Continued discussion: intersection of kids, tech, and well-being

About three months ago, Facebook rolled out a controversial mobile messenger app for kids. The app, which targets children aged 6-13 years, allows users to send texts online after connecting with a parent’s Facebook account. Its key features include sending pictures, edited pictures (think colorful drawings transposed over selfies, etcetera), videos, and emojis, all without the usual clutter of advertisements.

While Facebook argues their new novelty encourages kids to connect rather than spend time on passive mobile applications like games, health experts say the young children Messenger Kids targets are just beginning to grasp written communication and are developmentally unprepared for the app’s interactions. Facebook further claims kids increased involvement with technology in this modern age is inevitable, so parents might as well embrace platforms like Messenger Kids, which requires their consent and doesn’t subject young users to harmful advertisements. On the other hand, health experts ask if Facebook is truly acting in the best interest of children, or just trying to exploit parents’ loyalty to their platform while hooking kids early on.

At the core of this debate is the question of how young is too young for kids to begin using and relying on digital communication. It is reminiscent of the Fitbit for kids case covered in February: are children too young to be wearing health-tracking devices? As new technology like these challenge traditional notions of childhood, it’s no wonder parents and pediatric specialists alike are divided.

Reflecting on our article from two weeks ago, too, regarding the adverse happiness effects of increased screen time on teens, Messenger Kids critics’ can add another layer to their argument. In light of Twenge et. al.’s research, it’s hard to see how Facebook’s new app could improve health.  The app gives young children yet another reason to use a screened device, setting them up for more phone dependency as they enter adolescence. Even if we say that increased social media time reduces  happiness, and not messaging apps or screens themselves, this point only goes so far when considering Messenger Kids as a gateway for younger users until they reach Facebook’s minimum required age for an account. Facebook guidelines state users should be 13, conveniently right at the recommended age cap for Messenger Kids users. If Messenger Kids preps users to join the Facebook community as soon as they are 13, then the introduction of the app would in fact increase social media time (thus reducing happiness, according to Twenge et. al.). As early as age 6, Messenger Kids ropes children into social media.

Another argument could be made for the better health outcomes associated with kids being more communicative with their parents and friends. Yet digital communication can only go so far. This point has no more validity than one that notes greater ease of texting could lead to fewer genuine interactions. More research on the topic is necessary to stake such claims.

Finally, Facebook’s defense that they are offering a connective, active app in contrast to other “passive” options does nothing to actually reduce time spent in front of the screen. Perhaps the answer to passive mobile applications is not an “active” app like Messenger Kids, but rather encouraging non-screen activities. Viewing all technology adoption as “inevitable” is a rather unproductive stance. If a new app for children could lead to decreased happiness down the line, potentially compromising mental health, it is insufficient to stand by idly, saying it’s the lesser of two evils. We encourage parents who do use this app for their kids to explore other options out there, encouraging positive, non-digital interaction. After all, with regard to the collective behavior we noted two weeks ago, the app is only as good as its popularity.

Interested in Behavioral Economics and Health?

The decision making of children, parents, and families can have a profound impact on the trajectory of an individual’s life. Understanding these behaviors can help change the way we think about and address the challenges that plague our healthcare system. How do people behave when it comes to making decisions about their health, and why do they behave a certain way? Are certain behaviors modifiable, and if so, what can we do to change them? If these are questions that you find interesting, check out the reading list below!

A New York Times best-selling author and professor, Dan Ariely explores the hidden yet foreseeable “forces that shape our decisions” in his book Predictably Irrational. Using common insights and experiments from his classroom, Ariely narrates each chapter with a question on how behaviors are often influenced, ranging from “The Power of Price: Why a 50-Cent Aspirin Can Do What a Penny Aspirin Can't” to “The Problem of Procrastination and Self-Control: Why We Can't Make Ourselves Do What We Want to Do”. This book may provide insight into motivation and behavior--for instance, why is it difficult for a child to take their medicine or exercise consistently? Watch an animated synopsis of the book here.

  • Nudge by Richard Thaler, Cass Sunstein

Nudge offers an individual and systemic look on daily decision-making, poor choices, and how this affects health outcomes and overall wellbeing. Nudge specifically focuses on how people can make easier choices if “choice architecture,” or the options given to people, is engineered with careful thought and precision. If you’re interested in large-scale behavior modification--for instance, how people can be “nudged” to purchase healthy food options at a grocery store--this book may be of interest to you! Watch a quick visual summary of the book here.

