Currently, the U.S. healthcare system is very reactive, mainly treating people and children once they are sick rather than preventing it. School nurse expert Erin Maughan and colleagues in the American Academy of Nursing's (AAN) Child, Adolescent and Family section believe a stronger focus on prevention could improve children's health throughout their lives.
In a recently published AAN policy consensus paper, Maughan and her peers outline a nurse-led framework for redesigning child health systems around prevention, strengths-based care, and collaboration across families, schools, communities, and health care settings. The AAN framework focuses on strengths and leveraging nursing's role in advancing child health.
“A person’s health is impacted by specific contexts during childhood that have a lasting impact,” said Maughan, associate professor in the School of Nursing. “By taking these into account and redesigning the health care delivery system to build upon strengths and protective factors, we can improve the lives and futures of children.”
Though there have been many advances in medicine and health that help us know what is best for the health and well-being of children, there have not been equal advances in the implementation of this new knowledge. This new paper proposes ways to integrate the research into practice.
Recommendations for improve children’s health
Expand Medicaid and Medicare coverage, provide free or subsidized childcare and after-school care, strengthen child and dependent tax credits, and establish and enforce child-specific air quality standards with continuous monitoring in schools and childcare facilities.
Increase funding to expand universal access to evidence-based, family-focused interventions and home-visiting programs from pregnancy through adolescence.
Ensure every school has access to a full-time, bachelor's-prepared registered nurse.
Increase funding for coordinated school health and school nursing programs, modeled after Head Start and adapted for K–12 students.
Create policies that encourage innovative technology solutions, including affordable and accessible health information sharing across healthcare and community settings such as schools, childcare centers, and community organizations.
Require the use of non-toxic, certified green cleaning products in educational and childcare facilities to reduce respiratory irritants and harmful chemical exposures.
“We provide context to redesign family, community, schools, environment, and health care systems to bring groups together for children and adolescents to lead healthier lives and to provide nursing strategies. By addressing the complex and interdependent components of today’s systems through policy changes, we believe that a cascade of positive effects will occur, improving the health of children today and in the future,” said Maughan.
“By connecting early relational health (including positive childhood experiences [PCEs]) and social health to traditional nursing, developmental, and medical models, the life course perspective encourages a paradigm shift toward health protection and prevention,” Maughan explained.
“ Redesigning ecosystems for all children to enhance health and well-being: An American Academy of Nursing consensus paper ” was published in the July-August 2026 issue of Nursing Outlook. Additional authors include Sonja J. Meiers of University of Wisconsin-Eau Claire, Susan M. Breitenstein of The Ohio State University, Jean S. Coffey of University of Connecticut, Kay J. Cowen of UNC Greensboro, Cynthia A. Danford of Cleveland Clinic, Catherine Dodd, Simmy King of Children's National Hospital, Donna M. O'Malley of Operation Breakthrough, Cheryl-Ann Resha of Southern Connecticut State University, Mary C. Sullivan of University of Rhode Island, and Susan K. Lee of The University of Texas.
Nursing Outlook
Redesigning ecosystems for all children to enhance health and well-being: An American Academy of Nursing consensus paper
1-Jul-2026