Securing America's Legacy: The First 1,000 Days
It’s time to invest in the nation’s Gross Developmental Potential
The first 1,000 days of life determine a child's future. For today’s American children, that future is more likely to include asthma, depression, and an early death than two decades ago in this country and more likely than among children in other wealthy nations.
Just as the energy that powers our homes and cities must be converted from the silent and unassuming gravitational potential of water flowing from a mountaintop, the nation’s future GDP and wellbeing flows from children’s Gross Developmental Potential - our strategic social, intellectual and economic reservoir. Neglecting children’s well-being will only guarantee that one day, the engine of America’s society sputters and stalls.
Dream-like time with Kai
Last weekend I spent time with my grandson at Umoja Festival, our neighborhood’s decades-long celebration of unity. There, I was keenly aware of his sponge-like silent and unassuming human development. I watched him navigate the festival crowd, his eyes tracking movement, his rhythms mirroring the music. As he soaked in his surroundings, his growing awareness, physical abilities, language, and curiosity held me in awe.
Stepping back from my time with Kai, I wish that every child could grow nourished in the rich soil of family, community, affirmation, and play. But the day’s joy was juxtaposed with somber data.
A Somber Awakening
That evening, I chanced upon a recent JAMA article titled, Trends in U.S. Children’s Mortality, Chronic Conditions, Obesity, Functional Status, and Symptoms. Pediatrician Christopher Forrest, the study’s lead investigator, found a generalized decline in US children’s health during the past two decades. Drawing from eight data sources, the study judiciously surveyed 170 unique health indicators. In an interview with Meghna Chakrabarti, Dr. Forrest said, “This represents a widespread languishing of children across the nation... a generalized decline in the nation's ecosystem [for raising healthy children].” Study findings, included:
Mortality Crisis: American children were 80% more likely to die than their peers in other high-income nations. Every day, 54 children die in the U.S. who would have likely survived if they were in other OECD nations.
Chronic Disease Epidemic: A U.S. child in 2023 was 15% to 20% more likely to have a chronic condition, such as anxiety, depression, or sleep apnea than a child in 2011.
Struggling from the start: In the US unborn children are 2.2 times as likely to die in utero and infants 1.8x as likely not to see their first birthday.
Forrest concluded, “I think people care about their kids … We don’t have a society that’s structured to support all children.” My sadness deepened.
These devastating trends are not random; they are the direct result of neglecting the most critical window in human life.
The Scientific Case for the First 1,000 Days
The period from conception to a child's second birthday, often termed "the first 1,000 days," represents the most significant phase of human development. Scientific consensus, sometimes called the Developmental Origins of Health and Disease (DOHaD) hypothesis, establishes that the environmental conditions experienced during this time profoundly influence an individual's lifetime trajectory.
-feel free to skip this section if you feel that science sometimes explains at the “particle level” what ancestral wisdom has known-
Both prenatal and postnatal exposures and experiences in early life program physiological and cognitive outcomes. They set the stage for future risk of chronic conditions, including metabolic disorders, cardiovascular disease, respiratory illness, and neurodevelopmental challenges.
The inputs and outcomes represent a complex web of interconnected factors, rarely showing simple one-to-one correlations.
Where I live, in Seattle, multiple University of Washington (UW) departments including the Department of Environmental & Occupational Health Sciences (DEOHS) and the Northwest Pediatric Environmental Health Specialty Unit (PEHSU) together paint a more comprehensive picture. For example:
Recent UW I-LABS research has demonstrated that neural synchrony between a mother and infant during face-to-face interaction strongly predicts a child's language development at 15 months of age.
A landmark publication in Social Psychiatry and Psychiatric Epidemiology by a multi-site Environmental influences on Child Health Outcomes (ECHO) study provided compelling evidence for the intergenerational transmission of stress. The study examined stressors from two critical periods in a mother's life: her own childhood and during her pregnancy.
Relying on ECHO data, PEHSU researchers found that inhaled pollutants (e.g. PM2.5 and ozone) trigger inflammation in the airways and throughout the body. These irritants undermine not only a child’s physiology but also their behavioral and cognitive development.
The scientific signals align with prior wisdom.
A Historical Warning Against Self-Destruction
In 1854, after losing his congressional seat and largely out of the political spotlight, Abraham Lincoln marked his ascendent return to politics by reminding the nation of her “Ancient Faith.” In his Peoria speech he compelled the country to pivot away from the enslavement of fellow humans, stating, “America will never be destroyed from the outside. If we falter and lose our freedoms, it will be because we destroyed ourselves.”
