Breves: Los Cimientos de una Salud Duradera ; In-brief: The Foundations of Lifelong Health
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Breves: Los Cimientos de una Salud Duradera ; In-brief: The Foundations of Lifelong Health

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Título: Notas breves: Los Cimientos de Una Salud Duradera; InBrief-The Foundations of Lifelong Health ...

Título: Notas breves: Los Cimientos de Una Salud Duradera; InBrief-The Foundations of Lifelong Health
Autor: Center on the Developing Child - Harvard University
Idioma: español - english (traducción no autorizada solo para fines didácticos)
Tema: psicología, neurodesarrollo, neurociencias, desarrollo, infantil, primera infancia, salud, principios, vida, psychology, neurodevelopment, neurosciences, development, child, early childhood, health, mental, foundations, lifespan
Material utilizado en catedras de la Universidad Continental de Huancayo - Perú (www.continental.edu.pe)

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Breves: Los Cimientos de una Salud Duradera ; In-brief: The Foundations of Lifelong Health Breves: Los Cimientos de una Salud Duradera ; In-brief: The Foundations of Lifelong Health Document Transcript

  • HARVARD UNIVERSITY Centeron the DevelopingChild NOTAS BREVES Los Cimientosde una Salud Duradera Unasociedadvital yproductivaconunfuturoprósperoy sostenibleseconstruyesobrela base deundesarrolloinfantilsano.Experiencias positivas tempranasproporcionan la base para una arquitectura cerebralrobusta y una ampliagama de habilidades y capacidades deaprendizaje. La salud en los primeros años –comenzandocon elbienestar de la futura madreantesdequedar embarazada- fortalece eldesarrollo de sistemasbiológicos que permitirán a los niñoscrecer yser adultos sanos. Laciencia deldesarrollo infantil ahoranos ayuda a vereldesarrollo saludable como cadena causal; laspolíticas yprogramas tanto delsectorpúblico comoprivado afectanlas capacidades de los cuidadores y comunidades para fortalecer las tresbases de un desarrollo saludable: relaciones responsables y estables;entornos de apoyo seguros; yuna nutrición apropiada. Estasbasesprincipales, asuvez,desencadenan adaptaciones fisiológicas o alteraciones que influyena lo largo de la vida en aspectostales comola salud,el aprendizaje yel comportamiento. La comprensión de cómo cada eslabóndeesta cadena afectaalos demáspuede proporcionar unmarcocientífico parala tomade decisiones en políticas,sistemasy prácticasque apoyan eldesarrollo saludable de todos los niños pequeños ysus familias. Una serie deresúmenes breves de los principales hallazgos de las publicaciones científicas recientes ylas presentaciones realizadas porelCentro de Desarrollo Infantil de la Universidad de Harvard. UnMarcoparaReconceptualizarlasPolíticasyProgramasdelaPrimeraInfanciaparafortalecerlasaludDuradera Políticas yProgramas Palancasparala Innovación SalúdPública CuidadoInfantil yEducación Temprana Bienestar Infantil Intervención Temprana Estabilidad Económica Familiar DesarrolloComunitario SaludPrimaria AccionesdelSectorPrivado Capacidadesdel CuidadorylaComunidad TiempoyCompromiso Recursos Financieros, Psicológicos eInstitucionales Conocimientos yHabilidades Principiosde laSalud Relacionesresponsables yestables Entornosdeapoyo seguros Nutrición Adecuada Biología de laSalud Adaptaciones fisiológicaso alteraciones ●Acumuladasalo largodeltiempo ●Incluidas durante periodos sensibles Lasaludyel Desarrolloa travésdelas EtapasdeVida Preconcepción Prenatal Primera Infancia Infancia Media Adolescencia Adultez 1234 Localizaciones Trabajo Programas Vecindario Hogar 1 – El estréstóxicocausadoporla adversidadsignificativa puedeproduciralteracionesfisiológicasquesocavanel desarrollodelsistemaderespuestaal estrésdel cuerpoy afectanlaarquitecturadel cerebroen desarrollo,ademásdelsistemacardiovascular,el sistemainmunológicoy loscontrolesreguladores metabólicos. – Estostrastornosfisiológicospuedenpersistirhastabien entradalaedad adultay conllevardañosdiversospara todala vida,tantoen la saludfísicacomomental. Labiologíadelasaludexplicacómolasexperiencias e influenciasambientalesse integrane interactúan con predisponentesgenéticos,que a suvezda lugara adaptacioneso interrupcionesfisiológicasquetienen efectosde porvidaenel aprendizaje,el comportamiento y elbienestartantofísicocomomental.Losavancesen laneurociencia,labiologíamoleculary la genómicahan convergidoen tres conclusionesimportantes: – Lasprimerasexperienciasse construyenen nuestro cuerpos,creando“recuerdos”biológicos quedan formaa nuestrodesarrollo,para bieno paramal.
