The impact of poverty on educational outcomes for children

Over the past decade, the unfortunate reality is that the income gap has widened between Canadian families. Educational outcomes are one of the key areas influenced by family incomes. Children from low-income families often start school already behind their peers who come from more affluent families, as shown in measures of school readiness. The incidence, depth, duration and timing of poverty all influence a child’s educational attainment, along with community characteristics and social networks. However, both Canadian and international interventions have shown that the effects of poverty can be reduced using sustainable interventions. Paediatricians and family doctors have many opportunities to influence readiness for school and educational success in primary care settings.     

Child poverty. Ways forward for the paediatrician: A comprehensive overview of poverty reduction strategies requiring paediatric support

The harmful effects of child poverty are well documented. Despite this, progress in poverty reduction in Canada has been slow. A significant gap exists between what is known about eradicating poverty and its implementation. Paediatricians can play an important role in bridging this gap by understanding and advancing child poverty reduction. Establishment of a comprehensive national poverty reduction plan is essential to improving progress. The present review identifies the key components of an effective poverty reduction strategy. These elements include effective poverty screening, promoting healthy child development and readiness to learn, ensuring food and housing security, providing extended health care coverage for the uninsured and using place-based solutions and team-level interventions. Specific economic interventions are also reviewed. Addressing the social determinants of health in these ways is crucial to narrowing disparities in wealth and health so that all children in Canada reach their full potential.     

National family health survey and children

This article aims to describe the National Family Health Survey (NFHS) being carried out in India with its first round during 1992–93 (NFHS-I) and second round during 1998–99 (NFHS-II), with special reference to information available in relation to children. The survey was on lines of the existing systems of Demographic Surveys (DHS) in various developed as well as developing countries. Another important objective of the survey was to provide quality data to the researchers to carry out analytical work on various aspects. Further, the survey has paved the way to carry out comparative studies not only between states in India but also between countries. An attempt has also been made here to present salient features of comparative results under NFHS-I and NFHS-II.     

The importance of the Child Health Services to the health of children

In September 1999, a state-of-the-art conference was held in Sigtuna outside Stockholm, Sweden. The subject of the conference was the future of the Child Health Services. The approximately 40 participants included researchers from all professions with a link to child healthcare. The conference was prepared by a working committee consisting of Claes Sundelin (chairman), Uppsala, Sven Bremberg, Huddinge, Gisela Dahlqvist, Umeå, Kerstin Hedberg Nyqvist, Uppsala, Anders Håkansson, Malmö, Gunilla Lindmark, Uppsala, Birgitta Wickberg, Göteborg and Maria Nyström Peck (secretary), Stockholm. The state-of-the-art report has recently been published by the National Council for Medical Research and is briefly summarized below.     

Socioeconomic status and injury risk in children

Research has consistently shown that low socioeconomic status (SES) is associated with an increased risk of poor health and death in adults and children. Studies from around the world have shown an inverse relationship between SES and childhood injury morbidity and mortality. For example, compared with children with high SES, children with low SES are at an increased risk of death from pedestrian collisions, fires, falls and drownings, and at an increased risk of hospitalization from recreation or play injuries. Research from England and Wales shows that these disparities in mortality between high and low SES children may be widening over time. This paper provides an overview of the literature on the relationship between SES and childhood injury morbidity and mortality, outlines the postulated mechanisms for this relationship, and highlights some intervention studies targeted to low SES children.     

Poverty during pregnancy: Its effects on child health outcomes

It is estimated that nearly 100,000 children are born into poverty each year in Canada. During pregnancy, their mothers are likely to face multiple stressful life events, including lone-mother and teenage pregnancies, unemployment, more crowded or polluted physical environments, and far fewer resources to deal with these exposures. The early child health consequences of poverty and pregnancy are multiple, and often set a newborn child on a life-long course of disparities in health outcomes. Included are greatly increased risks for preterm birth, intrauterine growth restriction, and neonatal or infant death. Poverty has consistently been found to be a powerful determinant of delayed cognitive development and poor school performance. Behaviour problems among young children and adolescents are strongly associated with maternal poverty. Sound evidence in support of policies and programs to reduce these disparities among the poor, including the role of health practitioners, is difficult to find. This is partly because many interventions and programs targeting the poor are not properly evaluated or critically appraised.     

