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Health feature

1 Dec 2008 9:08 PM - Medicine on Second

Every parent wants the best for their child and every generation expects to live longer than the one before it. As time goes on we look forward to seeing the results of our collective knowledge and medical research leading to an increasingly happy and healthy population.

Don’t we?

Looking back at the end of our lives we want to see our own children and grandchildren having better chances and a better life than we did ourselves.

Well hold it right there! Respected medical researcher Professor Fiona Stanley has some news that will make all doting grandparents jump clean out of their rocking chairs. “My generation is the last generation who can expect to live longer than its parents,” predicts the 62-year-old professor who heads the Telethon Institute for Child Health Research in Perth.

With a string of accolades to her name, including Australian of the Year in 2003, Professor Stanley is one medical professional that the nation really should sit up and listen to. Born in Sydney she studied medicine at the University of Western Australia and practiced in hospitals for two years before going to the UK and USA for further training in epidemiology (the science of describing and explaining the occurrence of disease in populations), biostatistics and public health. She has more than 200 published papers in scientific journals and is the UNICEF Australia Ambassador for Early Childhood Development.

All this training and research has led her to the conclusion that the children being born today will have a shorter life expectancy than she does.

But why? Surely with all the advances in immunisation and the relatively comfortable life lived by the vast majority of Australians we should have no problem outliving our ancestors?

Apparently not. In fact, we could have a few lessons to learn from them.

“In 1900 the community seemed to understand what children needed better than we do today with all our prosperity and knowledge,” wrote Professor Stanley last year in The Australian.

“Our founding fathers knew that the health of the nation depended upon the health and education of mothers, adequate resources for living (good housing, hygienic conditions and nutritious food) and childhoods that allowed for learning and playing in safety. Without any knowledge of the major causes of diseases of the time and with few known treatments, they implemented the most effective preventive strategies with resulting spine-tingling falls in infant deaths and illnesses that meant so many more of these babies survived to have good lives. Our founding fathers got it right big time.”

In a recent ABC documentary ‘Risking our Kids’ Professor Stanley outlined exactly what has gone wrong with the health of our children and what the nation needs to do to fix it.

At the moment, she said, there are a worrying number of threats to children’s health that are increasing in frequency, showing no improvement or getting dramatically worse. These include asthma (rates have quadrupled), mental health and suicide (one in three young Australian deaths is due to suicide and the adolescent male suicide rate has quadrupled) and obesity (one in four young Australians is overweight or obese). Unlike the historical diseases such as polio which can be eradicated with a vaccine, today’s issues are complex and often have their roots in longstanding risks going back more than one generation. Professor Stanley suggests that today’s rapid pace of life, technology, frenetic workplaces and the emphasis on individual success over community could all be contributing factors in the complex health problems affecting our kids. “We’ve forgotten how important those nurturing pathways are for children’s development,” she said.

Sunshine Coast general practitioner Dr Roger Morris of Medicine on Second agrees that mental health issues and obesity are major problems for today’s kids and he sees the role-model aspect of parenting as being crucial to fixing the problem.

“Childhood obesity is certainly a major issue in Australia – we are a world leader in obesity -and it is related mainly to poor family eating habits, a higher proportion of takeout in families and reduced activity levels,” he said. Dr Morris believes children are less active because of the technology obsession, reduced physical activity within families as a whole and safety concerns about walking/riding to school.

While rates of asthma increased significantly in Australia during the 1990s Dr Morris says they levelled off during this decade. “Asthma is well researched, well diagnosed at the primary care level and well treated and asthma related deaths are now thankfully rare,” he said. “What is much more concerning this decade is the huge rise in other allergic disorders such as allergic dermatitis, hayfever, allergic eyes and most worryingly, severe and life-threatening food allergy such as anaphylaxis to peanuts, tree nuts, eggs and dairy protein.”

Mental health problems in children are also on the rise according to Dr Morris, and he believes there are many social and lifestyle-based reasons for this, including:

  • Increased incidence of marriage and family break-ups caused by socio-economic stresses on the family unit
  • Increased materialistic aspirations of our society and increasing family debt
  • Career aspirations of parents given priority over parenting responsibilities
  • Increase in long hours of children in day care – from an increasingly young age
  • Reduced capacity of parents to actively communicate with and properly parent their children
  • General reduction in pleasant interactions within families
  • Increase in domestic violence, child abuse, alcohol and substance abuse within families(the Sunshine Coast has one of the state’s highest levels of reported child abuse and neglect)
  • Increased stress in children in general due to high levels of media exposure to world, national and local events and crises
  • Increased sexualisation of children, and society in general, and subsequent sexual experimentation at a younger age without the emotional skills to cope

Faced with a health problem that is mainly a lifestyle, societal and cultural issue, Dr Morris believes that treatment (or more accurately prevention) needs to be instituted in the family realm. He puts out a strong challenge to today’s parents to start truly putting their kids first.

