More than half of all US children will suffer from chronic health conditions during their childhood, according to a new study whose findings were published in the Journal of the American Medical Association on February 17. The study paints a portrait of an essentially unhealthy child population and also suggests a rapid deterioration in childhood health over the past two decades.
Common conditions include obesity, asthma, attention-deficit hyperactivity disorder (ADHD), diabetes, and allergic conditions. While the study did not attempt to isolate causes for the growth of these conditions, their links to poverty and other environmental factors have been well established.
“This is just another study emphasizing what many already knew. And, if we don’t eradicate the root causes, such as bad eating and little exercise, we’ll continue to see a lot more morbidity in children,” said study author Dr. Jeanne Van Cleave, a pediatrician with MassGeneral Hospital for Children in Boston. “I’m seeing more and more kids with high cholesterol and insulin resistance that already have blood vessel damage in them. They’re already like a 45-year-old in terms of blood vessel health. We need a basic change in how we live and how we eat. Prevention is key.”
The study analyzed about 5,000 children as they grew from the ages of two until eight years old in three different cohorts, from 1988 to 1994, from 1994 to 2000, and from 2000 until 2006. It defines a chronic health problem as one lasting for more than 12 months that requires extended treatment or disrupts a child’s capacity to carry out behaviors and actions typical of their age.
Among the first group, 12.8 percent exhibited a chronic health condition at the study’s end in 1994. This figure rose to 26.6 percent for the last year of the third group, 2006. Over the six-year period for the 2000 through 2006 group, a majority, 51.5 percent, suffered a chronic health problem, up from 30 percent in 1994. The rate of obesity has doubled in the same span.
“You read these numbers, and you get really sad,” commented Sandra Hassink, spokeswoman for the American Academy of Pediatrics. “It’s a different picture of what most people think childhood is like.”
The nature of the most prevalent chronic conditions confronting children appears to have changed since the 1980s. Commenting on the study, Dr. Neal Halfon, director of the UCLA Center for Healthier Children, Families and Communities, said that doctors today confront “a whole different set of conditions.”
“We’re seeing bigger increases in obesity, attention deficit disorder and other mental and behavioral conditions,” he explained. “Part of that has to do with the kinds of environments in which children are growing up.”
The study, based on Bureau of Labor in-home interviews, found that the risk of suffering a chronic health issue is higher among black and Latino children and among boys. It did not isolate for family income or other socioeconomic factors.
Research suggests that children who receive access to quality health care can have their conditions resolved. “The study speaks to the fact that children need continuous access to health care,” Van Cleave said, adding that “with good treatment, a lot of these conditions will go away.”
William Gardner of the Research Institute at Nationwide Children’s Hospital in Columbus, commenting on the results, concurred. “Asthma, attention deficit disorder, obesity—there aren’t robotic surgeries to fix these things,” he said. “It’s a situation where we need to have a really strong primary care system where kids have what we call a medical home and they have regular contact with a primary care doctor or nurse practitioner.”
But high quality health care is available to a relatively small number of US children. As of 2007, there were 8.7 million children in the US with no health insurance whatsoever, according to Families USA, and the number is almost certainly far higher now. Many millions more have only limited access to health care due to inadequate insurance coverage.
The Obama administration’s “health care overhaul” has dropped all pretense that it will aim to expand coverage to the millions without insurance. Its overriding focus—driving down costs while protecting the profits of the major “industry players”—has come into the open. In a recent interview with Business Week, Obama explained that the health care “reform” was conceptualized as a “system that is not a drag on business.”
Children will bear a disproportionate burden in the cost-cutting drive.
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[13 January 2010]