Social determinants of health and the future well-being of Aboriginal children in Canada

Aboriginal children’s well-being is vital to the health and success of our future nations. Addressing persistent and current Aboriginal health inequities requires considering both the contexts in which disparities exist and innovative and culturally appropriate means of rectifying those inequities. The present article contextualizes Aboriginal children’s health disparities, considers ‘determinants’ of health as opposed to biomedical explanations of ill health and concludes with ways to intervene in health inequities. Aboriginal children experience a greater burden of ill health compared with other children in Canada, and these health inequities have persisted for too long. A change that will impact individuals, communities and nations, a change that will last beyond seven generations, is required. Applying a social determinants of health framework to health inequities experienced by Aboriginal children can create that change.     

Lessening the impact of poverty on children

The present paper is divided into three sections. The first section deals with two issues: the impact of poverty on children and the hypothesized mechanisms by which poverty affects children. The second section discusses four guiding principles for programs that aim to reduce deficits in the quality of life and life chances of poor children. The third section describes promising intervention programs.     

贫困县双亲生育取向和对子女性别赋值的研究

目的 探讨贫困地区双亲的生育愿望和对子女性别的期望值。方法 从三个国家级贫困县每县随机选取0～6岁女童,1岁1个年龄组,共6个年龄组,每年龄组50名,共300名。3县共900名女童为实验组。按同样条件随机选取900男童作为对照组。结果 (1)独生子女的比例对照组为58．0％,实验组为65．0％。(2)男女童的性别比为1：0．87～1：0．95～1：0．97。(3)双亲的生育愿望取向趋向于少子女和小家庭。独生子女家庭占58．0％～65．0％,2个子女以下家庭占95．3％～96．6％。隔代亲属共居的家庭只占约40％,无隔代亲属家庭亦占约40％。对是否希望生男童的问题。持肯定态度者,占62．2％以上。但是对必需生男童的问题。持肯定态度者,占39．8％以下,(4)在“谁能养老”的选择中,大多数选择女童。结论 (1)被调查贫困地区基本生活条件,卫生服务和信息交流等大环境较过去已有较大进步,基本上达到国家的要求。这些变化对双亲性别认识(男女一样)产生很大的作用。(2)双亲的生育愿望取向趋向于少子女和小家庭。(3)双亲对子女性别赋值和预期值有重大变化。在“谁能养老”的选择中,绝大多数选择女孩。此种性别预期值的改变,是今日中国农村重大变化的标志(4)脱贫是实际上保障男女平等的一个重要物质基础。     

Canada’s history of failing to provide medical care for Indigenous children

In December 2007, the House of Commons unanimously supported Jordan’s Principle, a commitment that all First Nations children would receive the health care products, social services, and supports, and education they need, in memory of Jordan River Anderson. However, the process of applying for Jordan’s Principle was convoluted and not transparent, leaving several cases not being responded to. The Canadian Human Rights Tribunal found the definition and implementation of Jordan’s Principle to be racist and discriminatory in 2016, ordering the Canadian government to make immediate changes. Failing to make changes to Jordan’s Principle, the Canadian government was found to be noncompliant with the Canadian Human Rights Tribunal orders in 2018. This article provides one case example of Jordan’s Principle that was not responded to, details on the current status of Jordan’s Principle, and information on the recent implementation of the Act respecting First Nations, Inuit and Métis children, youth and families.     

Maximizing the impact of the Canada Child Benefit: Implications for clinicians and researchers

Child poverty remains a persistent problem in Canada and is well known to lead to poor health outcomes. The Canada Child Benefit (CCB) is a cash transfer program in effect since 2016, which increased both the benefit amount and number of families eligible for the previous child benefit. While the CCB has decreased child poverty rates, not all eligible families have participated. Clinicians can play an important role in screening for uptake of the program and helping families navigate the application process through several free resources. While prior research on past programs has shown benefit of similar cash transfer programs to both child and parental outcomes (both health and social), the CCB has not yet been extensively studied. Research would be valuable in both assessing the cost effectiveness of the program, especially across different income groups, and improving implementation in hard-to-reach populations.     

