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Child Public Health Resources

Reading Archive

Hot Reads for Child Public Health December 2005

"Here are December's Top Hot Reads, simply click on each heading and you will be taken to the article. There will be no January edition to allow the Southern Hemisphere fellas to enjoy the 'silly' season on the beach - apologies to our Northern Hemisphere relative, but a Merry Xmas and very Happy New Year to all and thank to Colin and Engy for their very efficient help."
Message from Dr Garth Alperstein

1. Community-based programmes to prevent falls in children: A systematic review
   Journal of Paediatrics & Child Health Vol 41 (9-10) Page 465 - Sept 2005
   A systematic review of the literature for the effectiveness of community-based interventions to reduce fall-related injury in children aged 0-16 years. Only 6 studies fitted the inclusion criteria and only 2 of those used a trial design with a contemporary community control. Neither of the high quality evaluation studies showed an effect from the intervention, and while authors of the remaining studies reported effective falls prevention programmes. Classic, isn’t it. Thanks why we need RCTs, systematic reviews and Cochrane. GA

2. Goals to reduce poverty and infant mortality will be missed
   BMJ 2005;331:593 (17 September)
   The UN's 2005 Human Development Report finds that progress on human development, public health, and education is slowing or stagnating in many parts of the world. On current trends, the report predicts, the world will not meet the goal of reducing child mortality by two thirds until 2045—30 years late. As for the goal of achieving universal primary education, 46 countries are currently going backwards or will not meet the target until after 2040, it says. The authors estimate that the income of the world's 500 richest people listed by Forbes magazine is equal to that of the world's poorest 416 million people. So, what are we doing about it?? GA

3. Overweight and obesity trends from 1974 to 2003 in English children: what is the role of socioeconomic factors?
   Archives of Disease in Childhood 2005;90:999-1004;
   This study examined childhood overweight and obesity prevalence trends between 1974 and 2003, and assessed whether these trends relate to parental social class and household income. There were 14 587 white boys and 14 014 white girls aged 5–10 years. The prevalence of obesity in boys increased from 1.2% in 1984 to 3.4% in 1996–97 and 6.0% in 2002–03. In girls, obesity increased from 1.8% in 1984 to 4.5% in 1996–97 and 6.6% in 2002–03. Obesity prevalence has been increasing at accelerating rates in the more recent years. Children from manual social classes had marginally higher odds (OR 1.14, 95% CI 0.98 to 1.33) and children from higher income households had lower odds (OR 0.74, 95% CI 0.61 to 0.89) to be obese than their peers from non-manual class, and lower income households, respectively. Are we some time going to address the upstream determinants? (GA)

4. Progress for children. A report card on immunisation number 3.UNICEF September 2005
   In 2003, 103 countries and territories had already achieved protection against measles of 90 per cent of children under one year of age. In 68 of these countries, coverage of the measles vaccine (MCV) was 95 per cent or more in 2003, a level that UNICEF projects will be sustained; and in 35 countries, coverage was 90 to 94 per cent, a level likely to be sustained. Of 90 countries that did not achieve 90 per cent coverage in 2003, 16 are likely to achieve it in 2010, 55 will require improvements in order to achieve it in 2010 and 19 need to reverse declining coverage. Eliminate poverty and war and we will be about there!!! (GA)

5. Mental health of children and young people in Great Britain 2004
   Office for National Statistics, UK
   Among 5-10 year olds, 10 per cent of boys and five per cent of girls had a mental disorder. Among 11-16 year olds, the proportions were 13 per cent for boys and 10 per cent for girls. The prevalence of mental disorders was greater among children and young people in deprived social environments, such as:

• living in the social or privately rented sector (17 per cent and 14 per cent) compared with those who owned their accommodation (seven per cent);
• living in low income, high unemployment areas (15 per cent) compared with affluent areas (seven per cent).
• in reconstituted families (14 per cent) compared with those containing no stepchildren (nine per cent);
• in lone parent families (16 per cent) compared with two-parent families (eight per cent);
• in families with neither parent working (20 per cent) compared with those in which both parents worked (eight per cent);
• in families with a gross weekly household income of less than £100 (16 per cent) compared with those with an income of £600 or more (five per cent);
• in families whose interviewed parent had no educational qualifications (17 per cent) compared with those who had a degree level qualification (four per cent);
• in families where the household reference person was in a routine occupational group, such as unskilled manual workers (15 per cent) compared with those with a reference person in the higher professional group, for example, doctors and lawyers (four per cent); Anybody see any clues as to which interventions to improve child and youth mental health outcomes might be more effective?? (GA)

6. Investing in children’s health: what are the economic benefits?
   Bulletin of the World Health Organisation 2005;83:777-784
   This paper argues that investing in children’s health is a sound economic decision for governments to take, even if the moral justifications for such programmes are not considered. Children born into poorer families have poorer health, as children, receive lower investments in human capital, have poorer health as adults, will earn lower wages, which will affect the next generation of children. The paper highlights the gains made by Early Childhood Care and Development programs. The conclusion that can be drawn from the literature studying the relationship between children’s health and the economy is that children’s health is a potentially valuable economic investment. An excellent hard-nosed economic analysis. (GA)

7. Mandatory fortification of flour with folic acid: an overdue public health opportunity
   MJA 2005; 183 (7): 342-343
   Fourteen years ago, randomised controlled studies in the United Kingdom confirmed observational studies from Australia, the United States, and elsewhere, showing that an adequate intake of folic acid by women at around conception prevents most neural tube defects in their babies. Despite recommendations by the National Health and Medical Research Council in Australia and other scientific bodies and scientists in the UK, mandatory fortification has yet to be introduced in these countries. After mandatory wheat flour fortification in the US, median serum folate levels in non-pregnant women of reproductive age more than doubled. Mandatory fortification has resulted in a 30% reduction of neural tube defects, or 1000 fewer cases every year. Each case of spina bifida prevented saves an estimated US$500 000 in lifetime costs. The case against gets weaker and weaker. Read on. (GA)

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