The rising incidence of chronic conditions among American children is going to be a serious challenge for the future provision of health and social welfare resources said researchers in a commentary in the Journal of the American Medical Association (JAMA).
The current issue of JAMA is devoted to the topic of pediatric chronic disease.
In the commentary, experts from Massachusetts General Hospital (MGH) and Harvard School of Public Health (HSPH) explain how obesity, asthma and attention-deficit hyperactivity disorder (ADHD) have gone up in the last 30 years in the US and they suggest reasons why this may be so and how it affects the future, for the children and the nation’s health and social care resources.
Dr James Perrin, professor of Pediatrics at Harvard Medical School and also from the Center for Child and Adolescent Health Policy, MassGeneral Hospital for Children said that:
“These new epidemics in chronic health conditions among children and youth will translate into major demands on public health and welfare in upcoming decades.”
“Active prevention efforts likely offer the best hope of reversing these trends,” he suggested.
Perrin and colleagues looked at the results of many studies from a range of journals and found that the evidence overall suggests there are more American children with health conditions today. They give some examples, comparing rates in the 1970s with today’s incidence:
- Obesity in children and adolescents has more than tripled from 5 per cent to 18 per cent.
- Asthma has doubled to nearly 9 per cent.
- Cases of ADHD now include about 6 per cent of school children.
Overall, between 15 and 18 per cent of all American children and adolescents have some sort of chronic health condition. Nearly half this number could be classed as disabled said Perrin and colleagues.
Speculating on the reasons behind these disorders, the researchers suggest that although some of the explanation could be put down to genetics, there are a number of potential environmental and lifestyle factors that have changed significantly in the last three decades. These are:
- Stress on parents, reducing the time and energy they spend on their children.
- Increase in sedentary time spent by children; they are indoors more, for example watching TV.
- Fewer opportunities for physical activity.
- Changes in diet, for instance increase in fast food and sugary drinks, plus overall increase in calories consumed.
Dr Steven Gortmaker, professor of the Practice of Health Sociology at HSPH and of the HSPH Department of Society, Human Development, and Health said that the food, physical activity and media environments of children have changed dramatically in the past few decades and these should be the primary target for improvement. Failure to do this means the children will carry these problems into adulthood:
“We know that major health conditions continue into adulthood; so if these trends continue, we will see increased health care costs and decreased quality of life, as many of these young people find their opportunities limited.”
The researchers, which also included Sheila Bloom of MGH, suggested that if current trends persisted then increases in the following conditions can be expected in young people and also in the future adult population:
- Increase in type 2 diabetes, hypertension and cardiovascular disease due to higher rates of obesity.
- Asthma continues into adulthood in at least 25 per cent of childhood cases. This increases the risk of disability.
- ADHD is known to persist into adulthood for 50 per cent of childhood cases. This increases the likelihood of mental health problems and limits opportunities for further education and employment.
The authors concluded that current provisions in the health and welfare system will not cope with the rising demands of this situation. It is important that plans are made to meet the health and social needs of these children and future adults and it is critically important that preventive strategies are put into place now.
“The Increase of Childhood Chronic Conditions in the United States.”
James M. Perrin, Sheila R. Bloom, Steven L. Gortmaker.
JAMA. 2007;297:2755-2759.
Vol. 297 No. 24, June 27, 2007.
Written by: Catharine Paddock
Writer: Medical News Today