Child Public Health Resources
Reading archive
Hot Reads for Child Public Health May 2007
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Brain basis of early parent–infant interactions: psychology, physiology, and in vivo functional neuroimaging studies. Journal of Child Psychol and Psychiatry 48 (3-4), 262–287
Parenting behavior critically shapes human infants’ current and future behavior. The parent–infant relationship provides infants with their first social experiences, forming templates of what they can expect from others and how to best meet others’ expectations. In this review, the authors focus on the neurobiology of parenting behavior, including their own functional magnetic resonance imaging (fMRI) brain imaging experiments of parents. They begin with a discussion of background, perspectives and caveats for considering the neurobiology of parent–infant relationships. Then, they discuss aspects of the psychology of parenting that are significantly motivating some of the more basic neuroscience research. Following that, they discuss some of the neurohormones that are important for the regulation of social bonding, and the dysregulation of parenting with cocaine abuse. Then, they review the brain circuitry underlying parenting, proceeding from relevant rodent and nonhuman primate research to human work. Finally, they focus on a study-by-study review of functional neuroimaging studies in humans. Taken together, this research suggests that networks of highly conserved hypothalamic–midbrain–limbic–paralimbic–cortical circuits act in concert to support aspects of parent response to infants, including the emotion, attention, motivation, empathy, decision-making and other thinking that are required to navigate the complexities of parenting. Specifically, infant stimuli activate basal forebrain regions, which regulate brain circuits that handle specific nurturing and caregiving responses and activate the brain's more general circuitry for handling emotions, motivation, attention, and empathy – all of which are crucial for effective parenting. They argue that an integrated understanding of the brain basis of parenting has profound implications for mental health -
Globalization of Behavioral Risks Needs Faster Diffusion of Interventions
US Centre for Disease Control. Preventing Chronic Disease [serial online] 2007 Apr.
International trade, population migration, changes in living conditions (i.e., consumption transition, nutritional transition), and changes in production, marketing, and availability of consumer goods (i.e., production transition) have brought about continuous and rapid changes in the human environment. Such changes have improved the health and economic status of many people in developing countries. At the same time, a parallel phenomenon is occurring: the rapid emergence and expansion of modifiable risk behaviours. These behaviours adversely affect the national health of developing countries and that of future generations because of their impact on maternal, child, and adolescent health. Furthermore, these behaviours are increasing at a faster rate than interventions to curb their growth are being implemented. The authors discuss the current status of five modifiable risk behaviours — alcohol consumption, tobacco use, overweight and obesity, low fruit and vegetable consumption, and physical inactivity — to emphasize the need for global advocacy and local action to enhance policy formulation and diffusion of interventions necessary to moderate the spread of these behaviours. -
Giving Everyone the Health of the Educated: An Examination of Whether Social Change Would Save More Lives Than Medical Advances. American Journal of Public Health. April 2007, Vol 97, No. 4 | 679-683
Social determinants of health, such as inadequate education, contribute greatly to mortality rates. The authors examined whether correcting the social conditions that account for excess deaths among individuals with inadequate education might save more lives than medical advances (e.g., new drugs and devices). Using US vital statistics data for 1996 through 2002, they applied indirect standardization techniques to estimate the maximum number of averted deaths attributable to medical advances and the number of deaths that would have been averted if mortality rates among adults with lesser education had been the same as those among college-educated adults. The authors found medical advances averted a maximum of 178193 deaths during the study period. Correcting disparities in education-associated mortality rates would have saved 1369335 lives during the same period, a ratio of 8:1. Conclusions. Higher mortality rates among individuals with inadequate education reflect a complex causal pathway and the influence of confounding variables. Formidable efforts at social change would be necessary to eliminate disparities, but the changes would save more lives than would society’s current heavy investment in medical advances. Spending large sums of money on such advances at the expense of social change may be jeopardizing public health. -
The Effect of School on Overweight in Childhood: Gain in Body Mass Index During the School Year and During Summer Vacation. American Journal of Public Health. April 2007, Vol 97, No. 4| 696-702
The aim of this study was to determine whether school or nonschool environments contribute more to childhood overweight, by comparing children’s gains in BMI when school is in session (during the kindergarten and first-grade school years) with their gains in BMI when school is out (during summer vacation). The authors found growth in BMI was typically faster and more variable during summer vacation than during the kindergarten and first-grade school years. The difference between school and summer gain rates was especially large for 3 at-risk subgroups: Black children, Hispanic children, and children who were already overweight at the beginning of kindergarten. Conclusion: Although a school’s diet and exercise policies may be less than ideal, it appears that early school environments contribute less to overweight than do nonschool environments. -
Trends in the Black-White Life Expectancy Gap in the United States, 1983-2003. JAMA. 2007;297:1224-1232.
Since the early 1980s, the black-white gap in life expectancy at birth increased sharply and subsequently declined, but the causes of these changes have not been investigated. The aim of this study was to determine the contribution of specific age groups and causes of death contributing to the changes in the black-white life expectancy gap from 1983-2003.
Among females, the black-white life expectancy gap increased 0.5 years in the period 1983-1993, primarily due to increased mortality from HIV (0.4 years) and slower declines in heart disease (0.1 years), which were somewhat offset by relative improvements in stroke (–0.1 years). The gap among males increased by 2 years in the period 1983-1993, principally because of adverse changes in HIV (1.1 years), homicide (0.5 years), and heart disease (0.3 years). Between 1993 and 2003, the female gap decreased by 1 year (from 5.59 to 4.54 years). Half of the total narrowing of the gap among females was due to relative mortality improvement among blacks in heart disease (–0.2 years), homicide (–0.2 years), and unintentional injuries (–0.1 years). The decline in the life expectancy gap was larger among males, declining by 25% (from 8.44 to 6.33 years). Nearly all of the 2.1-year decline among males was due to relative mortality improvement among blacks at ages 15 to 49 years (–2.0 years). Three causes of death accounted for 71% of the narrowing of the gap among males (homicide [–0.6 years], HIV [–0.6 years], and unintentional injuries [–0.3 years]), and lack of improvement in heart disease at older ages kept the gap from narrowing further.
Conclusions. After widening during the late 1980s, the black-white life expectancy gap has declined because of relative mortality improvements in homicide, HIV, unintentional injuries, and, among females, heart disease. Further narrowing of the gap will require concerted efforts in public health and health care to address the major causes of the remaining gap from cardiovascular diseases, homicide, HIV, and infant mortality.