Courtesy of CDC here is a graph of youth firearm deaths by country. If you are a parent who lives in the USA it may be time to ask whether tightening gun laws might be a good idea.
Here is a map of childhood asthma prevalence by state published by CDC with the north-east of USA taking the cake.
The CDC is rather coy in the article as to why this may be but The Green Man has some interesting factoids that may shed some light.
The Australian Government Health site speculates
1. in wealthy, hygienic Western countries, most babies are not exposed to bacterial infections that "kick start" the immmune system in early life and may be important in directing the immune system away from allergic responses. They also grow up in warm, well-furnished, carpeted homes that don't allow much airflow. This encourages the rapid breeding of large numbers of house dust mites in bedding, carpets and furnishings. Many children, instead of playing outside in fresh air, spend most of their time indoors. This further increases dust mite sensitisation.2. diet in Western countries, such as a high proportion of processed foods, a higher salt intake, a lower antioxidant intake and a lack of fresh oily fish (lower intake of omega-3 fatty acids) may contribute to the development of asthma.
3. spending more time inside in front of the television means that children get far less exercise. Reduced exercise may mean less stretching of the airways, and a greater tendency for the muscle in the airway walls to contract abnormally when exposed to minor irritants.
Could it be that children of the north east spend more time parked in front of a TV, consuming junk food, in a near sterile environment, than those of say, Arizona.
Pure Pedantry, a blog of inconsequential consequence, to which The Green Man is currently addicted, has an interesting piece on the realitive safety of c-section vs vaginal births vis-a-vis the baby. (Somehow, a photo did not seem appropriate for this post, but, given the nature of the internet, I'm sure I could have found one.)
Obviously abdominal surgery is not a trivial thing for the mother. Whilst being less painful in the short term, it can result in pain for a much longer term.
For the baby, however, the abdominal wall is far more flexible and forgiving than the pelvis. The latest issue of Radiology Dr John Gilmore has an interesting article looking at the incidence of bleeding in the brain of newborns in vaginal deliveries vs c-sections. Needless to say the softness of the abdominal wall does far less damage to the skull on the baby's path to freedom. Dr Jack says
"In our study, neither the size of the baby or the baby's head, the length of the labor, nor the use of vacuum or forceps to assist the delivery caused the bleeds .. The bleeds are probably caused by pressure on the skull during delivery."
Between 1990 and 2002 the number of teenage girls in the USA getting pregnant dropped by 25.6%. During the same period the number of teenage abortions dropped by 40.9%. If we assume that the percentage of girls who abort in responce to an unwanted pregnancy is roughly stable then we can assume that the number of unwanted teenage pregnancies has plumitted by approximately 62% during this period.
The notable exception to this trend is in the hispanic community where teenage pregnancies have jumped by 26.2% with the number of terminated pregnancies raising by only 15.7%. The majority of teenage hispanic girls getting pregnant are in the 18-19 (62.3%). This suggests that 18-19 y.o. teenage hispanic girls are choosing motherhood as their career of choice. Where as non Hispanic girls, for whatever reason, are choosing to delay their pregancy until their 20's.
We have all seen the obsessive mothers who subject their children to all sorts of programs aimed at developing brilliance in their children. So what is the single most important thing to give your child to ensure that their academic and/or artistic potential is realised.
Structured playgroup?
Expensive psychologically sound toys?
Intensive development programs?
Get them playing a musical instrument?
Expose them to great art and beauty?
well all of these things might be of benefit but the single most important thing that ensures that your child maximises their intellectual/artistic potential is a secure relationship with adults that adore them. This is the finding of Dr Eric Knudsen of Stanford University School of Medicine. He found that it is the earliest years of life that determine a persons ability to learn.
The important lesson is that a cardboard box may be as good as an expensive toy in developing your childs intellect and creativity. If they feel loved and supported they will benefit from even the simplest of toys. If not, the most expensive of toys and development programs will be limited value. He says
It's all about playing with your child. A child's eventual ability to learn calculus or a second language starts with the neurons that are shaped by positive interactions with nurturing adults.
Recognition of the importance of brain development in the under 4's has lead to the formation of the Council for Early Learning in Washington. The dark lord of computing, who has returned from the dark side to establish the Bill & Melinda Gates Foundation has provided support. Long time advocates for improving K-12 education have come to the conclusion that they are starting to late.
To quote Dr Jack Shonkoff, chair of the national Scientific Council on the Developing Child
The key issue is the nature of kids' relationships with the important people in their lives. It's not about toys its about the human connection.
I know that most of the readership of The Green Man are old farts (I mean that in the nicest possible way) and they are long past the age when they are likely to have a new baby around, unless, of course, your are a middle aged man who, in a crisis of realisation of your own mortality, has dumped the missus of 20 years and picked yourself up a trophy wife.
Never the less, you probably have adult children and this is an important message to pass on to them. The place for a baby is in a crib not your bed. Research continues to reinforce the dangers of sudden infant death syndrome related to infants sleeping with their parents. In October 2003 issue of Pediatrics, James Kemp, M.D., associate professor of pediatrics at Saint Louis University wrote that babies who sleep in an adult bed face a risk of suffocation that is as much as 40 times greater than babies who sleep in standard cribs.
