Upward Shifting Baselines
Recently I read about the concept of "shifting baseline" as a type of change to how a system is measured. The term comes out of the ocean/environmental world and the article went on the describe that a decline occurs in a way that is almost too slow for one to notice and that what we think of as normal is really reflective of a diminished reality (concept was coined by Daniel Pauly in 1995 and discussed in a recent Time magazine article).
I can't seem to stop thinking of this concept, shifting baseline, as it relates to our work in public health and particularly, maternal and child health (MCH). While so many wonderful health improvements have occurred over the past decades, I feel we must constantly reevaluate to prevent and not accept a diminished reality. The realization that we are seeing a generation of individuals likely to under-live their parents certainly seems like a diminished reality.
We in the MCH world must evaluate our history, measure our progress and incorporate the life course –future generations – in all we do. Title V services must respect and include the reality of our families – all families, including those with children with special needs. In order to reflect these realities we need to have an expanded scope to include social determinants of health across the life course. As we transform Title V, let's do so in a way that clearly says we are focused on shifting to improved baselines and prevention of any decline in the health and well-being of all families.
I have edited the following highlights from a December 2002 article by Randy Olson, a marine biologist, from actionbioscience.org in terms of our MCH focus (amazing how transferrable the concepts are):
- Shifting baselines result from chronic, slow and hard to notice changes
- Baselines document how things used to be and are used to evaluate change
- A baseline that shifted before it was charted can cause a degraded state to be accepted as normal
- Maternal and Child Health groups are calling attention to the family's problems
- Making the family/community healthy is everyone's responsibility
- Conclusion: we cannot afford to lower our standards for the family/community