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‘In the 21st Century social, economic and environmental factors are more important than biological disorders as causes of poor health in children.’ (HALL 2003)
Critically analyse evidence including data drawn from authorised mortality and morbidity statistics to support or refute this statement. Evaluate the potential for success of two Intervention Strategies designed to reduce health inequalities.
Hall (2003) states, that ‘In the 21st Century social, economic and environmental factors are more important than biological disorders’ with regards to the causes of poor health in children. The report will discuss social, economic and environmental factors first and then move on to biological disorders and weigh up, using statistics and data, which factors are more important to poor health; thus either refuting or agreeing with Hall’s initial statement (Hall, 2003) The second part of the report will evaluate two Intervention Strategies designed to reduce health inequalities. The focus here will be on current concerns on child obesity. Whilst critically evaluating these intervention strategies, healthy eating and yoga will be looked at. The author will further draw in his own experiences from his current setting at a central London primary school.
The aim of this report is to review and analyse health data in order to understand those factors leading to inequalities in health with regards to children aged four to five years. There will be a detailed examination of research documentation into inequalities in health from a variety of sectors giving a multi-disciplinary understanding. This report will find and promote health developmental needs of young children and their families within the early year’s curriculum. The report will also explore the inequalities of access to the school curriculum and the wider structural constraints to health in primary schools. It will also give a concept of health education, whilst linking the areas of physical, social and cognitive development.
Hall (2003) initiated a campaign for the World Health Organisation (WHO), an organisation that formulated in 1948. Hall started this campaign in the Philippines and it is called ‘Health at the Heart of Healing.’ This was a means of initially sustaining awareness and support for ongoing health efforts in the Typhoon Yolanda Corridor. Subsequently other health-related programmes were established. Macleod and Kay (2008, p. 222) agree with WHO(?) that health is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity.
Good health can have many benefits and mean many different things but certainly it is more than just the absence of diseases. A growing concern is child health and this will be explored in this report. Below each factor, namely social, economic, environmental and biological factors will be analysed (ref).
The next section explains that good health is not just the lack of illnesses, but there are many factors that can affect wellbeing of people.
1.1 Social Factors
WHO (2014) states that there are many factors that effects health in individuals. Social factors will be looked at first. Social factors can include parental involvement, family involvement as well as community involvement in a child’s upbringing. Their involvement can either lead to poor health or good health. According to WHO (1947-2012), good health depends on the context of our lives, therefore praising or criticising people for their good or bad health is wrong; most of the factors that contribute towards our health are out of our control (Geraghty, 1991, p.104). This is still very much relevant in 2014. WHO (1989-2012) further defines health as “a state of physical, mental, and social wellbeing” (WHO, 1948 cited in Macleod and Kay, 2008, p. 222). This is evidence to show that social factors have an extremely important affect children’s health.
Research shows that much of the debate around health choices relates to social factors. Macleod and Kay, (2008) consider that the root causes of ill health should be tackled through social and public policy which addresses health inequalities. This is further evidence that social factors are more important to health inequalities in children compared to biological factors.
Many things can be learned from having social interactions such as having a good relationship with neighbours. Dupas (2010) agrees that social factors are important as social learning leads to increased adoption of social norms. Adelman et al. (2009), agrees that households learn about the quality of care available at multiple facilities from their neighbours’ illness experiences; for instance, a neighbour can experiment with a new medicine and where one is unable to have the means of buying that particular medication, one can still learn from observing the neighbour. This shows and supports the ideas of Dupas (2010).
1.2 Economic Factors
The main course of economic inequality is outlined in the Black Report (1980). This report displayed the death rate of men in social class V (Upper class) and social class I (Lower class). The difference of the two was that class V had twice as more deaths rates than class I and it was increasing. This led to an impact on a political thought in the United Kingdom that resulted in an assessment by the Office for Economic Co-Operation and Development and the WHO (2012) of health inequalities. This clearly is evidence to show that peoples’ economic situation has a direct link to their health prospects.
