Category Archives: Pediatrics
How many children could possibly identify with a new Sesame Street character whose dad is in prison? Close to two million, according to many experts. A White House “Champions of Change” event yesterday honored twelve men and women who have spent their careers researching and improving the lives of children who have at least one parent in prison. That explains why Sesame Street released a new video and toolkit yesterday, as part of their "Little Children, Big Challenges" series, that tells the story of Alex, whose dad is in prison. Alex’s grown up and peer friends help him talk, and sing, about his feelings about his dad and how other people speak about his dad’s prison stay. The "Challenges" series includes issues many kids face such as divorce and a parent in the military, and the resources are distributed through therapist's offices, schools, jails and other key places to reach kids.
The White House program, led off by Domestic Policy Council director Cecilia Munoz and Secretary of Health and Human Services Kathleen Sebelius, included panel discussions on the needs of kids whose parents are in jail, which is a recognized “adverse childhood experience” that can lead to poor health outcomes as children become adults. Among the problems kids of incarcerated parents can face are decreased living standards, social isolation because of the stigma they feel about having a parent in prison, and long-term or permanent separation from the incarcerated parent.
>>Watch a CBS News story on the Sesame Street program that will help support kids with incarcerated parents.
U.S. News & World Report has added a new set of rankings, “America's 50 Healthiest Counties for Kids” to its just released annual report on the Best Children’s Hospitals. The top counties have some important measures including fewer infant deaths, fewer low-birth-weight babies, fewer deaths from injuries, fewer teen births and fewer children in poverty than lower ranked counties. Most of the measures were taken from this year’s County Health Rankings, a collaboration of the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation.
According to U.S. News, “America’s 50 Healthiest Counties for Kids,” represents the first national, county-level assessment of how health and environmental factors affect the well-being of children younger than 18 and shows that even the highest-ranking counties grapple with challenges such as large numbers of children in poverty and high teen birth rates.
>>Read the full U.S. News & World Report article.
Sesuagno Mola of Ethiopia, married at five, never went to school and had her first child at 14. More children would have followed in quick succession, but Sesuagno got involved with a program in her town run by Girl Up developed by the UN Foundation that empowers young girls to create a life for themselves and their families well beyond poverty and illiteracy.
In Sesuagno’s case, she joined a program developed to help teach literacy, and provide information about family planning, gardening and life skills to help reduce food contamination.
Through the program, Sesuagno learned to build shelves to keep her family’s food off the floor, built a stove that sends the smoke out of the house instead of into her lungs—a cause of pneumonia and death for thousands of girls and women in the developing world—and jointly decided with her husband, because of her time in the program, that they would wait to have their next child.
“What we support are comprehensive services for adolescent services for girls to help improve access to health services, education and safe spaces,” says Andrea Austin, a spokesperson for the UN Foundation.
As school winds down and camps and sports prepare for the summer season, a new study funded by the Robert Wood Johnson Foundation and published in the American Journal of Public Health on sports-related traumatic brain injuries in youth sports, is generating deserved attention.
The study, by Hosea Harvey, JD, PhD, Assistant Professor of Law at the Temple University Beasley School of Law, found that while forty four states and Washington, D.C., passed youth sport TBI laws between 2009 and 2012, none of the laws focus on preventing the injuries in the first place. The laws on the books deal primarily with increasing coaches’ and parents’ ability to identify and respond to traumatic brain injuries and reducing the immediate risk of multiple brain injuries.
>>Read more in a Q&A with the Babe Ruth League Inc. about how youth sports leagues are making strides to prevent injuries.
Harvey’s conclusion is that continued research and evaluation is needed to develop a more comprehensive reduction in youth sport traumatic brain injuries.
NewPublicHealth: What did your study address?
Hosea Harvey: I looked at traumatic brain injury (TBI) laws that were passed at the state level that purported to deal with the problem of youth TBIs in sports statewide. I looked at every related state law passed between 2009 through the end of 2012, though most states only had one law that they passed that dealt with youth sports TBIs during that period.
NPH: And your study found that no state that right now has a law that says this is what you have to do in order to prevent these concussions in the first place?