Daniel Kahneman, a Nobel Prize winner in economics, uses his research to explain cognitive biases, prospect theory, and happiness in his book Thinking, Fast and Slow. He describes two types of thinking through the lens of his academic research: “System 1”, which is quick and intuitive, and “System 2”, which is slower yet more logical. Kahneman’s writing allows readers to recognize their own miscalculations in decision-making, and how common errors in human judgment can explain much of the world. If you are seeking to understand how people frame their thoughts and biases, such as with self-esteem or self-image, you may find this book interesting!

"Would requiring everyone to buy health insurance make us better off?"

“Why would giving consumers lots of choices in their health care plans be a bad idea?”

Author Douglas E. Hough discusses these hard-hitting topics, amongst others, in his book Irrationality in Health Care. Using a behavioral economics perspective, Dr. Hough considers why the U.S. spends so much on healthcare yet lags in health outcomes compared to other nations. With CHIP being reauthorized for another 6 years, this book may provide insight into why certain healthcare policies are important to implement, especially when it comes to children’s health. Watch a crash course of this book’s topic here.


Look out for an impending book review soon!

On Screen Time, Health, and Collective Behavior

Continuing in the spirit of exploring the heath-technology intersection we wrote about two weeks ago, researchers at San Diego State University recently found that teenagers who spend more time on screen devices are less happy than their less-screen-time counterparts. Specifically, non-screen activities like sports, reading, and face-to-face interaction were more common among those who spent little time on their phones and TVs. Psychologist Jean M. Twenge and her colleagues further remarked their confidence that screens were causing unhappiness, not the other way around, evidenced by a growing body of literature on the topic.

The next logical question for Twenge et. al.’s “Monitoring the Future” longitudinal study would  look into possible explanations for the screen-time and unhappiness correlation. Perhaps it could be a lack of satisfaction with digital interaction, or the even negative impacts of social media—it doesn’t take a scientist to know the dangers of constant self-comparison to peers’ Instagram images. Maybe it’s something simpler: for example, the more time spent in front of the TV —even if it’s not a happiness-drain—the less time to spend on other activities that are more positively correlated with happiness. Either way, the findings certainly have implications for the mental well-being of teens. Adolescence is already a time of inner turmoil as the body goes through puberty and fluctuating hormones. This new research suggests screens could inflate these effects.

But what’s the deal with differential screen usage? Why do some teens use screens more than others?

A theory arising from observing many platforms is that networks behind screens thrive when more people are using them. For example, having a cell phone with a messenger app is useless unless other people also have a cell phone with the same app. The same goes for nearly all social media and remote gaming platforms. To some degree, the same logic also follows with TV shows or YouTube videos. If other people have watched the newest episode of, say, The Bachelor on a Monday night, it adds to an individual’s value of watching the show; they can now participate in Tuesday-morning conversation.

In other words, an increase in people using screens encourages even more people to join them as the value of doing so increases. Likewise, if fewer people use it, the value of screens decreases. A teenager may be swayed to spend as much time in front screen as her friends, and different friend groups could have different norms of screen time.

Twenge et. al.’s study found that the happiness-optimal level was an hour or less in front of screens. Their work begs the question: how can other teens have incentives to reduce TV time to this peak-happiness amount?

Maybe a change in group mentality can help reach a healthier equilibrium. Teens could find value in non-screen activities and collectively, perhaps without much thought at all, hold themselves accountable to limited digital interaction so as to maximize happiness. These are speculations, but nonetheless, asking what drives teens to use screens is imperative following studies like “Monitoring the Future.”

A Different Kind of Gap: Poverty, Income, and Health

You are walking to work Tuesday morning, and as you pass a bustling intersection, you see a Mercedes Benz parked in front of a three-story clothing department store. You pass the intersection and can’t help but notice, the next street down is a community health center, a major player in providing healthcare to the underserved, with a short line of families and children waiting to go in. You find the juxtaposition of the scene to be intriguing for a moment, but your mind soon wanders.

