Thirteen percent of pregnant women in the United States have no health insurance.

The president, when not worrying about the gun nuts, wants to cover them.

One would think these facts alone might encourage some sanity,­even unity, ­in the ever-childish debate about healthcare reform. It’s a natural for the family values cult. Ditto for the meshugga anti-abortion crowd. Why, you can even imagine those terrible death panelists advocating for mommy Obammy care­, even if what they really want is to ensure a steady stream of future Soylent Green.

But you don’t hear that­ and one wonders why. One reason is domestic culture.   America is nothing today if not a vast congeries of family worshippers. This, in itself, is not a bad thing. Modern life spirals ever out of control, and having a village to come home to helps bring meaning to life, even if you have to cut the lawn. But the consumer cult origins of family worship, ­born in a time of easy credit, Bush-era denialism and pastel capris, ­is simply not up to such a cause. One might wonder if this is because some mythical “mandated pregnancy leave” might affect the availability of their off-the-books maids, but let’s cut them a break and assume the best intentions. 

The nation’s ostensibly social justice-oriented Catholic bishops might also be champions; instead they have decided that O-mommy care would, weirdly, simply mean more abortions. Those Haimishe Hasidim? Ditto. And where are the Democrats on mommyObammy? 

Out battling Sarah Palin, of course. 

What they all should be doing is crafting an effective message built around strategic, prudent investments in maternal and child health.



That is because, of all the (often inflated) economic claims by preventive medicine, the one that clearly holds its own is that of maternal health. Support for that approach comes from research that originated in England, but which is largely refined and implemented in Los Angeles, itself now the nation’s mater noster.

Although long intuited, the notion that poor maternal health stands as one root of chronic disease is now buttressed by compelling historical and clinical data. Studying the impacts of the Dutch winter famine of 1943, British researchers some time ago documented huge upticks in adult heart disease and diabetes among men and women born that year.

Mining other epidemiological data, scientists have since expanded this observation, dubbed in utero programming, to illustrate a troubling fact of modern life: Infancy is destiny.

It’s the kind of observation that rubs hard against the American myth of the family, where the Yentl-esque fantasy of “nothing is impossible!” reigns. But it is a fact that other industrialized nations have increasingly embraced as one way to head off health costs. And I don’t mean just those bovine line-waiters in Quebec, either. Almost all developed nations dealing with large populations of young mothers get the connection. We still don’t.

Innovators in LA’s world of public health, ­inevitably called “nannies” by Coca-Cola-funded conservatives, ­have come up with several reasonable approaches. As relentlessly advocated by UCLA’s Neal Halfon and championed by both UCLA and Trojan researchers, a health strategy dubbed “life course” uses scientific findings about sensible, economic interventions to head off chronic health problems. These range from buffering young Angeleno mothers’ exposure to the severe effects of roadway traffic emissions to pre and post-natal monitoring to dietary and health counseling.

Instructively, LA is now ground zero in the new Children’s Health Study, which will track such health inputs­both positive and negative­in the young and their families. Infancy may be destiny, but infancy can be made better for all.

But “infancy is destiny” as a slogan doesn’t exactly warm the heart, does it? So I propose a mission statement for such a movement. It derives from the great British statesman and abolitionist Thomas MacCauley. “We take these actions not for ourselves,” he once proclaimed, “but for people we will never know.” 

We may never know them, but they’ll remember us.

Greg Critser is a longtime medical journalist and the author of Fat Land, Generation Rx, and the upcoming Eternity Soup: Inside the Quest to End Aging, to be published in January.