Predictability Can Reduce the Burden of Adverse Childhood Experiences: Policies to Promote It

Ample evidence indicates that unpredictability plays a fundamental role in lifespan health and represents a unique form of early life adversity. This article first summarizes the evidence supporting the role of unpredictability in childhood on mental and physical health. It then discusses the characteristics of predictability that render it a compelling policy target: it may buffer children from other forms of adversity and could help advance health equity. Finally, it concludes with three policy case studies: screening for unpredictability in pediatric primary care, legislation to eliminate precarious parental work schedules, and the secondary benefits of cash payments in the form of reductions in unpredictability. Promoting predictability in children's lives will benefit both them and society. Feasible policy solutions can achieve this goal.