These moments are something most individuals have witnessed in urban, suburban, or rural America without a second thought, especially when income inequality has been growing between upper-income and lower-income sectors of society for years. Such large wealth gaps may not initially seem to have a strict effect on health other than apparent gaps in medical care--however, socioeconomic differences and poverty can affect the behavior of individuals and the decisions they make. More specifically, poverty can have very real effects on the cognitive functioning and development of young children.

Our body generates the “fight or flight” response when we live through what our mind identifies as threatening situations. Our heart rate increases, we start working up a sweat, and our breathing gets faster. When people live under poverty, this stress response is ongoing, affecting the allocation of mental resources for what is important in the moment and what isn’t a priority, ultimately affecting how people think, their choices, and the outcomes of those choices.

For children’s developing brains, the response can be even more harmful. For instance, children living in poverty were correlated with having a smaller hippocampus region, which plays an important role in memory formation. One study even noted how certain brain regions specific to language and executive functioning, such as problem-solving or controlling emotions, were more prominent for children of higher-income backgrounds than lower-income backgrounds. With 21% of American children living in poverty, such forthcoming scientific evidence matters in how we target such problems.

Despite the growing body of research detailing the stark differences in the brains of children with different income backgrounds, there is promise for the future. More healthcare professionals, economists, and researchers are studying how poverty’s harmful effects on the brain can be reversed or mediated. Some scientists are even tackling the issue head on, by looking at how boosts in income can potentially improve children’s brain development. If we want to address poverty and income inequality, policymakers should not only pay attention to the income gap, but also its impact on the health of our nation’s children.

Fitbit for kids? Reservations amidst potential new health motivations

Health technology is an advancing market as the trend of tracking daily eating and exercise flourishes. Countless mobile apps exist to monitor running mileage, steps, heart rate, calories, and sleep cycle—a list which is by no means exhaustive. Moreover, wearable devices like those created by Fitbit aim to give consumers the health data they want without the inconvenience of carrying a phone everywhere. After seeing success among young adults, Bloomberg reported just last month that the fitness tracking company is looking to develop a wristband for kids. Fitbit guidelines currently suggest users be 13 years or older, so the market for this new device would likely be those 12 and under.

The idea is indeed an exciting prospect for children’s health. Just as the product has incentivized thousands of its young adult consumers to live more active lifestyles, it could do the same for kids. After all, younger generations love tech, but unfortunately most electronics—television, video games, computer time— encourage us to be sedentary. A smartwatch like the Fitbit could change that. For example, since getting Fitbits, my mom and sister have friendly competitions over who can get the most steps in a given day or week. They’re not alone in their game—Fitbit has a built in “challenge” function just for this purpose. Maybe challenges can start at a younger age, getting kids eager for active games rather than competing on couches with headsets via Xbox live. This new tech could potentially appeal to a wider range of children, including those who may not be into traditional sports.

While all of that sounds promising, it’s also important to consider the slippery slope health monitoring can follow. Data can be helpful, but it should not hijack our motivations.. In a society that continues to value health numbers, we’ve seen it get to a point of overvalue, where we face problems like excess stress and even eating disorders. If kids are exercising only for a number, not for fun, the Fitbit could take all the enjoyment out of recess and free time - a counterproductive consequence. Devices like Fitbits might also unintentionally act as indicators for  whose family can or cannot afford such devices, which raises questions of what health means in this era.  Health should not depend on someone’s ability to buy a wearable tracking device.

A Fitbit designed for kids could have the power to keep young people educated about health from an early age. This is a goal everyone can get behind. However, it also demands that we consider our reliance on health data. These points should be kept in mind and kept in check as health technology further modernizes.

As Flu Season Continues, Symptoms to Look Out For

Many news outlets are reporting that this year’s flu season is one of the worst in recent years. It is widespread and has tragically proven fatal for dozens of children. Those of us in CHIL who work at children’s hospitals have definitely seen emergency departments swell with flu patients the past few weeks, and doctors warn that the flu may remain a major problem for some time.


Since 2018, it may seem difficult to believe that the flu could still be so lethal. However, it is true that children, especially ones who already have chronic health conditions, are at risk. Media outlets like the New York Times have assembled lists of symptoms to look out for in children that could signal the need to seek medical care right away. The most common causes of complications from the flu include pneumonia, sepsis, and dehydration. Warning signs that a child may need immediate medical attention include: a fever that goes away only to return, confusion, extreme pain, severe vomiting, and a tinted blue color to the skin.


