Redesigning ecosystems for all children to enhance health and well-being: An American Academy of Nursing consensus paper

Although there have been many changes to community and family structure, and advances in scientific understanding of children's health and wellbeing, there has been little difference in how healthcare is delivered to children. The focus is often a deficit approach to acute situations. Halfon's Life Course Health Development Theory (LCHDT) focuses on a holistic approach to health and well-being. In the LCHDT, one's health is impacted by specific contexts during childhood that have a lasting impact. Key areas of family, community, schools, environment, and healthcare systems impart positive and negative experiences that affect children's health. Using the LCHDT as a guide, this consensus paper explores these five areas in the context of nursing practice roles and policy implications. With this approach, nurses lead and partner to build positive ecosystems for children and inform key policy actions to ensure change is a reality. © 2026 Elsevier Inc.