Early Childhood Health Interventions Could Save Billions In Health Costs Later In Life

Promoting the health of young children, before five years of age, could save society up to $65 billion in future health care costs, according to an examination of childhood health conducted by researchers at the Johns Hopkins Bloomberg School of Public Health. The results are published in the May 15, 2009, issue of Academic Pediatrics.

"Our review found convincing evidence that the four health problems we studied early life tobacco exposure, unintentional injury, obesity and mental health constitute significant burdens on the health of preschool-age children and are antecedents of health problems across the life span," said Bernard Guyer, MD, lead author of the study and the Zanvyl Kreiger Professor of Children's Health with the Bloomberg School's Department of Population, Family and Reproductive Health. "These health problems affect approximately one-third to one-half of children born in the U.S., and we estimated that total lifetime societal cost could be about $50,000 per child which translates to $65 100 billion for the entire birth cohort of children. The currently available research justifies targeted investments in early childhood health promotion as a means to averting future health costs and improving overall health during their life span."

Researchers conducted a systematic review of early childhood interventions using multiple health databases: PubMEd, PsycINFO, National Health Service Economic Evaluation Database, the National Bureau of Economic Research working paper database and EconLit. Guyer and his colleagues examined the magnitude of the future effects of tobacco exposure, unintentional injury, obesity and mental health. They looked at prevalence of these issues during the target age period, their cost implications across the life span, the availability of preventive interventions in this period of life and evidence indicating that prevention of these problems early in life would pay off or save costs in the future. Researchers found that the available evidence for the effectiveness of intervention in this age group was strongest in the case of preventing tobacco exposure and controlling unintentional injuries.

Smoking impacts young children through prenatal exposure and environmental tobacco smoke. In the U.S., an estimated 25 percent of children are exposed to environmental tobacco smoke by household members, and 500,000 babies are born annually to mothers who smoke during pregnancy, according to tobacco prevention studies. Environmental tobacco smoke programs specifically aimed at reducing exposure to children within the first five years of life would produce an estimated cost savings of $500 million.

Injuries are the leading cause of death, disabilities and health care utilization for U.S. children and teenagers between the ages of 1 and 19. Recent studies have concluded that both fatal and nonfatal injuries among children from infancy to four years resulted in $4.7 billion for lifelong medical costs and $14 billion for present and future productivity losses. While obesity among preschoolers has recently been recognized as a major health problem, age-appropriate prevention and intervention strategies are still lacking. Researchers believe there is a need for carefully targeted research to examine the relationship between early childhood preventive interventions and health outcomes across the life course.

"The four children's health topics selected demonstrate that the policy solutions needed to address them go well beyond the medical model of a doctor treating a sick child," said Sai Ma, PhD, corresponding author of the study and an assistant scientist with the Bloomberg School's Department of Population, Family and Reproductive Health. "Meeting the underlying health needs of American children will require decision makers and practitioners to understand complex multiple determinants of health and disease, as well as public health approaches that involve family, community and national interventions."

"Early Childhood Health Promotion and Its Life Course Health Consequences" was written by Bernard Guyer, Sai Ma, Holly Grason, Kevin Frick, Deborah Perry, Alyssa Sharkey and Jennifer McIntosh.

The research was supported by the Partnership for America's Economic Success and the Zanvyl and Isabelle Krieger Fund.

School Burnout Suffered By One In Five Girls In Upper Secondary School

The transition from basic education to upper secondary school is a challenge for many young people. According to a study of school burnout at different stages of school and higher education, upper secondary school is a particularly challenging stage for many young people. Success-oriented female upper secondary school pupils are at the greatest risk: up to 20 cent of them suffer from school burnout. Burnout is a phenomenon to be taken seriously, as it can lead to depression.

"These girls are high achievers but they also develop burnout. They tend to develop feelings of inadequacy, in particular, in upper secondary school. By contrast, boys who enter upper secondary school tend to develop more of a cynical, negative stance towards school," says Professor Katariina Salmela-Aro of the University of Jyväskylä, who is in charge of the research. The study was carried out at the Academy of Finland's Centre of Excellence in Learning and Motivation Research, and comprised 1,800 young people.

The study focused particularly on students' trajectories to well-being or problems during transitional stages in their education. "Transitions from one stage of education to the next have an impact on the well-being of young people and they need support during these life stages. A healthy level of self-esteem is a protective factor," Salmela-Aro says.

According to Salmela-Aro, school burnout in upper secondary school tends to complicate the transition to further studies, while an enthusiasm for school tends to predict a successful transition to the next education level. "This research finding has considerable importance for the efforts to encourage young people to make a faster transition into further studies and working life."

Medical students are the keenest

For the first time in Finland, research was also conducted on burnout and academic engagement among students in higher education. The material was provided by the Finnish Student Health Service (FSHS) and comprised 5,200 students. Results show that one in ten students in higher education suffers from burnout and one in three is at risk. However, the good news is that one in four students in higher education feel enthusiasm for their studies. Medical students were most likely to be enthusiastic about their studies and least likely to suffer from burnout.