Of course, most cases of the flu are less serious than these, and healthy children can usually get over them with medication, proper rest, and hydration. However, the article says that some doctors still recommend the flu vaccine at this point, since there are at least “several weeks” left in the season.


The article in the New York Times referenced here gives important information, but what was also insightful was the comment section for this piece. Quite a few comments touched on some several themes, including the importance of vaccination (and the consequences of refusing it for a child), as well as socioeconomic factors that may increase a child’s risk factors for severe flu. However, many readers agreed with the theme of the article — we need to balance finding prompt care for sick children while avoiding overcrowded emergency rooms. If emergency rooms are overwhelmed, less timely care is available for everyone. Questions that remain unanswered by this sort of advice should probably be directed to a child’s pediatrician or primary care provider.  




Mental Health and Social Good: A Partnership?

This week, we would like to continue our focus on discussing ways to actively improve our mindsets and mental health overall. A recent post in NPR discusses a new psychology study that suggests that teenagers benefit from a confidence boost if they help strangers or volunteer. While helping a friend or family member is obviously a positive experience, it is more difficult challenging, and maybe even intimidating, to help someone you do not know - and this is why teens can derive confidence boosts from helping others. Given the diversity of teens’ interests, it’s a wonderful thing that spending time helping strangers - even people one doesn’t meet - can happen in all facets of society.


Confidence boosts are always good, but teenagers today may benefit from them the most. Current research tells us that today’s teenagers live in challenging times — both socially and economically — and the numbers show it. The NPR article cites that “by the age of fourteen, 25% of teenage girls and 10% of boys struggle with depression.” Students of all ages seek out help for depression, anxiety, and other difficulties. The idea that they might help themselves and others at the same time by devoting time or energy to social good is wonderful.


Altruism has always had a somewhat broad definition, and the way today’s teenagers help others might look differently than the way their parents might envision it from their own experience. For example, teenagers can harness social media to spread awareness and raise funds for campaigns or causes they care about. Parents and teachers can introduce opportunities to get involved or answer questions about navigating ways students can positively contribute to society.


At CHIL, we are always trying to link health to many actors: children, parents, teachers, doctors, and officials all play a part in physical, mental, and social health. Linking children’s and teens’ mental well-being to social initiatives, and vice versa, could be very promising!


Last week was an exciting one for children’s health. After a harrowing few months of uncertainty over the fate of the Children’s Health Insurance Program (CHIP) — the very important federal children’s health insurance program which covers about 9 million children nationwide — Congress agreed to reauthorize CHIP for another six years. You can read about this fantastic news here at NPR.  


We will continue to monitor this big news to examine more closely what this means for children’s health and access in the immediate future. The past few months should have taught us that we should not take the program for granted. After all, the fact that CHIP — an “uncontroversial” program throughout its 20-year history — faced such an existential crisis is an indication of our current political climate. According to NPR, CHIP, which needs to be renewed every few years, was historically a bipartisan priority that legislators worked to renew far in advance. Researchers are still working on finding the impacts of children’s enrollment rates with CHIP within these months of uncertainty.


Some analysts say that extending CHIP for 10 years instead of six would save the federal government much more money, but this deal is still a solid one. Also, one analyst suggested that the national anxiety over CHIP might have brought more attention to it in the long run. More people can now be aware of the program and what it does (and possibly be encouraged to enroll), and more people can communicate to lawmakers about the importance of keeping the program alive. States can also start brainstorming safeguards for future use, just in case we are faced with a similar situation in the future. The role of states is especially important since CHIP is based on an architecture of shared responsibility between the states and the federal government.


CHIP is the sort of program that we may not have heard enough about if not for events such as the most recent budget crisis. It is, however, a very important source of health insurance for many American children. On his show, host Jimmy Kimmel explains a bit more about CHIL and its significance to his family. As we celebrate the most recent news, we should look ahead and start planning for CHIP’s future, so that we don’t repeat history.

Being Mindful: Coping with the Stresses of a Student’s Life

Students may face a different kind of stress compared to people who work. Before college, the school day ends at a certain time, but with homework, studying, and projects, there doesn’t really seem to be a definitive end to the school day. After high school, the division between the school day and the rest of the day blurs even further when there is always something we could be studying or reading for.


