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Almost a decade after policy on toxic stress, ‘relational’ health seen as key approach

Original article written by Andrew Garner for AAP News.


The concept of toxic stress may be more relevant than ever as we face structural racism; widening disparities in health, educational and economic outcomes; and a socially isolating pandemic. A revised AAP policy statement argues that to build healthy, resilient children and adolescents, family-centered pediatric medical homes need to be integral elements of community efforts to foster “relational” health.


Relational health refers to the ability to develop and sustain safe, stable and nurturing relationships with emotionally available, engaged and attuned adults. The adults provide children and adolescents with the positive experiences that buffer adversity and build the foundational social and emotional skills needed to be resilient in the face of adversity.



Here are several ways to promote this approach:

  1. Power of positive experiences

  2. Strengths-based model

  3. Public health approaches



Relational health is both the treatment for and mitigation of childhood toxic stress. This concept builds on the 2012 AAP policy and technical report that described how early childhood experiences are biologically embedded and influence developmental outcomes across the life course.


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