A community needs assessment of a Chinese-American community in New York City several years ago found multiple barriers to physical activity for children and teens including parents unable to supervise kids at play because of long work hours, unsafe neighborhoods, limited knowledge or access to existing programs, financial hardship, inadequate support for physical activity in schools, limited time due to competing priorities such as academics, and too much time in front of video games, computer screens and television. To increase exercise time and options and help to reduce obesity rates among Chinese-American youth, public health professionals from the Charles B. Wang Community Health Center sought out funding from the New York State Department of Health and Mental Hygiene to create the Chinatown JUMP (Joining Urban Partners for More Physical Activity) program.
>>Read more on New York's Health Improvement Plan, which sets out a plan for similar community health assessments and cross-sectoral collaborations in response to these findings.
Chinatown JUMP currently works with eight afterschool programs to incorporate daily physical activity into the curriculum of these academic programs, blending activity with learning. Program goals include:
- Promote healthier and fit children by educating them and their families about the correlation between exercise and staying healthy.
- Increase staff capacity to support students’ healthier lifestyle through training and technical assistance.
- Establish an afterschool culture that supports physical activity as well as academic achievement.
The program works hard to incorporate parents’ support and involvement as well. Participating students in iMove receive a community resource guide with information about free and low-cost recreational centers and public spaces in the neighborhood to share with their parents. Parents are also invited to workshops on the importance of physical activity and healthy eating habits.
NewPublicHealth recently spoke with Susan Yee, Associate Director of Programs at the Charles B. Wang Community Health Center, about Chinatown JUMP.
NewPublicHealth: What is the Chinatown JUMP program and what do you think sets it apart from other programs with similar goals?
Susan Yee: Chinatown JUMP’s goal is to try to improve opportunities for more physical activity in the Manhattan Chinatown area in order to create sustainable changes within the community.
CDC Issues First Comprehensive Report on Children’s Mental Health in the United States
As many as one in five American children under the age of 17 has a diagnosable mental disorder according to a new report from the Centers for Disease Control and Prevention. The report is the first expansive report on children's mental health ever done by the U.S. government and looked at six conditions:
- attention-deficit/hyperactivity disorder (ADHD)
- behavioral or conduct disorders
- mood and anxiety disorders
- autism spectrum disorders
- substance abuse
- Tourette syndrome
The most common disorder for children age 3 through 17 is ADHD (7 percent) followed by behavioral or conduct problems (3.5 percent), anxiety (3 percent), depression (2 percent), and autism spectrum disorders (1 percent).
Five percent of teens reported abusing or being dependent on illegal drugs, 4 percent abused alcohol and 3 percent reported smoking cigarettes regularly. Boys were more likely than girls to have the disorders. Read more on mental health.
New PSAs Help Parents Talk to Younger Kids about the Dangers of Underage Drinking
“Talk. They Hear You,” is a new national public service announcement (PSA) campaign from the Substance Abuse and Mental Health Services Administration (SAMHSA) to empower parents to talk to children as young as nine about the dangers of underage drinking. SAMHSA research shows that more than a quarter of American youth engage in underage drinking, and though there has been progress in reducing the extent of underage drinking in recent years, particularly among those aged 17 and younger, the rates of underage drinking are still unacceptably high, according to SAMHSA. A report from late last year shows that 26.6 percent of 12-20 year-olds report drinking in the month before they were surveyed and 8.7 percent of them purchased their own alcohol the last time they drank, despite the fact that all fifty states and the District of Columbia currently have laws prohibiting the purchase and use of alcoholic beverages by anyone under age 21.
“Even though drinking is often glamorized, the truth is that underage drinking can lead to poor academic performance, sexual assault, injury, and even death,” said said SAMHSA Administrator Pamela S. Hyde.
The goal of the new PSA is to help parents start a conversation about alcohol before their children become teenagers. Read more on addiction.
Advocacy Groups Petition FDA to Ban Menthol Flavored Cigarettes
In response to a Citizen Petition by close to twenty health and tobacco control advocacy groups, the Food and Drug Administration has opened a docket for public comment on banning menthol in cigarettes. In 2009, according to the Tobacco Control Legal Consortium, the lead group on the petition, Congress banned all flavors in cigarettes except menthol, and directed the FDA to decide whether continued sale of menthol cigarettes is “appropriate for public health." According to the petition, menthol cigarettes are the source of addiction for nearly half of all teen smokers. Read more on tobacco.