“Regarding mental health issues in children, I am a firm believer that this can only be tackled by a complete paradigm shift in our society’s attitudes and priorities. I think modern parents on the whole are far more self-focused than previous generations of parents – and our children are suffering as a result,” he said.

“Parents in general need to quit thinking about their own needs, their own priorities, their own problems, their own desires so much and need to focus more on the needs of their children who depend on their parents to be good role-models and give them the skills to grow into functional adults down the track.

“Parents need to be more aware of how their bad habits serve as a model of behaviour to their children – this includes domestic violence, alcohol abuse, substance abuse and attitudes to sex and relationships.

“This also means parents need to spend more time with their kids, put aside good quality family time and spend fewer hours working,” he said. “If that means down-sizing, reducing debt, saving money for leisure items (rather than buying now with credit) then so be it. Our kids need us and they need us right now.”

As well as highlighting obesity, asthma and mental health as modern health issues affecting Australian children, Professor Fiona Stanley also raised the concern of school-readiness, claiming that a quarter of all five-year-olds are not ready for school. Research showed that problems occurred in some of the wealthiest suburbs (where there was a high incidence of isolated parents and mothers with post-natal depression) as well as the poorer suburbs.

In an effort to address this problem a recent Australian government initiative is targeting the nation’s four-year-olds to ensure they are healthy, fit and ready to learn when they start school. The Healthy Kids Check (available at doctor’s surgeries) promotes early detection of lifestyle risk factors, delayed development and illness and introduces guidance for healthy lifestyles and early intervention strategies.

To supplement the health check a booklet titled ‘Get Set 4 Life’ is being issued to all parents of four-year-olds. In it a wide range of health issues are addressed, with obesity and mental health prominent among them.

The booklet aims to set up habits for healthy kids – family lifestyle choices that can have a profound effect on their future health – and there are some interesting observations inside.

On healthy eating the booklet offers the following comment. “Phrases like ‘Good girl for eating everything’ are not helpful because they teach your child to clean their plate or continue to eat when full. Many adults find it hard to break this habit, partly because they were told as a child to finish everything on their plate.”

Regarding mealtimes, the booklet suggests that parents should decide what healthy meals and snacks are offered and when. Children decide if they eat, what parts of the meal they eat and when they’ve had enough. Leftovers should be removed without a fuss and parents should avoid offering alternative foods if the child doesn’t eat much.

On the subject of ‘food bribes’ the booklet has this advice: “Finish your pumpkin, then you can have dessert.” Many parents say things like this not realising that it may make children further dislike pumpkin and like dessert even more. While it’s tempting to use bribes in the short-term, praise and patience can be better in the long run.

Reduced fat dairy products are recommended for children over the age of two (they provide as much calcium, vitamins and protein as full-fat choices) and water is promoted as the best drink.

Where weight gain has become an issue (for either the child or the parents) the booklet advises parents to avoid commenting on body weight (even your own weight) in front of your child. Never call your child fat or tell them to lose weight and never promote dieting to your child. “It can be hard to recognize your child is overweight because we are surrounded by big adults and big children. Comparing your child to their friends may not be helpful.”

Play and learning are divided into several categories with ‘active play’ being the first one. The booklet advises ‘your four-year-old needs to do some active play every day. Head outside at every opportunity to encourage your child to be active. Television and electronic games are the biggest barriers to your child being active. Sitting still for a long time can mean they’re not getting the active play they need. These habits can form at an early age, so limit you child’s television and computer use.’

The emotional health of four-year-olds is tackled in the booklet with advice on how to teach young children about feelings with the aid of toys, puppets and picture books. “Above all your child needs to feel loved, safe and secure in their environment. Make sure the positive things that you say to your child far outnumber the negative things you say.”

Health initiatives like this one, if followed, could start to halt the worrying rise in complex health issues affecting children today. The problems that are affecting kids are also affecting today’s parents. By starting to correct the problem we could be getting a double bonus - better life chances for mums and dads, and better life chances for our children and grandchildren in the future.