.

Q. You have a lot of interests. Why become a doctor?

A. My father was a pharmacist, and my uncle was a doctor, but my real inspiration came when I was 8 years old and experienced the loss of my 4-year-old cousin, who did not survive the repair of his congenital heart defect. To deal with the incomprehensibility of his death and my own grief, I began dissecting calves' hearts my mother got for me from our local market and embarked on a lifelong journey in trying to understand as much as I could about how the body grows, develops and functions. My interest in developmental biology, coupled with my desire to do something to affect the diseases of social injustice, brought me to medicine and public health.

Q. And pediatrics?

A. My father demonstrated a great love for all children, not just his own, and frequently expressed his concern for how many kids were not receiving the investments they needed to thrive. He used to say, "It's all about the kids." When I started medical school, I found that I had a natural rapport with children. I have spent most of my career trying to understand how a child's social environment affects his health development and the realization of his health potential.

Q. In childhood development, we hear the phrase "failure to thrive." What does that mean?

A. Failure to thrive is a diagnosis that is often given to children whose bodies stop growing and brains stop developing. This may happen as a result of psychological and social trauma, [such as] in children who have been abused and neglected. Failure to thrive can occur in spite of adequate calorie intake, as body systems shut down in response to toxic stress. Optimal lifelong health is about the experiences children have and the environments in which they live, not just the medical care they have access to once they get sick. We know what it takes for an individual to live into his 80s and be healthy. The decisions to facilitate that process are political, not medical.

Q. So the challenge to optimize children's health is as much political as medical?

A Before 1950, people in the U.S. were the tallest population in the world. Since that time, average height in the U.S., which is a reflection of how well we are achieving our human potential, has actually decreased relative to other nations. Holland and several of the Scandinavian countries now exceed the U.S. average height. Economists writing about this major shift in bio-demographics highlight how each of these countries has engaged in a concerted effort to make strategic investments in young children in order to assure optimal development. [In the U.S.,] we have not mustered the political will to make the kind of difference that we know we should.

Q. You played a key role in the development of California's First 5. Could you describe this effort to transform the way we raise kids in their first five years of life?

A. First 5 is one of the most ambitious health promotion and developmental optimization initiatives that has ever been launched in this country. It is part of a growing international movement that is based on our changing understanding of brain development and how much future human potential is programmed early in life. In much the same way public schools were developed to support the major social transformation that took place during the industrial revolution and the movement of individuals from farms to factory work, First 5 is about building the public health and educational infrastructure to support the development of children, who will become our future workforce in the era of information technology.

Q. Which policy makers have you worked with to realize your vision?

A. I began working with Al Gore, when he was vice president, on a national family policy initiative focused on family-centered community building. That led to an ongoing relationship and collaboration in developing a course and curriculum that he and I, along with fellow UCLA faculty, pioneered here at UCLA and in universities across the country. [In California,] the Schwarzeneggers are very committed to children's issues, and I have been working closely with the first lady on issues of childhood obesity and health care.

Q. The 2008 presidential race has begun. What advice would you give the next president?

A. One who stoops for the child stands tall. The time is right to transform the U.S. child health system and to consider a new social "operating system" that encourages greater investment in children and in the future well-being of our nation.