  • Para mayorinformación,consulte“TheFoundationsofLifelong Health Are Built in Early Childhood”yla serie de Documentosde TrabajodelCentro de DesarrolloInfantildela Universidadde Harvard. www.developingchild.harvard.edu/library/ Centeron theDevelopingChild HARVARD UNIVERSITY www.developingchild.harvard.edu ALSO IN THIS SERIES: INBRIEF: The Science of Early Childhood Development INBRIEF: The Impact of Early Adversity on Brain Development INBRIEF: Early Childhood Program Effectiveness Los principiosde lasaludestablecenun marco dentrodelcualse nutrenlasraícestempranasdel bienestarfísicoy mental. •Un entornoestabley sensiblede relaciones,loque proporcionaa losniñospequeñosunainteraccióncon losadultosconsistente,protectoray cultivadoraque incrementasu aprendizajey lespermitedesarrollar capacidadesadaptativasqueles permitapromover unasistemaderespuestaal estrésbienregulado; •Entornosfísicos,químicosyartificialessegurosy colaborativos,queproveanlugaresinfantileslibresde toxinasy delmiedo,quepermitanuna exploración activaysegura,y queofrezcaa familiasconniños pequeñoslasoportunidadesdeejercitary conseguir redessociales;y •Nutriciónsanay apropiada,queincluyala ingestade alimentosque promuevanla saludy buenoshábitos alimentarios,comenzandoconelmanejodel estado nutricionalpre-concepcionalde la futuramadre. Capacidadesdelcuidadory de lacomunidad para promoverla saludy prevenir enfermedades y discapacidadesreferidosa la habilidaddelos miembrosdefamilia,el equipode programasinfantiles,el vecindario,lasasociacionesvoluntariasylos lugaresde trabajodelospadrespara ayudary fortalecerlasbases dela saludinfantil.Estascapacidadespuedenser agrupadasentrescategorías: •Compromisoy tiempo,queincluyela naturalezay la calidaddeltiempoqueloscuidadoresempleanen los niñosy en susintereses,asícomola formaenque las comunidadesasignany aceptanlaresponsabilidadde supervisarla saluddel niñoy losobjetivosde desarrollo,yaprobartantocomoaplicarleyesy regulacionesque afectanel bienestardelniño; •Recursosfinancieros,psicológicose institucionales,lo 2 3 •Conocimientoy habilidades,queincluyeel nivelde instruccióndeloscuidadores,suentrenamiento,su interacciónconprofesionalesrelacionadosalcuidado deniños,y suexperienciapersonal,ademásde las capacidadesde lasociedadparaconstruirsistemas quetrabajenen beneficiode susniñosy familias. Políticasyprogramasdel sectorpúblicoy privado puedenfortalecerlasbasesdelasaludmediantela mejorade lascapacidadesdelos cuidadoresy de la sociedaden losmúltiplescontextosenquese desarrollanlosniños.Políticasrelevantesincluyen accioneslegislativasy administrativasqueafectana la saludpública,cuidadoinfantilyeducacióntemprana, proteccióndelainfancia,intervencióntemprana, estabilidadeconómicafamiliar,desarrollocomunitario, vivienda,protecciónambientaly atenciónprimariade salud.En resumen,cualquierpolíticaqueafectalas vidas delosniñosy lasfamiliaspuedeservistocomouna oportunidadpara mejorarlosresultadosdesaludpara todala vidaennuestrasociedad.El sectorprivado tambiénpuededesempeñarun papelimportanteen el fortalecimientode lascapacidadesde lasfamiliaspara criarniñossanosycompetentes,enparticulara través delaspolíticasde apoyoeneltrabajo. 4 queincluyelascapacidadesde loscuidadorespara comprarbienesy servicios,susaludfísicay mental,y sushabilidadesde crianza,así comoladisponibilidad deservicioscomunitariosy organizacionesque promuevaneldesarrollosaludableinfantily estructuras desoporte,talescomoparques,centrosde cuidado infantil,escuelasy programaspost-escuela;y IMPLICANCIAS POLÍTICAS •Lasactualespolíticasde promocióndela saludy prevenciónde enfermedadesenfocadasen losadultosresultarían más eficacessi tambiénse realizaraninversionesbasadasenla evidenciaparafortalecerlas basesde la saluden los periodosprenataly primerainfancia.Por ejemplo,las medidasparala reduccióndela obesidadorientadasa modificarcomportamientosenadultosy adolescentestendríanmás éxitosi se coordinaranconprogramasde apoyo a la nutriciónadecuaday unmejoraccesoa