What are the most important health issues affecting the nation’s children? We look into the latest reports and data on children’s health
We often hear how the children of today are less active, spend less time outdoors and more screen time than previous generations, and have more behavioural issues.
But how true is this perceived knowledge? What are the major issues in children’s health that will confront pharmacists and other primary care health professionals?
In late 2020, the Australian Institute of Health & Welfare (AIHW) released its report The Health of Australia’s Children 2020.
It identified diet, obesity and overweight, and the rate of pre-adult hospitalisations to be areas of particular concern, although overall, the findings were positive, the AIHW research team concluded.
“Childhood is an important time for healthy development and learning, and for establishing the foundation blocks of future wellbeing, but it is also a time of vulnerability.
“While a positive start in life helps children to reach their full potential, a poor start increases the chances of adverse outcomes for the individual, society and possibly future generations,” they said.
“The report shows that most Australian children are healthy, safe and doing well, but there is scope for further gains in some areas.”
Why is child health important?
Good health influences how children feel and go about their everyday lives because health can affect participation in family life, schooling, social and sporting activities.
“Chronic conditions that particularly affect children, such as asthma and diabetes, cancer, mental illness, and disability have a substantial impact on a child’s overall quality of life,” said the authors of the AIHW report.
“They can require considerable disease management and affect physical, social and emotional development, schooling attendance and education outcomes. There may also be an impact on family life, parental health and employment if time off work is needed for caring responsibilities, with a potential flow-on effect for household finance.”
Poor oral health is also associated with increased risk of chronic disease later in life, including stroke and cardiovascular disease, according to an earlier AIHW report. Children with poor oral health are also more likely to miss school and perform poorly in school (Jackson et al, 2011).
Children’s social and emotional wellbeing—how they think and feel about themselves and others, and deal with daily challenges—is one major component of mental health and wellbeing. Socially and emotionally competent children:
- are confident;
- have good relationships;
- communicate well;
- do better at school;
- take on and persist with challenging tasks; and
- develop the necessary relationships to succeed in life.
While rates of infant and child deaths are decreasing, and survival rates for certain cancers are increasing, perinatal conditions, injuries and cancer remain leading causes of death for children.
And obviously, good health in childhood also has a long-term impact, as problems that become more apparent in old age can have their origins in childhood, the authors pointed out, with, for example, children who smoke and drink at risky levels often continuing to do so into adolescence and adulthood, putting them at risk of chronic conditions and premature death.
Poor nutrition and sedentary lifestyles have been linked with obesity, and children who are overweight or obese are also more likely to become obese adults, putting them at risk of chronic conditions such as type 2 diabetes and cardiovascular disease at younger ages (Sahoo et al, 2015).
How are Australia’s children faring?
- Death rates among Australia’s infants and children have dropped substantially. Between 1998 and 2017, infant deaths dropped from 5.0 to 3.3 deaths per 1000 live births. Child deaths halved from 20 to 10 deaths per 100,000 children.
- Less mothers are smoking during the first 20 weeks of pregnancy. Between 2011 and 2017, the proportion of mothers smoking fell from 13% to 9.5%.
Could be better
- Around one in four children aged 5–14 are overweight or obese, with the proportion remaining relatively stable between 2007–08 (23%) and 2017–18 (24%).
- Most children (96%) aged 5–14 do not eat enough vegetables, with the proportion meeting the guidelines for vegetable consumption only increasing slightly between 2014–15 (2.9%) and 2017–18 (4.4%).
- In 2016–17, there were around 66,500 hospitalised injury cases for children aged 0–14, slightly higher than 10 years earlier. The rate was relatively stable between 2007–08 and 2016–17 (1419 and 1445 per 100,000, respectively).
- Around 19,400 (0.4%) of children aged 0–14 were homeless on Census night in 2016, similar to the proportion in 2006 (0.5%).
What do Australia’s children say?
- Most children (91%) aged 12–13 felt safe in their neighbourhood in 2015–16.
- One in five Year 4 students experienced bullying on a weekly basis in 2015.
- Most children (94%) in years 4, 6 and 8 spent quality time doing at least one of talking, having fun or learning with their family most days in the week in 2014.
- 97% of children aged 12–13 had someone to talk to if they have a problem in 2016.
- Almost nine in 10 children aged 12–13 would talk to their mum and/or dad if they had a problem in 2016.
- For children in years 4, 6 and 8, health ranked as the second most important domain, after family, for having a good life in 2014.
What the public thinks
In 2015, the Royal Children’s Hospital, Melbourne, conducted a poll assessing the public’s perception of children’s health.
It found that excessive screen time was seen as the top ‘big problem’ for the health of Australian children and teenagers.
The top 10 child health problems as perceived by the Australian public are:
- Excessive screen time
- Not enough physical activity
- Unhealthy diet
- Illegal drug use
- Family and domestic violence
- Internet safety
- Child abuse and neglect
Dr Anthea Rhodes, the poll director, said modern health problems such as those identified in the top 10 are often easier to ignore than address. “These issues have become so engrained in our lives that they’re almost perceived as unsolvable problems. But we now know that the community considers them to be the biggest health problems for children and teenagers today,” she said.
- Almost 60% of Australians say excessive screen time is a big health problem for Australian children and young people.
- Parents rate obesity more frequently as a big problem for children in the community than for their own children.
- One in 10 parents rate dental issues as a big problem for their own children.
- The top 10 perceived health problems relate to modern lifestyle, mental health concerns and child safety.
- Excessive screen time was the most frequently identified big problem followed by obesity, not enough physical activity and unhealthy diet.
The problem of parental perception
A number of experts said one of the most concerning findings from the poll was that while 48% of parents rated obesity as a big health problem for children overall, only 8% actually identify their own children as being in this category.
Dr Rhodes told The Huffington Post Australia these figures were concerning.
“It suggests that parents for whatever reason are less likely to recognise these problems for their own children in these families,” she said.
“If parents cannot identify the issue, they are much less likely to take on the health guidelines.”
*For more, see the full article in our February 2021 magazine or e-magazine
Royal Children’s Hospital. Top ten child health problems: What the public thinks. Available at: https://www.rchpoll.org.au/polls/top-10-child-health-problems/
AIHW. The health of Australia’s children 2020. Available at: https://www.aihw.gov.au/reports/children-youth/australias-children
Jackson SL, Vann WF, Kotch JB, Pahel BT, Lee JY. Impact of poor oral health on children’s school attendance and performance. American Journal of Public Health. 2011;101(10);1900–6.
Sahoo K, Sahoo B, Choudhury AK, Sofi NY, Kumar R, Bhadoria AS. Childhood obesity: causes and consequences. Journal of Family Medicine and Primary Care, 2015;4:187–92.