Once Again: Our Children are Not Well

This week’s Journal of the American Medical Association (JAMA) features an editorial with the ominous title, “Pediatric Chronic Diseases—Stealing Childhood.”

The commentary appears in a well-timed special theme issue, “Chronic Diseases of Children.” Authors Jody Zylke, MD and Catherine DeAngelis, MD (editor-in-chief) note that this issue “is devoted to the very real problem of chronic diseases” in infants, children, and adolescents. They begin, “It is easy to romanticize childhood, especially in the middle of summer. Memories of lazy days at the beach, playing baseball or double Dutch with friends, catching lightning bugs in a jar and hopefully remembering to let them go, and having no concerns about bills to pay or time pressures or health problems. Perhaps childhood still is that way for some children, but for those with a chronic illness, life can be complicated and difficult.” How complicated and difficult is made clear in the numerous scientific articles published in the special issue, which cover a litany of childhood chronic disease epidemics: diabetes, obesity and cancer, to name a few. James Perrin, MD is the lead author of an article titled, “The Increase of Childhood Chronic Conditions in the United States,” which documents clearly that “the number of children and youth in the United States with chronic health conditions has increased dramatically” over the past 40 years. Perrin et al. correctly point out that “the increased prevalence of chronic conditions has greatly changed the face of child health and the types of conditions observed by child health care professionals.”

As I noted in a prior post regarding the UNICEF report, “Child poverty in perspective: An overview of child well-being in rich countries – A comprehensive assessment of the lives and well-being of children and adolescents in the economically advanced nations,” the United States lags well behind most developed countries in terms of children’s health and well-being statistics. While poverty and socioeconomic disparities undeniably lead to health disparities, children of all economic, social, racial, and cultural groups are suffering. Deirdre Imus and I recently co-authored a report (slated for publication in September’s Explore) titled, “Environmental Injustice: Children’s Health Disparities and the Role of the Environment,” in which we review the state of children’s health in the U.S. and detail the impact environmental factors have on our children’s deteriorating health. Perrin et al. agree: “While genes may play a role in obesity, asthma and ADHD, environmental and social changes are behind the surge.” As we comment in our article, with a focus on the whole child, pediatric integrative medicine addresses these environmental and social concerns in a way that our current medical system does not.

Here are some of the eye-opening statistics sadly defining the state of our children’s health:

• Cancer continues to be the leading cause of death by disease in children. The age-adjusted annual incidence of cancer in children increased from 129 to 166 cases per million children between 1975 and 2002.

• One in eight babies is born prematurily, an increase of nearly 31 percent since 1981. A lack of prenatal care and poor nutrition may account for 40% of premature births in developed countries. Preterm birth contributes to more than one-third of all infant deaths and costs the U.S. more than $26 billion per year.

• Asthma is the most prevalent chronic disease affecting American children, leading to 15 million missed days of school per year. From 1980 to 2004, the percentage of children with asthma has more than doubled, from 3.6 percent to 8.5 percent.

• One in three adolescents are overweight or at risk of becoming overweight. One in six youths ages 6-19 years are overweight, a 45 percent increase in the past 10 years alone.

• Type 2 diabetes rates, directly related to the obesity epidemic, are rapidly increasing in U.S. youth. Of those children newly diagnosed with diabetes, the percentage with type 2 has risen from less than 5 percent to nearly 50 percent in a ten year period. This disease disproportionately affects American Indian, African American, Mexican American, and Pacific Islander youth.

• Neurodevelopmental disorders affect one in six American children today, with autism and attention deficit hyperactivity disorder (ADHD) reported at all-time high rates. Autism spectrum disorders are most recently estimated at 1 in 150 children (4:1 boys:girls), a 20-fold increase since the 1980’s. Most recent national surveys estimate that approximately 1 in 12 children (2.5:1 boys:girls) have been diagnosed with ADHD.

• Children and adolescents are suffering from mental health disorders at alarming rates. Nearly 20% of young adolescents report symptoms of depression, with even higher rates in Native American youth. Suicide is the 3rd leading cause of death in youth ages 10-19, and suicide rates in Native American adolescents are three times greater than the national average.