alimentosnutritivosengestantes,reciénnacidose infantes. • Reduccionessignificativasdeenfermedadescrónicaspodríanalcanzarsedurantela vidamediantela reducciónde experienciasadversastantoen númerocomoen suseveridadqueamenazanel bienestarde los niñospequeñosy medianteelfortalecimientodelas relacionesde protecciónqueayudana mitigar los efectosnocivosdelestréstóxico. •La promocióneficazde la saludy prevenciónde enfermedadesdependendemás queel simple accesoa una atenciónmédicade calidad.Un amplio rangode sistemasde serviciopodríanmejorarsusresultadosen forma significativamediantela aplicacióndeun entendimientocientíficounificadoacercadelos orígenesde la salud, aprendizajey comportamientoinfantilesa travésde múltiplessectores.Enotraspalabras,las agenciasde bienestar infantilpodríanayudara prevenir problemasde saludfísica ymentaladultos,y no soloproporcionarprotecciónde la infanciainmediata.Políticasde zonificacióny desarrollourbanopodríanfacilitarla mejorade la saludpública(yla reducciónde los costosde salud),y no sologenerarbeneficioscomerciales.Cuidadostempranosy programas educativosde alta calidadcapacesde protegeryaliviarlosefectosdelestréstóxicoexcesivoenetapasinfantiles puedenpromoverla saludy prevenirla enfermedad,ynosólopreparara losniñosparateneréxitoenla escuela. Losautores agradecen los aportes delCentro para Mejores Prácticas de la Asociación Nacional de Gobernadores yla Conferencia Nacional de Legislaturas Estatales. Traducciónnoautorizadasoloparafinesdidácticos.DiegoBedónAscurra
  • 1The biology of health explains how experiences and environmental influences “get under the skin” and interact with genetic predispositions, which then result in physiological adaptations or disruptions that affect lifelong outcomes in learning, behavior, and both physical and mental well-being. Advances in neuroscience, molecular biology, and genomics have converged on three compelling conclusions: l Early experiences are built into our bodies, creating biological “memories” that shape development, for better or for worse. l Toxic stress caused by significant adversity can produce physiological disruptions that undermine the development of the body’s stress response systems and affect the architecture of the developing brain, the cardiovascular system, the immune system, and metabolic regulatory controls. l These physiological disruptions can persist far into adulthood and lead to lifelong impairments in both physical and mental health. i n b r i e f | T h e F o u n d at i o n s o f L i fel o n g Healt h A vital and productive society with a prosperous and sustainable future is built on a foundation of healthy child development. Positive early experiences provide a foundation for sturdy brain architecture and a broad range of skills and learning capacities. Health in the earliest years—beginning with the future mother’s well- being before she becomes pregnant—strengthens developing biological systems that enable children to thrive and grow up to be healthy adults. The science of child development now helps us to see healthy development as a causal chain—policies and programs across the public and private sectors affect the capacities of caregivers and communities to strengthen three foundations of healthy development: stable, responsive relationships; safe, supportive environments; and appropriate nutrition. These foundations, in turn, trigger physiological adaptations or disruptions that influence lifelong outcomes in health, learning, and behavior. Understanding how each link in this chain affects the others can provide a science-based framework for decisions about policies, systems, and practices that support the healthy development of all young children and their families. A Framework for Reconceptualizing Early Childhood Policies and Programs to Strengthen Lifelong Health A series of brief summaries of essential findings from recent scientific publications and presentations by the Center on the Developing Child at Harvard University.
