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The First 1000 Days of Life

The 1000 Days of Life Initiative, part of the Democracy of Opportunity effort, is guided by the question of what we owe the new generation of newborns. It aims to provide an opportunity for all Americans to live healthy, flourishing, and thriving lives by focusing on the crucial period from preconception to 24 months of age. This initiative recognizes that all citizens must have the opportunity to flourish and have the capabilities to participate in the public sphere.


The First 1000 Days Initiative is a comprehensive effort to optimize health, development and wellbeing in the critical period from preconception to 24 months of age. This initiative recognizes that complex bio-psycho-social and environmental factors during this seminal phase shape long-term outcomes across the lifespan.

The initiative is driven by two key principles: 1) All citizens deserve the opportunity to flourish and possess core capabilities to fully participate in society; 2) Focusing on the first 1000 days provides the optimal foundation for lifelong wellbeing. By addressing influential early determinants, this initiative aims to foster healthy, thriving lives and promote health equity.

A major component is active citizen participation in co-creating policies, programs and interventions to effectively assist families and children. Community engagement fosters inclusion, empowerment and shared responsibility for enabling all children to thrive.

The initiative integrates multilevel interventions while emphasizing individual-centric assessment and care. The Salutogenic Apgar program, grounded in the salutogenic health model, enables granular analysis of each mother-infant dyad’s health indicators. These span medical, psychosocial, community and environmental factors. The resulting insights allow tailored interventions and resource allocation responsive to each family’s risks and needs.

By focusing on the first 1000 days, the initiative establishes crucial cognitive, emotional and physical building blocks for developmental flourishing. Proper nutrition, nurturing environments and responsive care during this time lay the groundwork for lifelong wellbeing. Assessment of individual needs combined with community-informed supports provides an effective approach to optimize outcomes.

Key elements of the initiative include:

  • Fostering collaboration among diverse stakeholders

  • Providing an organizing framework and access to timely data

  • Promoting evidence-based practices to support early childhood development

  • Advocating policies that prioritize maternal, infant and early childhood wellbeing

  • Addressing medical and social determinants of health

  • Enabling targeted interventions responsive to each mother-infant dyad

Through comprehensive efforts tailored to the earliest developmental phase, the First 1000 Days Initiative seeks to establish equal opportunities for all children to grow and thrive. By investing in this critical window, we can cultivate lifetime wellbeing and contribute to a vibrant, equitable society.

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