The U.S. Food and Drug Administration (FDA) has announced that it will investigate the safety of caffeine in food products, especially the effects of caffeine on children and teens. The FDA’s announcement comes as an increasing number of food companies have introduced food products that contain caffeine—including gum, jelly beans, hot sauce, marshmallows and Cracker Jacks.
Caffeine can be addictive, and can lead to high blood pressure and insomnia, according to the American Academy of Pediatrics (AAP). AAP discourages the use of caffeine by kids and teens. Caffeine levels vary in the new foods on the market. According to the FDA, a caffeinated version of Wrigley’s gum contains as much caffeine as four ounces of coffee, per piece. The new caffeinated gum packs each contain eight pieces of gum.
Certain Alcohol Brands Dominate Underage Drinking
A small number of alcohol brands in particular are most popular with underage drinkers, according to a new study in Alcoholism: Clinical & Experimental Research. About 27.9 percent of underage youth reporting they’d had Bud Light in the past 30 days, making it the most used. Smirnoff Malt Beverages and Budweiser were second and third. “Importantly, this report paves the way for subsequent studies to explore the association between exposure to alcohol advertising and marketing efforts and drinking behavior in young people,” said study author David Jernigan, PhD, director of the Center on Alcohol Marketing and Youth at the Johns Hopkins Bloomberg School of Public Health. Read more on alcohol.
Report: Informational Tools Help Men Make Better Prostate Health Decisions
Decision-making aids help men make better—and more informed—decisions about prostate screenings, according to a new report in JAMA Internal Medicine. Researchers found the aids help the men weigh different possible outcomes, such as catching extra cancers, possibly reducing their risk of death or avoiding unpleasant side effects. As many as one in four family physicians regular perform prostate screenings without first getting a patient’s permission, according to Reuters. The U.S. Preventive Services Task Force recommends against prostate-specific antigen tests for men who are not at high-risk. Read more on cancer.
Study: Kids Treated for ADHD Still Show Serious Symptoms
As many as 90 percent of kids who are treated for attention-deficit/hyperactivity disorder (ADHD) still show serious symptoms after six years, indicating the chronic condition requires advancements in long-term behavioral and pharmacological treatments, according to a new study in the Journal of the American Academy of Child & Adolescent Psychiatry. The study did not look into issues such as whether medications were ineffective or not taken as prescribed. "Our study was not designed to answer these questions, but whatever the reason may be, it is worrisome that children with ADHD, even when treated with medication, continue to experience symptoms, and what we need to find out is why that is and how we can do better," said lead investigator Mark Riddle, MD, a pediatric psychiatrist at the Johns Hopkins Children's Center. ADHD causes difficulty in concentration, restlessness, hyperactivity and impulsive behavior. Read more on mental health.
Baby boomers, the generation born in the two decades after World War II, are in worse health than their parents were at the same stage of life, according to a U.S. study published in JAMA Internal Medicine. Researchers analyzed data from National Health and Nutrition Surveys (NHANES) of people 46 to 64 years old between 1988 and 1994 and the baby boomers who were in the same age range between 2007 and 2010.
In spite of medical advances, the study shows the boomers fared worse than their parents at the same age:
- 13 percent of the baby boomer generation reported being in “excellent” health in middle age, compared to 32 percent of the previous generation
- 39 percent of boomers were obese, compared to 29 percent of the previous generation
- 16 percent of boomers had diabetes, compared to 12 percent of the previous generation.
While the study doesn’t explain why baby boomers are in worse shape than their predecessors, Dana King, the study’s lead author believes it may be attributed to their poor lifestyle habits.
Read more on nutrition and obesity
Increasing the minimum price of alcohol by 10 percent can lead to immediate and significant drops in drink-related deaths, according to a study published in the journal, Addiction. Conducted by Canadian researchers in the western province of British Columbia, the study looks at three categories of alcohol related deaths: wholly alcohol attributable, acute, and chronic.
Each death rate was analyzed from 2002 to 2009 against increases in government-set minimum prices of alcoholic drinks. The major finding relates to wholly attributable deaths in which a 10 percent price rise was followed by a 32 percent death rate drop. Researchers say the reason for the lower death rates are likely due to the fact that raising the price of cheaper drinks makes heavy drinkers drink less.
