Lecture 2- Paediatric public health

Question 1

Health is defined by more than biology- social determinants of health

Answer 1

• E.g. Poverty / deprived backgrounds associated with poor health
• More children from ethnic background- different disease risk

Question 2

What are the health issues for English children?

Answer 2

• 1 in 10 children have a chronic illness that effects normal day to day function
• Long-term conditions (asthma is the most common, type 1 diabetes, epilepsy, or other complex needs such as disability or sensory impairment)
• Special educational needs(SEN)
• Allergies(food, eczema, allergic rhinitis)
• 34.3% of 10-11 aged children are obese (BMI >30).
• Poor diet leading risk factor for half of CVD risk and oral health
• Communicable diseases(Meningitis,E.coli0157, Measles, Mumps)
• Youth violence is increasing (incidence of sharp injury)

Question 3

How do we prevent ill health?

Answer 3

• Healthy weight (improved food and food environments, ability to buy healthy food, weight management, food advertising, food reformulation, health warnings)
• Vaccination and immunizations (promote complete vaccination schedules, address trust and concerns, have good call recall systems)
• Oral health (preventive dental care, water fluoridation, improved diet)
• Accidents/violence (20mph speed limits, reduce car usage, public health approach to youth violence rather than criminal justice)
• Sexual and reproductive health (easy access contraception, reduce stigma)
• Adult tobacco use (smoking cessation, nicotine replacement, smoking bans)
• Substance misuse (minimum unit alcohol pricing, drug treatment)

Question 4

Public health interventions

Answer 4

• Health improvement (change4life, Brush4Life, Whole Systems Approach to Obesity, National Child Measurement Programme [NCMP])
• Health protection (child vaccination schedules, screening, surveillance)
• Healthcare public health (improving access to services, data and epidemiology)

Question 5

Why is child mental health important

Answer 5

• Early intervention key to reducing damage
• Good mental health begins in infancy
• Everyone’s responsibility

Question 6

Trends in mental health

Answer 6

Overall there has been a slight increase in overall rates of mental disorder

Question 7

Mental health: Differences in age and gender distribution

Answer 7

Rates in mental health disorder vary depending on the age and gender group

Question 8

Sexual identity and mental disorder

Answer 8

Young people who identified as lesbian, gay, bisexual or with an other sexual identity were more likely to have a mental disorder (34.9%) than those who identified as heterosexual (13.2%)

Question 9

Socioeconomic context of mental disorder

Answer 9

• Mental disorders tended to be more common in children living in lower income households
  
  • This was evident for emotional, behavioural and autism spectrum disorders, but not for hyperactivity or eating disorders
• Disorder rates tended to be higher in children whose parents were in receipt of low income benefits
  
  • Neighbourhood deprivation, however, was not associated with most types of disorder

Question 10

Social and family context

Answer 10

• Rates of mental disorder tended to be highest in children living with a parent with poor mental health, or in children living with a parent in receipt of disability related income
• Children with a mental disorder were more likely than those without one to have experienced certain types of adversity in their lives, like parental separation or financial crisis at home
• Having low levels of social support, a smaller social network, and not participating in clubs or organisations (either in or out of school) were all associated with the presence of mental disorder

Question 11

Mental and physical health – the overlap

Answer 11

• Children with a disorder were more likely to have poor general health, a limiting long-term illness, a physical or developmental problem, or a special educational need
  
  • Nearly three-quarters (71.7%) had a physical health condition or developmental problem

Question 12

Health inequalities: The Marmot review

Answer 12

Question 13

measure of deprivation

Answer 13

school food

Question 14

Youth crimes

Answer 14

• Youth crime and violence is one of the multiple negative outcomes of disadvantage and exclusion, and being a victim or perpetrator of crime, or living in an area with high crime, and being involved in the criminal justice system directly impact on health
• Numerous studies report the stress and mental health impacts of living in a violent environment and being involved in the criminal justice system
• Analysis of council youth service budgets and knife crime data since 2014 has found areas suffering the largest cuts to spending on young people have seen bigger increases in knife crime than other areas

Question 15

link between health and offending

Answer 15