All the new age crap about bonding with your baby means little if, in your sleep, you smother it and this is a real and ever present risk when adults share their beds with babies. New babies particularly lack the ability to extricate themselves from situations where they are smothering. It is so easy to do when you are asleep and so tragic. Here are the rules
Infants should be placed on their backs – not on their stomachs and sides – to sleep. Babies should sleep on a firm crib mattress, covered by a sheet, with no soft, cushy bedding such as pillows, comforters or quilts, in a room that isn't overly hot. Smoking during pregnancy increases a baby's risk of SIDS, and giving pacifiers at naptime and bedtime are associated with a reduced risk of SIDS.
 |
Two thirds of injuries from fireworks in the United States occur in the days surrounding the July 4th holiday |
|
Children 14 years and younger sustained about 45% of injuries related to fireworks |
|
Boys represented 72% of all those injured |
|
Hands and fingers (26%), eyes (21%), and head and face (18%) were the parts of the body most frequently injured |
|
Injuries were most commonly associated with fire-crackers (24%), rockets (18%), and sparklers (21%). |
|
U.S. fire departments reported approximately 24,200 fireworks-related fires in 1999 that were estimated to have cost $17.2 million in direct property damage |
Source: Centres For Disease Control.
Dave of McRaven has taken exception to The Green Man scattering doom and gloom about willy nilly vis-a-vis obesity in the USA. Pointing out that weight gain may indicate increased health, not decreased, and this is a cogent argument. The reduction in smoking alone, which is a major killer in the USA, may have contributed to this.
Heart disease is often quoted as a major negative health outcome of obesity and yet, in spite of the rapid increase in obesity, there has been a dramatic reduction in deaths from heart disease over the same period, from 322 to 241 per 100,000. This reflects a reduction in heart disease generally with hospital figures showing discharge rates for patients for whom Ischemic Heart Disease was first-listed diagnosis have decrease from a high of 72 per 1,000 individuals in 1992 to 50.7 in 2002.
The fall is even more dramatic in the age group most at risk 65-74 year olds with rates falling from 100 to 57 per 1,000. What this dramatic fall masks in the overall statistics is the raise in heart disease in the age group 0-44. Over the lifetime of the statistics rates in this group have remained relatively stable at an average of 16.4. In 2002 the rate rose to 21.2 and one might hypothesise that this is correllated to the increase in childhood obesity.
This chart shows the growth in obesity over the period. Another very scary fact for children--Type II Diabetes, which used to be known as late onset diabetes, is now increasingly being diagnosed and adding to the cardiovascular risk profile of children. Many children now who are not only overweight, but they also have high blood pressure, lipid abnormalities, and diabetes--all of the factors that increase the risk among adults for cardiovascular disease and stroke.
Apart from these more clinical aspects, at a practical level, it is just not as much fun being a kid when you are fat.
Accordingly you would expect that it would be a big issue for pediatricians and so it is however research by Dr Eliana M. Perrin at the University of North Carolina has revealed that as few 12 percent of pediatricians surveyed felt effective in treating overweight children. You might think that ADHD would be a challenging complaint for pediatricians or that dealing with sexually transmitted diseases in children may confront a pediatrician's sensibilities but most surveyed were more comfortable dealing with these complaints than with obesity and the major reason appears to be their lack of comfort with their own body image. She says
pediatricians who thought they were thin had the toughest time counseling because they worried that patients would consider them unsympathetic ... Those who think themselves too heavy might have trouble counseling about weight for more obvious ‘pot-calling-the-kettle-black’ reasons.
Consequently, there is a culture of under-diagnosis of obesity problems in children despite the strong links to diabetes, high blood pressure and cardiovascular disease in later life.
The solution is relatively simple, a reduction in fast food and sugar rich carbonated drinks and a move to a less sedentary lifestyle. Implementing the solution on the other hand is a far from simple process.
The great social leveler in American society is turning out to be obesity. Once the province of the poor, it is now a general malaise.
Below are some comparative figures from 1974 and 2002. You porkers!
|
Income |
1974 |
2002 |
Percentage increase |
|
< $25,000 |
22.5 |
32.5 |
144% |
|
$25,000-$39,999 |
16.1 |
31.3 |
194% |
|
$40,000-$60,000 |
|
|
209% |
|
> $60,000 |
9.7 |
28.6 |
276% |
Here is a random picture of a collection of ninth graders picked up off the net. They look like an ordinary bunch of 14 year olds don't they? If they are then sex is very much a part of their lives and their sex of choice is oral sex. New research by University of California, San Francisco shows that oral sex is far more prevalent amongst this group than vaginal sex.
Awareness of pregnancy, AIDS and other STDs is high amongst this age group and, quite correctly, they assess oral sex as a safer alternative. Not only that, the adolescents believed that oral sex also was less likely to have negative social and emotional consequences, such as a bad reputation, getting into trouble, feeling bad about themselves, feeling guilty, or having a relationship with a partner become worse.
The mean age of those sampled was 14.8 and 20% had already participated in oral sex and further 31% said they intended to within the next six months. Compare this with vaginal sexual activity which were 13% and 26% respectively.