In this kind of environment, it can be easy to feel overwhelmed with work and stress. On top of that, students of all ages might feel competition among their friends, further complicating the school and social life balance. What are some tips for managing these stressors?


Get Organized. Juggling all our commitments in our head is unnecessarily stressful. There are many physical planners and productivity apps available to help us manage deadlines and test dates. Choosing one that works for you might take some time, but will definitely pay off in the long-run! The key is not to let the planner/organizer stress you out further. Each day can begin or end with a recap of things to do, and crossing off accomplished tasks can be really satisfying! Planners can also help you avoid overbooking yourself.


Get Help, If You Need. This could simply mean asking a friend or teacher for help on understanding a new concept covered in class. This could also mean asking a trusted adult or advisor for help navigating changes difficult to face alone: a parent, a doctor, or a teacher are all great starting points for questions about politics, gender and sexuality, or social phenomena we see everyday. The internet is full of information and can be a tempting go-to but it’s easy to get lost in a sea of opinions out there.


Breathe. This is meant both literally and figuratively - we need to relax! In our fast-paced lives, it takes effort and planning to do so. Taking a few minutes each day (such as signing up for the eMindful Challenge) to try some meditation techniques can help us clear our mental clutter, which can make facing the next task easier. If meditation isn’t for you, that’s okay - there are other ways to relax productively such as putting down your smartphone for at least a few minutes. Some of our friends use cooking, baking, exercising, reading, writing, just to name a few, as ways to decompress. The point is to challenge yourself to do something that you might continue to benefit from. For example, if you make a healthy snack now, it means you’re less likely to go grab fast food later. If you read a book by your favorite author now, you can remember it later and enjoy it then too.


Sarah is CHIL's lead blogger and currently a student at UPenn with plans to attend medical school in the future. To decompress, Sarah likes to go running or do crossword puzzles.

The Parent's Role Amid a Sea of Opinions

A few weeks ago, we wrote about the significance of the language we use when we talk with children about weight. The words that parents and doctors use can have a great impact on how children and teens think about, or perceive, their weight and overall health.


Recently, the New York Times published an article by a physician titled, “Do Parents Make Kids Fat?” This rather startling question can be thought of as an extreme example of the influence parents could have on their children’s weight and how they think about weight.


The first thing the article pointed out was the “tremendous stigma” we direct at parents of overweight children, whether we intend to or not. As Dr. Julie Lumeng at the University of Michigan, who was interviewed in the article, puts it, “‘Everyone looks at the parent and thinks: That parent is incompetent. They don’t care about their child. Why can’t they just make the child eat less and exercise?’”


These questions illustrate several assumptions people may easily make about parents of overweight children. For example, people may think that the parents do not care about their children’s health, or they simply lack the willpower to enforce healthy habits at home or read the nutrition information on the back of food packages.  However, we simply cannot make these assumptions without knowing the full story of a child’s health. This involves family history, health history, and degree of exposure to what doctors today call an “obesogenic” environment in which unhealthy fast food is more accessible and cheaper than healthy food made from scratch.


There are many different opinions out there about how to raise healthy children, and while there are general guidelines that indicate what healthy weight ranges may be, different families and children need different things. The physicians mentioned in the article, who even consult each other with questions, agree that a parent must trust their instinct when it comes to their child. Being mindful about the child’s environment can help with this instinct.


This is where our campaign with eMindful can be helpful - through increased awareness of our circumstances, we can make healthier decisions for ourselves and for our children.

Why I'm going to CHIL with the Mindful Daily

by Jess Jeavons

Very often, when I chat with a friend who is stressed, overwhelmed, unmoored, or overstimulated by everyday life, I recommend meditation. Meditation changes lives! Individuals who meditate are better able to live in the moment, manage stress, and find time to do the things they've been meaning to do, like eating healthy and exercising. In addition, meditation can improve physical health, including lowering blood pressure, reducing headache frequency, and decreasing risk for heart disease. 

But when it comes to meditating, I haven't been able to make it stick as a healthful habit in my own life. 2018 will be my year for meditation, and I'm starting with eMindful's 1% Challenge to meditate for 1% of each day for 30 days straight. 

