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May is Women’s Health Month, and it’s also the month we celebrate mothers. I lost my mother to cancer in 2017 and there has not been a day since when I have not thought about her and felt her presence. There are so many things I love about my wife, but none is more important to me than being the best possible mother to our children. 

This Mother’s Day, my wife and I joined a group video chat with our children, who work and study in different parts of the country. After the call, I thought of two things. First, families have come to increasingly rely on video communications to stay connected, see a doctor, and attend school. Second, I thought about how we, as a society, could better care for the health of women, so that all mothers could live longer, more productive, and more fulfilling lives. The pandemic has placed an especially heavy burden on moms, making this month the perfect time to shine a light on women’s health — at every stage of life.

The State of Women’s Health in the U.S.

Since the first day I began treating children as a pediatric surgeon, my appreciation for mothers has grown, extending beyond my own experiences as a son, husband, and father. I am continuously awed by the dedication, selflessness, and determination of the moms of the kids and teens we treat at Nemours Children's. And as we work to raise the healthiest generations of Americans, I feel the opportunity to improve the health of the many children who will become mothers themselves.

Thanks to widespread prevention efforts and treatment, the average lifespan of women in the United States has increased from 78 to 81 years since the early 1980s. Still, we have significant room for improvement, especially compared to women’s health in other parts of the world. As the Office on Women’s Health notes life expectancies of Asian and European women range from 81-90 years. When it comes to maternal health, America has the worst maternal mortality rate among the 10 wealthiest nations. The ratio of maternal deaths per 100,000 live births in France, which ranked ninth, is almost 50% less than the ratio in the United States. These impacted babies will grow up without a mother. This is an unacceptable tragedy in a nation that is the world’s wealthiest and spends massively more on healthcare than peer nations.

The Common Culprit: Heart Disease

While various factors contribute to America’s shorter average lifespan among women and its high maternal death rate, heart disease is the primary and most common culprit of both. Among American women in general, the leading cause of death is heart or cardiovascular disease. Among American mothers, according to the Office on Women’s Health, “the most common cause of pregnancy-related death is cardiovascular and coronary conditions.”

So how do we improve women’s health and reduce maternal deaths in the United States? We can and should make every effort to improve heart health among adult women and mothers. To most effectively improve the heart health of American women and mothers, we must also realize that these diseases begin in childhood, and prevention efforts must focus there.

Building Heart Health in Childhood

By taking steps to ensure that more people have a strong foundation for heart health when they enter adulthood, we could lower our mortality rate, improve life for millions of Americans, and save hundreds of billions of dollars a year.

Here are three areas of focus for building heart health in childhood:

  1. Nutrition – Evidence suggests that nutrition may be the most critical factor when it comes to preventing heart disease. In addition, research suggests that“healthy dietary habits established during childhood and adolescence could continue into adulthood.” Not surprisingly, one of the best places to introduce children to healthy foods is at school, where they spend a significant amount of their time. There is strong evidence that dietary habits established before age 10 persist for a lifetime. And as the CDC notes, healthy behaviors, including eating habits, “are connected to academic achievement.”
  2. Physical Activity - Exercise in childhood isn’t just about establishing good habits, boosting mood, and supporting cognitive functions like learning – studies suggest that exercise in childhood may trigger changes that protect against heart disease in adulthood. The authors of a study published in the journal Nature explain that cardiovascular disease “starts in childhood even though its symptoms are absent until much later in life… A physically inactive (even normal-weight) child may have no symptoms of disease, but evidence of deterioration in vascular health may already be present.”
  3. Chronic Stress – Adults who experience high levels of chronic stress are at greater risk of heart disease. But there’s more to the story. High levels of stress in childhood can increase the risk of heart disease in adulthood. And young women, recent studies suggest, “are especially vulnerable to the negative effects of stress on the heart, which may result in earlier onset of heart disease or more negative health outcomes if the disease is already present.”

It’s Never too Early to Invest in our Future

Through programs in schools and partnerships with parents, we can improve the heart health of tomorrow’s adults – including women and mothers. I’m proud of the many ways in which Nemours works to promote nutrition, physical activity, and mental health through initiatives like Healthy Kids, Healthy Future and Raising Resilient Kids, a video series in collaboration with the Michael Phelps Foundation that features gold medalist Michael Phelps and his wife, Nicole with Nemours Children’s experts. Of course, providing high-quality medical care is also a critical component of heart health in children and young adults. One recent example is Nemours’ patient Grace Ryan, whose rare heart condition was treated in her teens and who now attends college.

Mother’s Day may have arrived “early” in 2022, but it’s never too early to invest in the health of the next generation of Americans.

About Dr. Moss

R. Lawrence Moss, MD, FACS, FAAP is president and CEO of Nemours Children’s Health. Dr. Moss will write monthly in this space about how children’s hospitals can address the social determinants of health and create the healthiest generations of children.