All this is quite normal of course, the one area of concern was that a number of those surveyed believed that there were no risk of STDs associated with oral sex which clearly is not the case. The messages from the study are
1. If you have a 14 year old, its time to take your head out of the sand and accept that sex is part of their immediate world
2. Sex education needs to address issues relating to oral sex as well as vaginal sex.
Self harm amongst adolescents is far more common than you might think and it is primarily the domain of girls with the age of most risk being when they are between 13-15 with 9% of girls within this demographic having self-harmed sufficiently to present to hospital.
Self harm can take a number of forms of course and only immediate forms are usually included in statistics, such as cutting and posioning. Whilst most incidents of poisoning end up reporting to hospitals, many incidents of cutting are not reported, the implication being that the figures are probably much higher than the statistics suggest. One could also consider incidents of long term calculated harm, such as anorexia nervosa, which are not included.
Why do adolescents self harm? The answer is generally different for boys and girls.
For girls the major reason given is "to punish myself"
For boys it is "to kill myself"
Other reasons that are common are
"to find relief from a terrible state of mind"
"frighten someone"
"get attention"
Not surprisingly there is a close correlation between mental disorder and self-harm incidents . Most of the teenagers who are self harming presented with a psychological disorder, most commonly depression.
It is interesting to look at the family characteristics of the families in which these self harm events take place. The common theme was one of poor communication skills, with parents agreeing with statements such as
"We avoid discussing our fears and concerns"
"Planning family activities are difficult because we misunderstand each other"
"There is lots of bad feeling in the family"
"Making decisions is a problem for our family"
Additionally 32% of victims of self harm had experienced 3 or more stressful life events, 41% reported living with family discord and 32% were frequently punished.
In summary, these children were not living in loving, caring families who worked through their difficulties together. In particular 53% of the children who self-harmed agreed with the statement
"Since child was born parent had a separation due to marital difficulties or broken off a steady relationship"
There is a clear message here and that is that your childs psychological and emotional well-being is closely tied to the amount of love and stability they receive at home.
One final point, you may ask why boys don't feature as prominently in the self-harm statistics and the answer is simple, boys are much more fragile than girls and boys that are suffering frequently kill themselves. They are included in a different set of statistics.
If you wish to read more on this topic
click here for some detailed analysis by British Statistics
click here for recent research by Dr Karen Rodham published in Psychiatric Times.
So a sixteen year old girl goes into a clinic and asks for a prescription for the contraceptive pill. Should the doctor be obliged to notify her parents?
It seems that 55% of American parents think "yes".
Regardless of whether they think that parental notification laws should be in place, almost all recognise that these laws will have negative consequences, such as more girls indulging in unprotected sex.
Dr Marla Eisenberg of the University of Minnesota says
Although parents may intellectually recognize the need for adolescents to have access to confidential care, support for parental notification laws may arise from other factors such as fear of unknown others making decisions about their children's health, the desire to monitor their children's activities, and global beliefs about the appropriate role or parents.
The fact that most parents who support PNLs recognise that their daughter may participate in dangerous sexual excounters as a result of these laws and yet still support them points to a complex set of beliefs relating to their role in protecting and nuturing their daughter. It seems obvious that they are not of the opinion that their daughter would abstain from sex. If this was the case they would not be supporting PNLs, since their would be no need for them.
It seems likely that punishment plays a role, ie if she is denied access to contraceptives and information about sex and STDs and she participates anyway then any negative outcomes are her punishment. This is a nice simplistic approach however it is important to get things in perspective. A girl dying of AIDS is a punishment on both the girl and her parents that does not seem to fit the crime of doing what your body was built to do.
Are you a parent of a 9-12 year old girl. You may well be reluctant to have them roaming the net, there is so much that is bad on on it. Here is a good website just for them.
Powerful Bones, Powerful Girls looks like a fun site to me but I am not a 9-12 year old girl so what would I know? Anyway it is an appropriate site for them to explore. It aims to establish lifelong, healthy habits that build and maintain strong bones in a fun manner.
October 4th-8th is international walk to school week and it is half over. Never mind there a whole lot of other school days in the year and you can walk to school on almost any of them.
Walk to school is an international initiative to encourage children to obtain some exercise safely by
- Encouraging children to walk in groups.
- Organizing responsible adults to accompany children as they walk to and from school.
- Teaching and practicing safe pedestrian behavior during the walk to and from school.
- Empowering neighborhoods to work together with local agencies, such as the department of public works, to identify and create safe routes to school.
- Partnering with local police to enforce speed limits in and around schools.
Providing crossing guards for children on their way to and from school.
The Green Man remembers a time when we didn't worry too much about these things. Your mother put your lunch in your hand and pushed you out the front door and said see you tonight.
One wonders whether times are really any less safe now or whether we are raising a timid generation where fear will be one of the more prevalent emotions in their lives. How sad in either case. Our society has actually regressed rather than progressed if our children spend more of their life in fear than we did.
Visit the I Walk To School website for more information on the program.
US National Centre for Chronic Disease Prevention also has some excellent resources on Walk To School week.