"Students' engagement for their studies declines over time, which raises the question of what happens to the highly motivated students who enter higher education. A sense of optimism during university studies along with high self-esteem tend to predict job engagement ten years later on, while an avoidance strategy tends to predict work-related burnout," Katariina Salmela-Aro says.

School burnout is a chronic school-related stress syndrome which manifests as exhaustion, cynicism about school and feelings of inadequacy. Engagement about school is characterised by energy, dedication and an ability to become absorbed in the work.

In basic education, school burnout is caused by a negative atmosphere in school, usually in the form of a stressful and restless working environment. Support from the adult staff of the school, especially the school healthcare services, helps reduce school burnout. Teachers who have a positive attitude and an ability to motivate students are extremely helpful for upper secondary school students. The more encouragement the students got from their teachers, the less likely they were to experience school burnout.

New Health Taskforce To Spot Signs Of Violence Against Women, UK

A new taskforce of health professionals working together to spot early signs of violence and abuse against women and girls, investigate the scale of the problem and ensure victims across the NHS get the support they need was announced by Home Secretary Jacqui Smith and Health Secretary Alan Johnson.

The taskforce has been set up in response to issues raised during the Violence against Women and Girls consultation which began in March. The Government recognises that victims may talk more freely with health professionals about their fear of violence - even when they are not ready to take the next step to reporting the crime. The Government wants to make sure that health professionals are prepared to give victims of violence and abuse information about local support services. The taskforce will also look at helping health workers to identify women at risk earlier and how they can offer these women support to reduce repeat victimisation.

Professor Sir George Alberti, former National Clinical Director for Emergency Access and Service Design, will lead the work of the taskforce. The taskforce will comprise health professionals, NHS managers and representatives from the public, social services and voluntary sector.

Alongside this, the Government also pledged to double funding for the 24-hour National Domestic Violence helpline, bringing total support to £1 million for this year.

Home Secretary Jacqui Smith said:

"Violence against women and girls is completely unacceptable and we must all see it as our duty to step in and help someone who is at risk. This is not limited to friends and family; as we said in our consultation document, we need a wide range of workers on the frontline to be alert to the signs of violence against women and girls and able to provide support.

"I want to make sure that vulnerable women or victims who access healthcare can also get help and advice about protecting themselves as well as information about local support services.

"That is why we need this new taskforce - violence against women and girls is a public health issue affecting the lives of thousands of NHS patients every year and we need to do all we can together to prevent violence from occurring."

Swine Flu Confirmed Human Cases 8,480 In 39 Countries, Including 71 Deaths

The World Health Organization (WHO) has announced that globally a total of 8,840 swine flu A(H1N1) cases of human infection have been confirmed, including 71 deaths (all of them in Mexico, the USA and Canada). The death rate for this novel influenza strain appears to be no different from that of seasonal human influenza. Several countries have now lifted travel restrictions on non-essential visits to Mexico.

Below is a list of countries and swine flu infection and death totals:
Mexico - 2,895 cases, including 66 deaths
USA - 4,714 cases, including 4 deaths
Canada - 496 cases, including 1 death

Spain - 103 cases, and no deaths
United Kingdom - 82 cases, and no deaths
Panama - 54 cases, and no deaths

France - 14 cases, and no deaths
Germany - 14 cases, and no deaths
Colombia - 11 cases, and no deaths
Italy - 9 cases, and no deaths
New Zealand - 9 cases, and no deaths
Brazil - 8 cases, and no deaths
Israel - 7 cases, and no deaths
Japan - 7 cases, and no deaths
China - 5 cases, and no deaths
Belgium - 4 cases, and no deaths
El Salvador - 4 cases, and no deaths
Cuba - 3 cases, and no deaths
Guatemala - 3 cases, and no deaths
Netherlands - 3 cases, and no deaths
Republic of Korea - 3 cases, and no deaths
Sweden - 3 cases, and no deaths
Finland - 2 cases, and no deaths
Malaysia - 2 cases, and no deaths
Norway - 2 cases, and no deaths
Thailand - 2 cases, and no deaths
Argentina - 1 case, and no deaths
Australia - 1 case, and no deaths
Austria - 1 case, and no deaths
Denmark - 1 case, and no deaths
Ecuador - 1 case, and no deaths
India - 1 case, and no deaths
Ireland - 1 case, and no deaths
Peru - 1 case, and no deaths
Poland - 1 case, and no deaths
Portugal - 1 case, and no deaths
Switzerland - 1 case, and no deaths
Turkey - 1 case, and no deaths
Although several countries have either imposed, the WHO does not recommend this. If you become ill with flu-like symptoms after travelling to a country with known swine flu confirmed cases of human infection you should telephone your doctor - several countries advise against walking into your doctor's surgery so that the people there are not put at risk of infection. If you are ill with flu-like symptoms, and plan to travel abroad you should consider delaying your trip, says WHO.