Read more on alcohol
Preschoolers with known exposure to intimate partner violence (IPV) or parental depression may be more likely to develop attention-deficit/hyperactivity disorder (ADHD) by the age of six and be prescribed psychotropic medication, new research from JAMA Pediatrics Journal suggests. Researchers from Indiana University looked at 2,422 children who were part of the Child Health Improvement Through Computer Automation (CHICA) program, a computer-based decision support system that combines elements for implementing clinical guidelines in pediatric practice. Researchers collected information related to IPV and mental status of the parents, as well as the child's psychotropic drug treatment between 2004 and 2012.
Fifty-eight caregivers reported a history of IPV and/or parental depressive symptoms before their child turned three. Sixty-nine reported IPV only and 704 reported depressive symptoms only during this time frame. Children of parents reporting both IPV and depressive symptoms were more likely to have a diagnosis of ADHD and children whose parents reported depressive symptoms were more likely to have been prescribed psychotropic medication. While the study doesn’t prove a cause-and-effect link between IPV and/or maternal depression and likelihood of an ADHD diagnosis, the researchers say it does show a strong association.
The American Association of Obstetrics and Gynecology recently issued guidelines recommending that women get screened by their physicians for intimate partner violence at regular intervals, including during pregnancy. The U.S. Preventive Services Task Force, which advises the Department of Health and Human Services, recently issued final guidelines for doctors to screen women of childbearing age for intimate partner violence and either provide or refer women who appear to be victims of IPV for services.
Read more on pediatrics
U.S. Preventive Services Task Force Recommends Physicians Ask All Women about Intimate Partner Violence
Physicians should screen all women of childbearing age for signs of domestic violence and refer them for treatment if necessary, according to a new recommendation from the U.S. Preventive Services Task Force. In the United States, according to the U.S. Centers for Disease Control and Prevention, nearly one-third of women and more than 25 percent of men have been victims of domestic violence. In addition to the risks of injury and death, people who experience domestic violence may also develop sexually transmitted diseases, pelvic inflammatory disease, unintended pregnancies, chronic pain, neurological disorders, gastrointestinal disorders, depression, anxiety, post-traumatic stress disorder, substance abuse and suicidal behavior. Domestic violence in women is also linked to preterm birth and low-birth weight babies. The panel found that women who were screened for domestic violence were far more likely to discuss the issue with their doctor than women who were not screened. Read more on violence.
AAP: Playgrounds Need Yearly Safety and Quality Check
A new study of close to 500 Chicago playgrounds published in Pediatrics finds that the quality and safety of playgrounds can vary by neighborhood. Researchers looked at the playgrounds between 2009 and 2011 and assessed four categories: age-appropriate design, ground surfacing, equipment maintenance and physical environment. While most of the playgrounds met the criteria for age-appropriate design and physical environment, failing grades were often given for problems with ground surfacing, such as not enough wood chips to cushion falls, or equipment maintenance problems. The authors also found that neighborhoods with a higher percentage of low-income individuals had both fewer overall sites and more failing-grade playgrounds. The researchers reported failing grades to local authorities, which led to more passing grades at the end of the study. The researchers say strengthening community partnerships and training appropriate staff for yearly playground checks can result in a safer urban play environment for children. Read more on pediatrics.
Tenth Annual Traffic Law Report Card Finds Fewer Laws and More Deaths
The tenth annual report card on traffic safety by the group Advocates for Highway and Auto Safety finds that several states have repealed traffic safety laws and others have not moved to enact new ones. Last year only 10 state highway safety laws were enacted, while 16 laws were passed in 2011 and 22 were passed in 2010. According to the group, preliminary National Highway Traffic Safety Administration (NHTSA) data show the largest jump in traffic fatalities since 1975, a 7.1 percent increase in crash deaths during the first nine months of 2012 compared to the first nine months of 2011. The report card also found that:
- 18 states still need a primary enforcement seat belt law;
- 31 states still need an all-rider motorcycle helmet law;
- 19 states still need an booster seat law;
- No state meets all the criteria of Advocates’ recommended Graduated Driver’s License program;
- 40 states and Washington, D.C. are missing one or more critical impaired driving laws and;
- 15 states still need an all-driver text messaging restriction.
Read more on injury prevention.