Focusing on the health and wellbeing of our children is the most important investment Australia can make
Australia is similar to other wealthy Western democracies for many aspects of child and youth health and wellbeing but, despite our material wealth, Australian rates of vaccination, obesity, child abuse and neglect do not compare well, and youth unemployment and the gap between rich and poor are increasing.1,2 Canadian researchers suggest that an unwanted outcome of economies focusing heavily on wealth creation is an impoverishment of the health and wellbeing of children, which will affect adult health and the human capability of nations — so-called modernity's paradox.3
Problems including developmental delays, substance misuse, child maltreatment and obesity and overweight are occurring at such high rates that they are already putting pressure on our health and welfare services. Most of these problems do not have effective treatments, hence they demand an urgent preventive approach. With a third of Australian children now overweight or obese, baby boomers may be the last generation to live longer than their parents, given the disease complications that will result.4
Further, mental health problems including substance misuse and autism appear to be increasing, or at least increasingly diagnosed.5 The impact on children of increasing mental health problems and substance misuse in their parents is hard to quantify and likely to be enormous.6 In a healthy country like Australia, it is unacceptable that many child health problems are much more prevalent in Aboriginal populations.
Can we replicate the successes of population interventions such as folate supplementation for preventing neural tube defects7,8 and supine sleeping for preventing sudden infant death syndrome?9 Surely some measures, such as improved vaccination coverage and prevention of prenatal alcohol exposure, are achievable. Most interventions will require collaborative action on multiple fronts outside health and with increased attention to social, economic and health inequalities. No issue is more urgent than climate change, which will have a disproportionately greater effect on child health.10 Let's hope the dithering, delaying, denying and disparaging of the scientific evidence does not mean it is too late.
Australia really is a lucky country, but if we want future prosperity, then focusing on the health and wellbeing of our children is one of the most important investments we can make.
Provenance: Commissioned; not externally peer reviewed.
- 1. Commission on the Social Determinants of Health. Closing the gap in a generation: health equity through action on the social determinants of health. Geneva: World Health Organization, 2008. http://www.who.int/social_determinants/thecommission/finalreport/en/index.html (accessed May 2014).
- 2. Australian Research Alliance for Children and Youth. Report card: the wellbeing of young Australians. Canberra: ARACY, 2013. http://www.aracy.org.au/documents/item/126 (accessed May 2014).
- 3. Keating DP, Hertzman C, editors. Developmental health and the wealth of nations: social, biological, and educational dynamics. New York: Guilford Press, 1999.
- 4. Gray V, Holman CD. Deaths and premature loss of life caused by overweight and obesity in Australia in 2011-2050: benefits from different intervention scenarios. Report for the Australian Preventative Health Taskforce. Perth: University of Western Australia, 2013.
- 5. Nassar N, Dixon G, Bourke J, et al. Autism spectrum disorders in young children: effect of changes in diagnostic practices. Int J Epidemiol 2009; 38: 1245-1254.
- 6. O'Donnell M, Anderson D, Morgan VA, et al. Trends in pre-existing mental health disorders among parents of infants born in Western Australia from 1990 to 2005. Med J Aust 2013; 198: 485-488. <MJA full text>
- 7. Bower C, Stanley FJ. Dietary folate as a risk factor for neural-tube defects: evidence from a case-control study in Western Australia. Med J Aust 1989; 150: 613-619.
- 8. De-Regil LM, Fernández-Gaxiola AC, Dowswell T, Peña-Rosas JP. Effects and safety of periconceptional folate supplementation for preventing birth defects. Cochrane Database Syst Rev 2010; (10): CD007950.
- 9. Dwyer T, Ponsonby AL. Sudden infant death syndrome and prone sleeping position. Ann Epidemiol 2009; 19: 245-249.
- 10. McMichael AJ. Climate change: health risks mount while Nero fiddles. Med J Aust 2014; 200: 507-508. <MJA full text>
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