Child Health Part 1 Flashcards
What is a life course approach to health? What is the opposite approach?
- Adressing wider determinants of health across life course
- Rather than ‘disease-focussed’ approach
Why are the early years of life so critical?
Marmot review: The foundations for physical, intellectual and emotional development are laid in early childhood.
* Interventions are cost effective
* Adults have inertia to change
* Poor physical literacy or unadressed ACEs in childhood can cause lifelong issues
Which aspects of health and wellbeing are affected during early years?
obesity, heart disease and mental health to educational
achievement and economic status.
What can inadequate foetal nutrition lead to as the child grows up (2)?
- irreversible delayed cognitive or motor development in the child
- obesity and CVD risk in adulthood
What prenatal factors play a role in the weight of a child in childhood as well as adulthood?(2)
- Foetal nutrition
- Maternal physical activity levels during pregnancy
What term describes lifestyle factors being inherited influencing an individuals future health before even born?
intergenerational relationship
During the first two years of life, What factors influence the foundations of behaviour formed during this time such as cognitive, physical, social and emotional development?
diet, physical activity, relationships, sleep, stress and socioeconomic status.
Which interventions are crucially important in getting a healthy start to life? What group is uptake of these interventions lower in?
- breast feeding and vaccinations
- uptake of these interventions is lower amongst more deprived groups in society.
Define school readiness.
a marker linked to educational attainment, life chances and even involvement in crime.
- Modifiable factors in early years influence this
What is the most reported disturbing trend amongst school children in the UK?
epidemic of childhood obesity
What is the umbrella term for obesity and overweight
Unhealthy weight
Whats one way unhealthy weight can be managed?
lifestyle interventions.
What does current data show in terms of childhood unhealthy weight.
- one in five children entering reception class, that’s as young as four and five years old, are already overweight or obese.
- Overweight infants are five times more likely to be obese in later childhood, adolescence and adulthood.
Other than unhealthy weight, which other conditions are increasingly being observed in children?
- type 2 diabetes
- OSA
- fatty liver
- atherosclerosis
Why are those who are physically active in childhood much more likely to be physically active as adults.
Improved physical literacy
Describe physical activity patterns of children in the UK.
- Today’s children are the least active generation that has ever been.
- only 23 percent of boys and 20 percent of girls currently meeting age specific recommendations for physical activity.
- Across the population levels of physical activity reach a lifetime peak at the age of school entry, and this typically declines with age, declining even further during the school holidays, more markedly amongst those living in deprived areas.
Is inactivity or activity a more persistent behaviour?
inactivity - so important interventions occur before this behaviour becomes habituated.
Define physical literacy.
- physical literacy = the motivation, confidence, physical competence, knowledge and understanding to value physical activity throughout their life course.
Describe how physical literacy is developed.
- When children engage in inclusive, positive, meaningful physical activity that place equal value on both the physical and psychological benefits to health and well-being, children develop physical literacy
What does physical activity in children and young people contribute to?
- improved cardiovascular fitness, improved sleep and contributes to healthy weight.
- There’s strong evidence for improved learning, better academic achievement and higher executive functioning.
- Active children are happier, more resilient, report higher levels of self-esteem, confidence and are more trusting of others.
- They show reduced feelings of anxiety, stress and depression all fundamental when looking to improve children and young people’s mental and physical health.
At what age are lifelong Health behaviours established and why?
Adolescence - Between the ages of 10 and 24 years old
- individuals experience a range of changes in lifestyle with associated behavioural, emotional and social changes.
When is the best opportunity to intervene and promote positive health behaviour?
Adolescence - Children, young people start to become more independent with their behaviours,
Which individuals help form a child’s expectation of themselves and those around them?
Parents, families and caregivers are, of course, crucial for shaping childhood behaviour.
What is the single biggest risk factor for childhood obesity.
parental obesity - Lifestyle behaviours are often entirely dependent on caregivers initially, and children mirror the lifestyle behaviours of parents, for example, mirroring eating habits. - Genetic, environmental and social factors also contribute
What approach to child health is used to ensure advice can be implemented when considering barriers like household income and can be impleneted by the whole family
Family approach
Which practise is crucial for self-regulation and internalisation of healthy behaviours amongst children.
autonomy supporting parenting practises
Outline our duty of care as physicians
- involves promoting healthy lifestyles and practising lifestyle medicine with children and their families.
- For the population - have a role in advocating to reduce and mitigate health inequalities from the beginning of the life course. It’s our moral duty as professionals.
What does giving every child the best start in life enable
- enables individuals to thrive and reach their potential,
- reducing health inequalities, preventing chronic disease and improving health and well-being.
How does encouraging a life course approach, starting early and enabling positive health behaviours benefit the society?
- Improves life outcomes
- More cost effective for NHS
What did Royal College of Paediatrics and Child find?…were identified as children’s priorities for staying healthy, happy and well.
good quality, cheap food and drink, exercise and hobbies
What are dental carries?
- when oral bacteria metabolise sugar and produce acid that demineralises enamel and dentin from the hard coating of the tooth
Symptoms and impacts on life of dental caries
- Pain, infection, sepsis
- School and work absenteeism
Most common communicable disease and prevelant in children
Dental caries
Why is management of dental carries limited?
Management may need to involve tooth extraction – both extremely expensive, time consuming and widely unavailable in low income countries. The average cost of a tooth extraction admission for a child between 2015-2016 was £836!
Describe sugar intake, Dental carries and obesity in terms of social deprivation.
- associated with excessive intake of sugar.
- often occurs with obesity occur together,
- affecting disadvantaged populations.
How can we prevent dental carries
- sugar reduction in the diet and maintaining good oral hygiene.
- Reducing free sugar intake to less than 10% of energy intake
- Population-wide approaches can include water fluoridation, fluoride varnish programmes and sugar-reduction programmes.
What are adverse childhood experiences. Give examples.
ACES are stressful events that occur in childhood. They include, but are not limited to:
Experiencing abuse: Physical, sexual, psychological or neglect.
Witnessing domestic abuse
Having a close family member or caregiver who misused drugs or alcohol
Having a close family member or caregiver with mental health problems
Having a close family member or caregiver who served time in prison
Experiencing parental separation or divorce on account of relationship breakdown.
Summarise Study about ACEs
https://www.sciencedirect.com/science/article/pii/S2468266717301184
- ACEs often cluster in children’s lives and a growing body of research is identifying cumulative relations between multiple ACEs and poor health.(1990s.)
- multiple ACEs affect health-harming behaviours and development of health conditions, including non-communicable diseases.
- individuals with at least four ACEs were at increased risk of all outcomes examined
- Associations were weak or modest for physical inactivity, overweight or obesity, and diabetes (ORs of less than two), moderate for smoking, heavy alcohol use, poor self-rated health, cancer, heart disease, and respiratory disease (ORs of two to three),
- strong for sexual risk taking, mental ill health, and problematic alcohol use (ORs of more than three to six), and strongest for problematic drug use and interpersonal and self-directed violence (ORs of more than seven)
- This systematic review and meta-analysis highlights the pervasive harms that ACEs place on health throughout the life-course and the importance of addressing the various stressors that can occur in children’s lives, rather than limiting attention to any one type
- strong relations between multiple ACEs and poor health suggest that a reduction in ACEs and building of resilience to enable those affected to avoid their harmful effects could have a major effect on health.