Check back in here between now and the end of February, and we'll keep you updated on our progress. We would also love to hear from you! Let us know how you're doing with the challenge in the comments section below, email us at, and join us on Facebook, Twitter, and Instagram


Consequences of Sugar, Even Before Childhood

We often hear just how bad sugar is for your health. We also know that limiting sugars in children’s diets - in drinks and desserts, for example - is probably a good idea. Furthermore, a recent Harvard study has found that high sugar consumption (particularly fruit sugars and sugary drinks) during pregnancy might lead to increased asthma risks in their children, according to the New York Times.


The study builds on existing literature that links “obesity and poor [nutrition]” to “current increases in childhood asthma.” In the study, researchers tracked more than 1,000 women during their pregnancies and looked at their children’s asthma diagnoses by the time they were 3 to 7-years-old. The women who consumed the least amount of sugar in the study had 21 grams per day on average while women who consumed the most amount of sugar in the study had 46 grams per day on average. Researchers also collected data on the mothers’ education level and pre-pregnancy body mass index (BMI), as well as children’s BMI and race.


As a result, they found that the children of women who had the most sugar were 58 percent more likely to have asthma than the children of mothers who had the least amount of sugar during pregnancy. A lead author of the study noted that the mechanisms behind this difference is still unknow; however, the idea that a mother’s diet during her pregnancy could impact her children’s health years later is very important.


Once a baby is born, environmental and hereditary factors may influence the baby’s future health. Yet it seems that in some respects, prenatal environment may also contribute to children’s long-term health.


Weight, Language, and Self-Image

The language we use when talking to a child about their weight is very important. Doctors say that they themselves take great care in the words they choose when they talk to a child or their family member about weight and body mass index, even if their official classification falls under obesity.


The New York Times recently published a piece by pediatrician Dr. Perri Klass, who writes that physicians try to take care in order to avoid further hurting a child who may already be unhappy about their weight. A new policy statement jointly issued from the American Academy of Pediatrics and the Obesity society urges pediatricians to use seemingly neutral words instead of words like “overweight” and “fat.”


Past and ongoing research into the social and emotional effects of obesity agree that comments on weight can have a large impact on a child’s self esteem. According to Dr. Rebecca Puhl, a clinical psychologist who is one of the lead authors of the policy statement, “Weight is now one of the most frequent reasons kids are teased or bullied.” One of her studies followed more than a thousand teenagers into their early thirties, and found that children who were bullied because of weight were correlated with binge eating, poor body image, and eating to cope with emotions (not to mention other eating disorders). These correlations, in turn, were linked to obesity in adulthood as well. The effect was present for men and women, but more pronounced for women.


Dr. Puhl says that healthcare professionals might be some of the few allies overweight children and teenagers can have. After all, they are most likely teased by family members as well as their peers. Another ally that comes to mind is teachers - where appropriate, they can intervene in a bullying situation, as well as promote body positivity and physical activity.


We can all be allies if we understand and recognize that making comments about a weight does not encourage positive change; instead, making comments about weight can result in negative, longterm impacts. It is important to make sure that children and teens have access to healthy, positive influences for their physical, mental, and emotional health.

Our Small Grants Winner: Jessica Trinh


Earlier this year, we invited undergraduate students to submit ideas and develop programs that will promote healthy behaviors in children through behavioral science practices. The student with the most creative and well thought out project that incorporated evidence-based practices was selected to receive a $500 grant to pilot their idea.

We are excited to announce the winner of our 2017 Behavioral Science for Healthy Children Challenge: Jessica Trinh. Jessica has developed a program where children are encouraged to be active participants in the food choices they make.

Get to know Jessica and her winning program for yourself.

Tell us a little bit about yourself.

My name is Jessica Trinh, and I was born and raised in Illinois. I am studying neuroscience at Yale College, and I hope to use my skills to pursue degrees in public health and medicine after completing my undergraduate degree. Besides working on my nutrition program, I also help at HAVEN Free Clinic as a nutrition education counselor and teach health education in New Haven middle schools.

What is your program about?

Research has indicated that student performance in schools are related to the foods they eat. And both schools and educators are taking note. The foods children consume impact growth and development, while increasing healthy habits may help decrease risk for various diseases, including childhood obesity. I hope my program will foster healthy habits that can be carried into adulthood.

