Cook: Child care for the next 30 years

Cook: Child care for the next 30 years

November 24th, 2013 by David Cook in Opinion Columns

David Cook

Photo by Ashlee Culverhouse/Times Free Press.

What if there was a way to do things differently so that the problems we face could be fixed for generations to come?

Take childhood health in the area, or the lack of it. For many kids, life is a five-alarm fire: obesity, asthma, toxic stress, pollution, hours of screen time, shelves of high-fat, high-carb food.

• One of every three children in Alabama, Tennessee, Georgia and North Carolina is overweight.

• The infant mortality rate for black children in Hamilton County is higher than rates in Jordan, Romania, China, Colombia and Mexico.

• Chattanooga ranks as one of the worst cities in America for asthma. Asthma is a top reason children miss school.

• One of every five children in South Chattanooga is not ready to begin kindergarten because of physical problems.

These healthproblems are passed down from generation to generation, not just through cultural messages and family dynamics, but genetically. When an overweight teenage girl who lives in an environment surrounded by toxic stress gets pregnant, then her child will not only receive unhealthy behavioral habits but a genetic predisposition that causes are to continue.

Such an inheritance leaves physicians in a reactive state, managing chronic disease but rarely fixing the problem.

What if there was a way to interrupt all of that?

"We can go in and alter the epigenetics," said Dr. Allen Coffman, president of the newly formed Pediatric Healthcare Improvement Coalition -- Tennessee Valley.

His group, which released the above statistics, brings together physicians, CEOs, parents and other community members with the goal of improving pediatric health in the area. Much of its work will be based on the science of epigenetics.

Certain parts of our genetic code are unchangeable: eye color, for example. But other parts can be altered, delayed or reversed. Sort of like a programmable light switch, epigenetics tells your body when to turn on or off certain processes.

And the environment children are raised in can be the hand that flips the switch.

"We add 16 hours of TV to the day, we add polluted air, we add chronic stress and a loud toxic environment, then the child's body adapts to that," said Coffman, president of the Tennessee Chapter of American Academy of Pediatrics and a doctor at Highland Pediatrics.

How bad are things? One recent study showed that 75 percent of all American youths are unfit for military service because they're too overweight, didn't graduate from high school or have criminal records. It's a national emergency, with certain populations affected more than others.

"There is toxic stress in just being an African-American in the United States," said Coffman.

It's like a genetic curse that dooms future generations.

"It's not just affecting these children," he said. "It is changing their genetics and their kids and their kid's kids will be affected."

Instead of trying to dump water on the blaze, Coffman's group is seeking to destroy the kindling that repeatedly sets the burn. If genes can carry toxic behavior from generation to generation, then those same epigenetic triggers can be delayed by changing the environment.

But first, you've got to have specifics.

"Obesity in South Chattanooga is different from obesity in Dayton," Coffman said.

PHIC is working with Michigan's Blue Cottage Consulting to create a regional assessment of the state of pediatric health in the area. Once the study is completed, PHIC hopes to build more community partners, identify best practices from other communities, and begin to implement them here.

Like this: every elementary school also has a mini-health clinic. A nurse practitioner is on site, with regular visits from dentists, nutritionists and mental health experts. Children, normally taken in sporadic, never-see-the-same-doctor-twice trips to the emergency room, are now seen routinely by the same medical expert. It's health care triage that also creates a paradigm shift by normalizing pediatrics to communities that need such care the most.

Plus, the second-grader can bring his 5-month-old sibling, too.

Or this idea: pediatricians' offices become family-centered medical homes that provide not only traditional pediatrics, but also mental health assistance, nutrition advice, asthma specialists, orthopedics and so on. It would be like mini-children's hospitals located in high-risk communities.

Doing so helps kids today ... and in 2040.

"We know scientifically these things are impacting at least the next two generations," Coffman said.

We have the knowledge and resources to make sure that impact is for good, and not bad.

Contact David Cook at dcook@timesfreepress.com or 423-757-6329. Follow him on Facebook and Twitter at DavidCookTFP.