  • 2The foundations of health establish a context within which the early roots of physical and mental well-being are nourished. These include l A stable and responsive environment of relationships, which provides young children with consistent, nurturing, and protective interactions with adults that enhance their learning and help them develop adaptive capacities that promote well- regulated stress response systems; l Safe and supportive physical, chemical, and built environments, which provide places for children that are free from toxins and fear, allow active, safe exploration, and offer families raising young children opportunities to exercise and make social connections; and l Sound and appropriate nutrition, which includes health-promoting food intake and eating habits, beginning with the future mother’s pre-conception nutritional status. 3Caregiver and community capacities to promote health and prevent disease and disability refers to the ability of family members, early childhood program staff, neighborhoods, voluntary associations, and the parents’ workplaces to support and strengthen the foundations of child health. These capacities can be grouped into three categories: l Time and commitment, which includes the nature and quality of time caregivers spend with children and on their behalf, as well as how communities assign and accept responsibility for monitoring child health and developmental outcomes and pass and enforce legislation and regulations that affect child well-being; l Financial, psychological, and institutional resources, which includes caregivers’ ability to purchase goods and services, their physical and mental health, and their child-rearing skills, as well as the availability of community services and organizations that promote children’s healthy development and supportive structures, such as parks, child care facilities, schools, and after-school programs; and l Skills and knowledge, which includes caregivers’ education, training, interactions with child-related professionals, and personal experiences, plus the political and organizational capabilities of communities to build systems that work for children and families. 4Public and private sector policies and programs can strengthen the foundations of health by enhancing the capacities of caregivers and communities in the multiple settings in which children develop. Relevant policies include legislative and administrative actions that affect public health, child care and early education, child welfare, early intervention, family economic stability, community development, housing, environmental protection, and primary health care. In short, nearly any policy that touches the lives of children and families can be seen as an opportunity to improve lifelong health outcomes in our communities and states. The private sector can also play an important role in strengthening the capacities of families to raise healthy and competent children, particularly through supportive workplace policies. ___________________________________________ For more information, see “The Foundations of Lifelong Health Are Built in Early Childhood” and the Working Paper series from the Center on the Developing Child at Harvard University. www.developingchild.harvard.edu/library/ POLICY IMPLICATIONS l Current health promotion and disease prevention policies focused on adults would be more effective if evidence-based investments were also made to strengthen the foundations of health in the prenatal and early childhood periods. For example, obesity-reduction measures focused on changing adult and adolescent behaviors would be more successful if they were coordinated with programs supporting appropriate nutrition and better access to nutritious foods for pregnant mothers, infants, and toddlers. l Significant reductions in chronic disease could be achieved across the life course by decreasing the number and severity of adverse experiences that threaten the well-being of young children and by strengthening the protective relationships that help mitigate the harmful effects of toxic stress. l Effective health promotion and disease prevention depend on more than access to high-quality medical care. A wide range of service systems could improve outcomes significantly by applying a unified scientific understanding of the early childhood origins of health, learning, and behavior across multiple sectors. In other words, child welfare agencies could help prevent adult physical and mental health impairments, not just provide immediate child protection. Zoning and land-development policies could facilitate improved population health (and reduced health care costs), not just generate commercial profit. High-quality early care and education programs that buffer young children from excessive stress could promote health and prevent disease, not just prepare the children to succeed in school. ALSO IN THIS SERIES: InBrief: The Science of Early Childhood Development InBrief: The Impact of Early Adversity on Brain Development InBrief: Early Childhood Program Effectivenesswww.developingchild.harvard.edu The authors gratefully acknowledge the contributions of the National Governors Association Center for Best Practices and the National Conference of State Legislatures.