Child Public Health Resources
Reading archive
Hot Reads for Child Public Health October 2007
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Research Review: Can we justify the widespread dissemination of universal, school-based interventions for the prevention of depression among children and adolescents? Journal of Child Psychology and Psychiatry June 2007; 48(6), 526-42.
This review examines the evidence concerning the efficacy and effectiveness of universal, school-based interventions designed to prevent the development of depression in children and adolescents. It evaluates the outcomes of research in relation to standards of evidence specified by the Society for Prevention Research (Flay et al., 2005). The limited evidence available brings into doubt the efficacy and effectiveness of current universal, school-based approaches to the prevention of depression, suggesting that the widespread dissemination of such interventions would be premature. Relatively brief programs, that focus specifically on enhancing individual skills and characteristics of the individual in the absence of environmental change, may be insufficient to produce lasting effects in the prevention of depression among children and adolescents. -
Decline in pneumonia admissions after routine childhood immunisation with pneumococcal conjugate vaccine in the USA: a time-series analysis The Lancet 2007; 369:1179-1186
The authors assessed the effect of routine infant immunisation with seven-valent pneumococcal conjugate vaccine (PCV7), which began in the USA in 2000, on rates of all-cause and pneumococcal pneumonia hospital admissions. Data from the Nationwide Inpatient Sample, the largest inpatient database available in the USA, were analysed with an interrupted time-series analysis that used pneumonia (all-cause and pneumococcal) admission rates as the main outcomes. Monthly admission rates estimated for years after the introduction of PCV7 vaccination (2001–2004) were compared with expected rates calculated from pre-PCV7 years (1997–1999). The year of vaccine introduction (2000) was excluded, and rates of admission for dehydration were assessed for comparison.
At the end of 2004, all-cause pneumonia admission rates had declined by 39% for children younger than 2 years, who were the target population of the vaccination programme. This annual decline in all-cause pneumonia admissions of 506 (291–675) per 100,000 children younger than 2 years, represented about 41,000 pneumonia admissions prevented in 2004. During the 8 study years, 10,659 (2%) children younger than 2 years admitted with pneumonia were coded as having pneumococcal disease; these rates declined by 65% (47–77). This decline represented about 17 fewer admissions per 100,000 children in 2004. Admission rates for dehydration for children younger than 2 years remained stable over the study period. The reduction in all-cause pneumonia admissions in children younger than 2 years provides an estimate of the proportion of childhood pneumonias attributable to Streptococcus pneumoniae in the USA that are vaccine preventable.
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Health of Aboriginal and Torres strait Islander children in remote Far North Queensland: findings of the Paediatric Outreach Service. MJA 2007; 186 (10): 519-521
A retrospective review of the Far North Queensland Paediatric Outreach Service’s Medical Director database for the period June 2001 to February 2006 was conducted. Three subpopulations were compared: children from predominantly Aboriginal communities, predominantly Torres Strait Islander communities, and other communities. All children referred to the service during the study period were reviewed. 3562 children were referred during the study period, and a total of 3932 diagnoses were made; 56% of the paediatric population of the Aboriginal communities and 23% of the paediatric population of Torres Strait Islander communities were seen. Of 40 separate diseases/health problems reviewed, the three most common reasons for presentation were chronic suppurative otitis media, suspected child abuse and neglect, and failure to thrive. In the paediatric population of Aboriginal communities, the prevalence of fetal alcohol spectrum disorder was at least 15/1000 (1.5%), and in Torres Strait Islander children, rheumatic heart disease prevalence was at least 6/1000 (0.6%). Rheumatic fever rates were among the highest in Australia. Conclusion: Rates of preventable complex and chronic health problems in Aboriginal and Torres Strait Islander children in remote FNQ are alarmingly high. Areas requiring urgent public health intervention include alcohol-related conditions and rheumatic fever. -
Childhood Abuse, Adult Health, and Health Care Utilization: Results from a Representative Community Sample American Journal of Epidemiology 2007 165(9):1031-1038
The long-term consequences of childhood abuse on adult mental health have been a major focus of research. Much less attention has been directed to its effects on physical health outcomes. By use of data from the Ontario Health Survey (n = 9,953), the association between retrospective reports of childhood physical and sexual abuse and adult health and health care utilization was examined in men and women. The population health survey was conducted from November 1990 to March 1991 in the Canadian province of Ontario. An association of moderate strength was found between childhood abuse and multiple health problems, poor or fair self-rated health, pain that interferes with activities, disability due to physical health problems, and frequent emergency room and health professional visits but not frequent general practitioner visits. These effects were more pronounced in females and younger respondents. The strength of the associations reported here with odds ratios of 1.3–2.2 was lower than that found between childhood abuse and adult mental health, with odds ratios of 1.9–3.4. Given the growing evidence of the long-term effects of childhood abuse, greater efforts are clearly needed in developing more effective strategies for the prevention and treatment of child abuse. -
Duration of Poverty and Child Health in the Quebec Longitudinal Study of Child Development: Longitudinal Analysis of a Birth Cohort PEDIATRICS Vol. 119 No. 5 May 2007, pp. e1063-e1070
Data from the Quebec Longitudinal Study of Child Development for 1950 children who were followed annually up to age 3 years were analyzed. Poverty was defined as having an income below the low-income cutoff from Statistics Canada. Five health indicators were examined: asthma attacks, infections, growth delay, a cumulative health-problems index, and maternal perception of the child's health. The association between duration of poverty and child health was explored with logistic regression modeling controlling for child and mother characteristics, including the mother's level of education, social support, and physical violence. RESULTS. In this birth cohort, 13.7% (268) 3-year-old children from the Quebec Longitudinal Study of Child Development experienced intermittent poverty since birth (1–2 episodes), and another 14.4% (280) experienced chronic poverty (3–4 episodes). Children from families with chronic poverty had more frequent asthma attacks and had a higher cumulative health-problems index score, whereas children with intermittent poverty were more often perceived to be in less than very good health by their mothers. These associations remained statistically significant when controlling for child and mother characteristics. No association was observed between duration of poverty and infections or growth delay.
CONCLUSIONS. Chronic poverty affects a large number of children and has negative consequences for preschool children's health, although universal health care is available. The effects of chronic poverty may vary according to different health indicators and the age of the child.