Clyde Hertzman Research Paper

The goal of this research was to examine the role of supportive adults to emotional well-being in a population of Grade 4 students attending public schools in Vancouver, Canada. Reflecting the ecology of middle childhood, we examined the extent to which perceived family, school, and neighborhood support relate to young people’s self-reported emotional well-being (N = 3,026; 48% female; Mage = 9.75). Furthermore, we investigated the hierarchy of importance among those support factors in predicting students’ well-being. As expected, adult support in all three ecological contexts was positively related to emotional well-being. School support emerged as the most important adult support factor, followed by home and neighborhood support. All three support factors emerged as stronger predictors than socioeconomic status (SES) in our study. We discuss our findings in relation to the empirical field of relationship research in middle childhood, and how our findings can inform educational practice.

In medical school at McMaster University in the 1970s, Dr. Clyde Hertzman figured out that he didn’t want to practice medicine. Instead of focusing on the health of one patient, he decided to study the health of populations at large, particularly how early childhood development influences health in societies over a lifetime. 

He completed his training in community medicine and epidemiology at McMaster, where he participated in think-tank sessions that defined the concept of population health during Dr. Fraser Mustard’s tenure as vice-president of health sciences. That experience laid the foundation for his life’s work.

Today, Dr. Hertzman is regarded as a world expert in virtually all aspects of early childhood development. Since 1985, he has served on the faculty of the University of British Columbia as Professor in the School of Population and Public Health. He holds a Canada Research Chair in Population Health and Human Development.

He is the Director of the Human Early Learning Partnership (HELP), College for Interdisciplinary Studies, at UBC. This interdisciplinary network of 200 health researchers from 6 BC universities studies early child development “from cell to society”. Founded in 2001, HELP’s mission is to carry out leading-edge research on the relationship between biological and socioeconomic factors in the developing child in order to help children thrive.

Early in his career, Dr. Hertzman wondered why, sooner or later, moving from the most privileged to least privileged members of society, the incidence rates of most diseases tended to rise.

“I was very interested in discovering the source of socioeconomic inequalities in health. I could see that you couldn’t explain health inequalities across the social spectrum in a society like Canada without understanding how vulnerability and resilience develops early in life and how the early years influence what unfolds over the life course,” he explains.

He began to study the ways in which early experiences set children on different developmental trajectories that influenced their health over their lifetimes.

“I thought, there must be some way in which different qualities of experience in different walks of life get under the skin, as the metaphor goes, and change brain and biological development in ways that create a different susceptibility to disease,” he says. In 1999, he coined the term “biological embedding” to describe this notion.

According to Dr. Hertzman, one of his most satisfying moments was the day that he realized that epigenetic research might provide a scientific explanation for biological embedding.

Canadian Institute for Advanced Research

As a fellow of the Canadian Institute for Advanced Research (CIFAR), Dr. Hertzman has led groundbreaking population-based studies that have put early childhood development on the world map as a key determinant of social health.

In 2000, armed with the Early Development Instrument (EDI), a 103-question score card on child development – co-designed by Drs. Dan Offord and Magdalena Janice in conjunction with other researchers in CIFAR’s human development program – Dr. Hertzman and his team asked the Vancouver School Board to fund a pilot project.

They received financial support from the Medical Officer of Health, who had some unspent funds in his budget. The money was used to pay release time to all kindergarten teachers to enable them to fill out EDIs for all children registered in Vancouver schools. The researchers plotted the results on a city map of social-planning neighborhoods. Vancouver newspapers published this first snapshot of early childhood development in different sectors of the city in January 2001. The maps were colour-coded to make them easier to understand.

“Once that happened, all hell broke loose,” recalls Dr. Hertzman. “No one had ever seen a neighbourhood-by-neighbourhood map on the state of children’s physical, social and emotional development or their language and cognitive skills. You saw these huge differences between neighbourhoods.”

Within 2 weeks, school districts across the province were lining up for evaluation. A provincial government effort to fund local intersectoral coalitions to support early childhood development had just begun, “so not only did we have willing school districts,” he says, “we had a client base who wanted the information.”

The team collected EDI data, mapped results, and met with local intersectoral committees to explain what the information meant, compare it to socioeconomic factors in the community and create a community development toolkit to effect change. 

“The day that I could see that the EDI was taking hold, when I could say that we had really come up with a way to bring early childhood development into the public realm for discussion, was very satisfying,” he recalls.

Their work expanded across the entire province. Because BC has a unified public school system, every school district is population-based and the maps of EDI results mirrored child development across all socioeconomic groups within the province.

The EDI project has received provincial funding since 2002. Over the last decade, the team has conducted population-based assessments of BC children’s development at the transition period between preschool and school no less than 4 times. The last survey collected data on children’s readiness for school from public, independent and first-nations schools in 480 BC neighbourhoods.

Nationally, his work has influenced public policies, such as Ontario’s decision to move to full-day kindergarten for 4 and 5 year olds.

Dr. Hertzman hopes to develop a world-class monitoring program that links data on the state of childhood development across the country at key times in early life to determine how Canadian children are thriving.

The world stage

When HELP’s approach to EDI mapping went viral around the world, “we developed an instantaneous reputation as the primary research shop taking a population-health approach to early childhood,” Dr. Hertzman recalls. 

On the basis of this work, he was invited to be Team Leader of the Global Knowledge Hub in early childhood development as part of the World Health Organization’s international commission on the Social Determinants of Health.

Dr. Hertzman and his team have turned the concepts and lessons learned in BC into a global knowledge network that has contributed to work on the United Nations Convention on the Rights of the Child and early childhood development projects in Africa, China, Central and Eastern Europe, the Philippines, and Latin America.

“I’m walking a tightrope all the time, because the paradigm is innovative and unusual,” he says. “My biggest worry is that the resources that we need to continue working will disappear. In an ongoing way, that is the most difficult challenge to meet.”

In 2010, Dr. Hertzman was named Canada’s Health Researcher of the Year and awarded a $500,000 grant from the Canadian Institutes of Health to fund his global initiatives.

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