Improved perceived health status persists three months after a special sports camp for children with congenital heart disease

Introduction Although summer and sports camps for children with congenital heart disease are organized in many countries and regions, empirical data on the effects of such camps is limited.Objectives The aim of the present study was to investigate changes in the perceived health status and habitual physical activities in children attending a special sports camp.Materials and Methods In this longitudinal study, 25 children with congenital heart disease who participated in a three-day multi-sports camp were included. The perceived health status was measured using the Child Health Questionnaire-Child Form, CHQ-CF87, completed by the child at the start of the camp (T1), at the end of the camp (T2), and 3 months after the camp concluded (T3). Habitual physical activities were assessed by means of a modified version of the Baecke questionnaire, which was completed by one of the parents at T1 and T3.Results During the sports camp, we observed significant improvements in the children’s perception of their physical functioning, role-physical functioning, general health, role-emotional functioning, self-esteem, mental health, and general behavior. For physical functioning, role-emotional functioning, and family activities, high scores persisted three months after the sports camp concluded. The habitual physical activities (sport and leisure time) of the children remained unchanged.Discussion and Conclusion In conclusion, we propose that a special sports camp for children with congenital heart disease may improve specific dimensions of subjective health status. Our study confirms a previous report on the benefits of such camps for afflicted children. If these findings can be further corroborated in other settings, participation in sport camps should be advocated as a simple, noninvasive means to promote healthier children.     

The role of the Child Health Services in promoting mental health: an introduction

This paper gives an introduction to the psychosocial work in the Swedish Child Health Services (CHS). There are substantial problems in defining and evaluating the preventive mental health work of the CHS. The issues raised include: why early preventive intervention is important; the promotion of parental mental health as an aim of the CHS; how the CHS can increase parenting knowledge and skills; what evidence there is about intervention among target groups; and finally, how recent research knowledge can be applied in the CHS.     

孤独症儿童父母心理健康状态的研究

目的：研究孤独症患儿家长的心理健康状态。方法：采用症状自评量表(SCL-90)对34名孤独症儿童和35名健康儿童的父母亲进行评分。结果：孤独症儿童父母亲SCL-90总分分别为162.5±34.0,175.1±51.0,均高于正常儿童的父母亲(分别为142.4±82.8,152.3±40.6;P<0.05)。孤独症儿童的父亲在强迫症状、忧郁、焦虑、偏执等4个因子上的分数高于健康儿童的父亲（P<0.05）;孤独症儿童的母亲在强迫症状、人际关系敏感、忧郁、焦虑、偏执、敌对性、精神病性和睡眠/饮食等8个因子的分数较正常儿童的母亲高（P<0.05）;在人际关系敏感、焦虑、精神病性症状因子上,孤独症儿童的母亲得分较父亲高（P<0.05）。结论：在对孤独症儿童给与关爱和治疗的同时,也要关注孤独症儿童父母的心理健康。［中国当代儿科杂志,2010,12(12)：947-949］     

Quality of evidence for the present Swedish child health surveillance programme

The present Swedish health surveillance programme includes 15 examinations by a nurse, 5 examinations by a physician, 7 assessments of development, 2 assessments of hearing and 1 assessment of visual acuity. The WHO criteria for evaluation of screening programmes can be applied to the Swedish health surveillance programme. These criteria state that the health problem must be important, that there should be an early phase during which the condition is only detectable by medical professionals and that treatment at an early phase should favourably affect the prognosis. The quality of evidence for fulfilment of these criteria has been graded I-III. Grade II-2 refers to evidence obtained from well-designed cohort or case-control analytical studies. The following disorders might be affected by health surveillance at child health centres: amblyopia, ADHD/DAMP, failure to thrive, cerebral palsy, congenital heart failure, congenital luxation of hip, hearing impairment (severe or moderate), mental retardation, retentio testis and hydrocephalus. None of these conditions fulfils the WHO criteria with quality of evidence grade II-2 or better.
Thus, the evidence for the present Swedish health surveillance programme is problematic.