Through cooking competitions, I want students to be master chefs in their home kitchens. My program combines nutrition education through demos and healthy recipe booklets I created with a cooking challenge to encourage hands-on learning at home. The goals of the program are to encourage collaboration between students and parents at home as students learn more about food preparation, and increase children's decision-making role in their meals.

How did you come up with your program?

Growing up, I never thought twice about the ingredients in fast food, nor did I think about the importance of eating a balanced diet. It wasn’t until I was older that I came to realize the importance of nutrition and became more conscious of the food choices I was making. From that moment, I became determined to address disparities in nutrition education.

In my last year of high school, my concerns about nutrition education manifested itself in my senior capstone project. I wanted to create an after school program with middle school students that allowed them to grow their own vegetables, so that they can use them as ingredients in dishes we made together as a group. Each week, I taught students about a new nutritious ingredient that they may have not known about before, and taught them how to cook a healthy dish using this ingredient.

At that time, I was awarded a local grant and was able to support my nutrition education program in my hometown of Rockford. From these early experiences, I became inspired in college to start another nutrition education initiative in New Haven, Connecticut.

What does this program mean to you?

My hope is that students become more active participants versus passive consumers. I believe that motivating students by involving them in food preparation and educating them about their food can improve nutrition outcomes. Rather than imposing restrictions on what students can or can’t eat, I want students to feel empowered to become key players in the decision-making process of choosing what they eat. Through my program, I would like to show them that they can be creative in making healthy substitutions in their meals without sacrificing flavor.

How are you implementing your nutrition program so far?

With the CHIL grant, I am working to set up a healthy cooking competition for students at East Rock Magnet Middle School, a New Haven public school. I designed and produced a booklet of healthy recipes and plan to distribute them to students. Using the recipe booklet, I challenge students to prepare and cook meals (with parent/guardian help when necessary). I hope this will encourage students to be more open to trying new, healthier foods. I also hope that it raises awareness in making healthier substitutions in their food choices.

If this program is successful, I hope to expand my program by working with other schools!

What do you do in your free time when you’re not out trying to save the world, one nutrition program at a time?

I enjoy spending time with friends, watching The Great British Baking Show, and exploring different libraries around campus. One of my greatest joys is being able to cook and bake for family and friends.

Congratulations, Jessica! We are so thrilled to see your program thrive! 



Understanding Toddlers and Tantrums

An interesting piece in the NYTimes this week discusses temper tantrums, and what they do or do not tell us about a young child’s emotional state. Tantrums are most common around ages two or three, and gradually decrease as a child grows older. According to Dr. Egger, chairwoman of child and adolescent psychiatry at NYU, childhood tantrums can be thought of as frustrations from a child who is fearful or angry but is still developing language skills to express these feelings.


According to the article, approaching childhood tantrums with adult reasoning or anger might not be productive or helpful. The neuroscientist interviewed in the article, Dr. Potegal, describes the emotions in a tantrum as a combination of anger and distress - anger usually subsides in a tantrum, but distress might remain fairly constant.


Dr. Egger said that a parent’s role during a tantrum is not to become stressed or angry herself - a parent should instead act as a container for the child’s feelings, since the child will not feel in control of the situation. Tantrums “typically happen when children are hungry or tired or when there has been some significant change in their routine,” and confusion and frustration can easily manifest themselves in these situations.


Experts say the tantrums parents should be concerned about are the ones that occur in public and the ones where children or toddlers become violent and bite or kick. If parents find themselves changing their routines or avoiding triggers in fear of setting off a tantrum, they should seek help instead of struggling on their own. Though this usually isn’t the case, tantrums might be an indication of an underlying developmental problems such as ADHD, or even a medical one.

Mindfulness - Something for Everyone

The timing couldn’t be better - not long after our recent post on ways to be in the present, the New York Times published a piece on “Mindfuless for Children.” The author defines mindfulness as “the simple practice of bringing a gentle, accepting attitude to the present moment,” and argues that even the youngest children can benefit from this approach.


The graphics in this article are beautiful and worth checking out, but we’ve condensed some of the main points here:


Mindfulness starts young. Even infants can notice the difference between a stressed, distracted parent and a smiling, “present” parent. Mindfulness experts say that eye contact is important to establish a connection between an infant and a parent; unfortunately, smartphones have become a huge distraction in establishing that connection. Experts recommend putting down the phone, however briefly, to interact with infants. The same goes for raising toddlers - as they start to learn to express themselves, helping them identify and describe their feelings is very important.