Lincoln’s warning against self-destruction compels us to look for a unifying, constructive path forward. To keep from destroying ourselves, we cannot only play defense or repair what is broken; we must ambitiously pursue a positive goal. This requires a new national commitment and a structured plan to achieve it. One such approach, Collective Impact, has been well documented by co-framers John Kania and Mark Kramer across multiple journals.
In this piece, I center the goal (not the methodology): the nation must collectively focus on the first 1000 Days of all our children.
A Legacy of Collective Action: Lessons from the Past
We can do this. Building a nation where all children’s lives matter will require innovation and reinvention. Both are core American competencies.
While the American identity is often defined by individualism and capitalism, its history is also rich with powerful examples of proactive, collective action for the common good. Time and again, the nation has demonstrated a remarkable ability to look beyond immediate private interests and come together to build foundational systems that create enduring value for all citizens. For example:
The National Park System (NPS) - Starting with Yellowstone in 1872, represented a revolutionary vision that the nation’s spectacular natural wonders should be preserved for the perpetual benefit of all people.
The Internet - arguably the most transformative technology of the modern era, ARPANET began as a Department of Defense project to create a decentralized communications network that could withstand a nuclear attack. In the 1980s, the National Science Foundation built NSFNET on the ARPANET backbone, opening the system to the public and supporting commerce.
The Clean Air and Clean Water Acts - Like the health of today’s children, in the 1970s, industrial pollution was rampant, with rivers catching fire and smog choking cities. With these two acts congress established a positive national framework built on the assumption that a healthy environment is a matter of collective value.
Together, these and other ambitious projects illustrate a powerful, recurring theme: the nation is at its best when it acts with foresight and unity to address large-scale challenges and opportunities.
Here lies one of America's great contradictions: we are simultaneously the most innovative nation on earth and the most neglectful of our foundational investment. We engineer rockets that land themselves after journeying to space yet struggle to ensure babies land safely into their third year of life. We've connected every corner of the globe digitally while leaving our smallest citizens disconnected from opportunity.
Aligning investments with strategic goals requires national discipline.
Local Efforts and the Need for a National Strategy
Responding to the findings of countless former studies such as Dr. Forrest’s, state and local agencies (government and non-profit) across the country engage in thousands of important efforts to improve children’s wellbeing. A small sampling includes:
Pomona, California conducted Early Development Mapping of neighborhood-by-neighborhood data showing where children were struggling versus thriving revealed that household instability and lack of access to parks were key indicators. The city implemented strategies to address both conditions.
Cincinnati, Ohio addressed asthma and infant mortality by partnering with Legal Aid Society to achieve a 35% reduction in hospital admissions. Rather than simply prescribing more medicine, the intervention addressed housing conditions, mold, and cockroaches that trigger asthma.
In Seattle, kindergartners consistently enter school more prepared than their peers statewide—with readiness hovering near 70% compared to the state's 53%. The game-changer, Seattle Preschool Program (SPP) investments pay attention to the Social-emotional, motor skills, language and communication, cognitive, literacy, and math (numbers and patterns). Meeting WaKIDS standards in these domains as children enter kindergarten represent early indicators of whether students are likely to earn post-secondary credentials - a pathway to mastery, family and community flourishing.
But while these local initiatives produce valuable outcomes, they represent a paradox of their own: a) most are applied following the foundational window of the first 1,000, and b) in the absence of a national strategy, they represent a quilt-work of necessary solutions.
Conclusion
The quiet moments watching my grandson, Kai, underscored a profound truth: the most critical growth is often silent and unassuming. His development, like that of every child, represents the potential energy of our nation's future. Yet, as the data starkly shows, we are systematically failing to nurture this potential.
We are a nation obsessed with metrics—stock prices update by the second, sports statistics fill databases, social media engagement gets tracked to the microsecond. Yet when Dr. Forrest presents us with comprehensive data showing widespread child health decline, we can easily treat it like weather: notable, concerning, but ultimately beyond our control.
By marshaling the same spirit of unified, large-scale action that built our national parks and cleaned our rivers, we can—and must—prioritize the first 1,000 days of every child's life. It is the bedrock of our national strength and the core of our enduring legacy.