By Annette Min (COL ’17)

When is the right time to start pursuing a healthy life? Is there a specific time when a person should put down the candies and reach for the carrots? When acquiring language for the first time, there is something called the critical period, which is the period during which language must be learned and after which acquiring language becomes very difficult. For developing healthy life, however, it is uncommon to think that there is such a thing as the critical period. The attention we pay to our health seems to be never-ending; In fact, it begins even before we are born. Our life is very patterned and governed by our habits. Once they are set, it is hard to change the habits. Our habits during the early life can have tremendous effects on later life. Living healthy can also become a habit. It is why it is important to develop healthy habits early in life. There are some factors that make it easier for us to lead a healthy life while there are others that pull us away from healthy life. Proper nutrition, nurturing families, emotional well-being of mothers are just a few of the things that determine maternal, infant, child, and adult health [1].

For example, adults whose mothers had high level of stress hormones during pregnancy show greater dependence on nicotine [2]. Children of mothers who smoked during their pregnancy have greater probability to be obese at 21 years of age [3]. Sleeping less than 12 hours daily during infancy increases the risk of being overweight in pre-school aged children [4]. Children of parents who have substance-abuse problems are more likely to become substance-abusers themselves [5].

Underlying all these factors are also the social determinants such as access to health care and economic status. Caring about health is not just about physical health anymore. I agree with Dr. Dhruv Khullar that the U.S. health care system should allocate more resources for social support [6]. The U.S. ranks highest among Organization for Economic Co-operation and Development (OECD) countries in healthcare spending, but ranks the lowest in key health indicators. In 2014, the U.S. spent almost 18 percent of the gross domestic product (GDP) on healthcare—one trillion dollars more than Netherlands, which is ranked the second highest [8]. Some of the things that cause the U.S. to spend so much more on health care than other developed countries are improved health care technologies and high prices of health care providers. Compared with another OECD country, U.S. delivers more mammograms, MRI scans, and more C-sections. Greater availability means greater access for Americans, but it also means greater cost [8]. Using these technologies involve more capital, more labor, and more expenses for spreading the knowledge [9]. Of course, new technologies can lead to a lot of benefits, but the problem comes from an inappropriate overuse of these technologies. A higher price for the services of specialist physicians is also a factor [8]. Compared with other countries, the fees of specialist physicians are two to three times higher. Adding to this is the general misconception that a more expensive care is the better care. Many ways have been suggested to reduce the health care costs. Greater access to primary care can reduce hospital use while preserving quality [10]. Overuse of new technologies can be reduced through well-informed patients and physicians making decisions together. Another study that presented what might be the most effective way to reduce the health care cost in regards to Dr. Khullar’s claim. This study examined the relationship among health service expenditures and social service expenditures and five health outcomes [7] In order to make sure the money the country spends is indeed well-spent, it is necessary to expand the scope of health care to social services including “income supplements, housing, unemployment coverage and other social policy targets” [7]. Furthermore, this study examined the ratio of social expenditures to health expenditures and its effect on the health outcomes. This ratio in U.S. is significantly lower than the OECD average. According to the study, the social expenditures adjusted for GDP per capita were significantly associated with better health outcomes in higher number of indicators than the health expenditures adjusted for GDP. Raising the ratio of social expenditures to health expenditures, could lead to better health outcomes.

As shown in the beginning of this article, personal decisions can affect not just our present being but also our future and our descendants. Lack of resources and suitable environment can have negative impacts on our health, and this could last for generations. It is necessary to reform the health care spending to improve social policies. It is also important to educate people about the impact of their decisions and to screen socioeconomic backgrounds in addition to health backgrounds in children early so that the pattern can be broken.




[1] Office of Disease Prevention and Health Promotion. Maternal, infant, and child            health. Retrieved from           objectives/topic/maternal-infant-and-child-health#seven


[2] Stroud, L. R., Papandonatos, G. D., Shenassa, E., Rodriguez, D., Niaura, R., LeWinn, K. Z., … Buka, S. L. (2014). Prenatal glucocorticoids and maternal smoking        during preganancy independently program adult nicotine dependence in daughters:             A 40-year prospective study. Biological Psychiatry, 75(1), 47-55.


[3] Mamun, A. A., O’Callaghan, M., Williams, G. M., Najman, J. M. (2012). Maternal     smoking during pregnancy predicts adult offspring cardiovascular risk factors –   Evidence from a community-based large birth cohort study. PLos ONE, 7(7),         e41106.


[4] Taveras, E.M., Rifas-Shiman, S. L., Oken, E., Gunderson, E. P., Gillman, M. W.          (2008). Short sleep duration in infancy and risk of childhood overweight.     Archives of Pediatrics & Adolescent Medicine, 162(4), 305-311.


[5] Kumpfer, K. L. (1999). Outcome measures of interventions in the study of children of            substance-abusing parents. Pediatrics, 103(5 Pt 2), 1128-44. Retrieved from


[6] Khullar, Dhruv. (2015, Jan. 29). Intergenerational health: How parents and       grandparents influence our risk of mental illness, substance abuse, and other    disorders. Slate. Retrieved from            rgenerational_health_disparities_parents_influence_mental_illness_and.html


[7] Bradley, E. H., Elkins, B. R., Herrin, J., Elbel, B. (2011). Health and social services      expenditures: Associations with health outcomes. BMJ Quality & Safety, 20(10),             826-31. http://10.1136/bmjqs.2010.048363


[8] Fuchs, V. R. (2014, Jul. 23). Why do other rich nations spend so much less on             healthcare? The Atlantic. Retrieved from     spend-so-much-less-on-healthcare/374576/


[9] Bodenheimer, T. (2005). High and rising health care costs. Part 2: Technologic innovation. Annals of Internal Medicine, 142(10), 932-937. Retrieved from


[10] Bodenheimer, T., Fernandez, A. (2005). High and rising health care costs. Part 4:       Can costs be controlled while preserving quality? Annals of Internal Medicine,       143(1), 26-31. Retrieved from

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