Mindfulness is important throughout childhood, from infancy to early childhood to teenage years. The appearance of mindfulness can evolve. For example, a focus on gratitude and recognizing happy moments for young children evolves to a focus on healthy interpersonal relationships in teenage years. A surprising number of diverse factors are involved in mindfulness. For example, increase in movement and activity relieves stress and improves physical health for guardians and children alike.

Mindfulness can’t be “outsourced.” People who work with children and teens to bring mindfulness into their lives emphasize the key role parents and guardians can have in contributing to children’s health. Mindfulness “isn’t like piano lessons,” where parents can simply drop off their kids to get their weekly lesson. The author of the article concedes that parenting is hard work, and often very stressful, but they are the main figures in their children’s young lives. Caregivers don’t have to be expert meditators; instead, they can focus on things like forgiveness and appreciation of the present along with their children. Having this approach will have positive mental health impacts for everyone involved.

Prize-Winning Behavioral Economics

Earlier this month, Professor Richard Thaler at the University of Chicago Booth School of Business won the 2017 Nobel Prize in Economics. Professor Thaler’s work in behavioral economics has impacted our understanding of human behavior, and has also influenced government's’ approach to behavior as well.


A recent article in the New York Times explains some of Thaler’s work and contributions. Standard economic theory assumes that human beings behave “rationally.” Economists knew this was not precisely true, but operated on this assumption for a long time. Professor Thaler pushed the field to try to truly model human behavior by observing the fact that humans consistently behave in ways that deviate from what is expected - in other words, even if people behave “irrationally,” we can still model and predict their behavior.


Professor Thaler has found, for example, that people who own a good will value it much more than other people who do not own that good. This is called the endowment effect. This could suggest, for example, that people who own fitness technology or pedometers might value them more than other people do. If they value them more, Thaler’s work suggests that people may be more likely to use them.


Thaler also found that people will punish what they perceive to be unfair behavior, “even if they do not benefit from doing so.” It would be interesting to see the link between this sort of behavioral finding and application to health care and children’s health. Since there are so many actors involved in children’s health - the children themselves, providers, teachers, public officials, parents and guardians, and more - unfair practices or policies could be a real complaint that affects relationships between these actors.


Thaler hopes that behavioral economics, now part of mainstream economics, will move beyond the discipline alone to become an integral part of how we think about human behavior. More research in its intersection with health and children’s healthcare will be very exciting to see!


Some Thoughts on Recent Events

Fall is a time of many changes, from the weather to the new school year starting. This year, though, it has been an especially anxious time. On the heels of successive events such as the effects of natural disasters and ongoing recovery efforts, the senseless tragedy in Las Vegas, and political divisions especially within our government, children listening to the news lately would likely alarm parents with questions.


It’s not a stretch to imagine the impact these events can have on societal and children’s health: federal funding for health insurance for many children is still up in the air; food and water are in short supply in Puerto Rico; and gun violence has become a public health issue and its impact on children is hard to ignore.


There is no real advice to be given in times like these, but there are many conversations parents, educators, and caregivers can have with children to talk about stresses from these events. At CHIL, we hope that adults and children alike embrace the fact that people impact lives more directly than any policy change can, as dramatic as the latter may be.


Mindfulness is always important but feels especially relevant today.

A Follow-Up on the Children’s Health Insurance Program

The NYTimes reports that a bill to refinance CHIP, the popular children’s health insurance program we discussed in a previous blog post, has moved from the Senate to the House of Representatives, only to get stuck in the latter. If this bill survives partisan gridlock, then its provisions would set aside more than $100 billion over the next five years for the nearly nine million children enrolled in this program.


Although the main architects of the Senate bill hailed it as a “prime example of what government can accomplish when both parties work together,” there are still many points of contention between Republicans and Democrats when it comes to healthcare spending. The only thing they seem to be able to agree on at the moment is the urgency of the situation.


Federal funding for CHIP expired a few days ago, and apparently, there is no way to predict when a bill might be ready to move on to the White House. Several states have already tapped into emergency federal provisions in order to offset spending while Congress deliberates. Three states are scheduled to run out of CHIP funds at the end of this year, and a total of 30 states will be out of cash by March 2018.