B R I G H T F U T U R E S G U I D E L I N E S F O R H E A LT H S U P E RV I S I O N O F I N FA N T S , C H I L DR E N , A N D A D O L E S C E N T S
Recognizing the Social Determinants of
More than 15 years ago, the members of
the first Bright Futures team were given the
task to imagine our country’s health picture
if every child in America could look forward
to a bright future—every child, regardless of
race, religion, background, income, politics,
or any other factor.
Imagine a bright future for every child in
America. What would it look like? Who
would be part of it? Who would sustain it?
How would a truly bright future for children
and youth intersect with change and brighten
the present and future of all in the United
States? Would a bright future for children
translate into a brighter future for everyone?
With those questions in their collective
conscious, the group developed the Bright
Futures Children’s Health Charter1 (see box on
page xvi). This charter delineates the necessi-
ties and entitlements that all children deserve
and, indeed, must have to look ahead to a
bright future. The charter states unequivocal-
ly, the explicit connection between a wide
range of social determinants and the health
of children and youth.
Making a Bright Future a Reality
First published in 1994, Bright Futures:
Guidelines for Health Supervision of Infants,
Children, and Adolescents provided a stan-
dardized, well-researched way in which
everyone who cares for children in any
capacity can help realize the charter’s goals—
one child at a time.
The guidelines were updated in 2000,
and again in this third edition, to address
the ever-changing landscape in which our
children are living. This latest edition, for
example, includes special emphasis on 2
new significant challenges: mental health
and healthy weight. Woven throughout the
guidelines are new discussions about cultural
competence, complementary and alternative
medicine, and caring for children with special
health care needs.
Like previous editions, this third edition
of the Guidelines outlines activities that are
vital to achieving the health goals of the
Children’s Health Charter, setting forth spe-
cific guidance to:
• Enhance health care professionals’ knowl-
edge, skills, and practice of developmen-
tally appropriate health care in the context
of family and community.
• Promote desired social, developmental,
and health outcomes of infants, children,
• Foster partnerships between families,
health care professionals, and com-
• Increase family knowledge, skills, and par-
ticipation in health-promoting and preven-
• Address the needs of children and youth
with special health care needs through
enhanced identification and services.
A Bright Future for Every Child
—Morris Green, MD, FAAP, and Judith Palfrey, MD, FAAP