It is easily perceived that to have a good standard of healthy living is to live in good quality housing rather than a poor household. The effects on a child in a poor household could be overcrowding, damp, cold and infestations of pests; this will all lead to chronic illnesses, and could even lead to hospitalisation. Research shows that poor educational qualifications and unemployment are linked with poverty and are associated with poor housing. This clearly shows that economic factors can have a serious effect on health, particularly for children as they are growing up in those surroundings.
According to Macleod and Kay (2008) poverty is the most vital determiner and the most difficult area that affects health. Macleod and Kay (2008:225) argue that causes of poverty are manifold and can lead to poor qualifications, ill-health, disability, addiction and crime; hence economic factors are very important in the outcome of a child’s health.
In addition research shows that parents that are single are at risk of falling into poverty (WHO, 2014; ----) which may lead to children from a single parent household being more at risk of poor health (REF).
Further evidence to show that economic factors are more important than biological factors in a child’s health can be illustrated through looking at developed countries and developing countries. Often the standard of living and the quality of life in a developed country, such as England, are better than the standard of living in developing countries. This is largely due to economic reasons, such as income and access to health facilities (REF).
1.3 Environmental factors
WHO (2014) mentions that health is determined by peoples’ circumstances and their environment. There are many considerable impacts on health, for example the place or area which one lives in, the state of the environment, genetics, income and education level as well as relationships with friends and families (Macleod and Kay, 2008; WHO, 2014).
Air pollution which is often a major problem within big cities such as London has an impact on everyone living and working there. Research shows that REF the most vulnerable people affected by air pollution in our cities are children and the elderly. Furthermore, research shows that people living in deprived areas are also more affected by air pollution because often these are the areas that are near the busy roads, which tend to have most exposure to road traffic pollution (REF). Therefore, this is evidence to show that inequalities in health in children are due to environmental factors, which are more important than biological disorders, as argued by Hall (2003).
However, other commentators have argued that biological disorders are more important to inequalities of health in children than social, economic and environmental factors.
1.4 Biological Factors
The word biological in this report is in reference to inheritance from parent to child. For example, a child has asthma because it is in the genes of parents hence the child inherited the asthma gene.
Stewart and Vaterston ()
Recent research shows that poor health in children resulting to obesity or being overweight is not just a direct link from over eating, poor nutrition or having a poor diet. Research has demonstrated that being overweight is associated with an array of health issues, such as cardiovascular disease and diabetes. Stewart and Vaterston
According to the National Cancer Institute (2012), obesity is associated with certain types of cancers, namely cancers of the gastrointestinal tract, pancreatic cancer and post-menopausal breast cancer. This is evidence to show that biological disorders do play a key role in causes of poor health in children.
According to all the arguments presented above, it is clear that one cannot dismiss the argument that causes of poor health in children is due to a variety of factors and reasons. Biological disorders do play a role in poor health in children and it is a very important area to look in to however after weighing all the arguments presented, the researcher agree with Halls statement, that in the 21st Century, social, economic and environmental factors are more important than biological disorders with regards to causes of poor health in children. (HALL 2003)
The second part of this report will look at intervention programmes which tackle inequalities of poor health in children. The National Health Service (NHS) 2013 study looked at English hospital admissions over a 10-year period for obese children and teenagers. It found that hospital admission rates for obesity and obesity-related health problems among children and young people have risen more than fourfold in the last decade, particularly among girls and teenagers. This clearly shows how serious poor care can be. This is a very serious matter which the current government recognises. This is evident by the scheme introduced in September 2013 which aims to help pupils at infant schools in England to get free school lunches. The aim of the scheme is to ensure children get at least one healthy meal a day. The scheme is targeting infants to ensure ‘every child gets the chance in life they deserve.’ The scheme aims to teach healthy eating habits and boost attainment.
The following will look at intervention strategies that aim to tackle poor health in children. The report here will focus on obesity; this will be separated into two parts to appreciate the topic more fully:
- Healthy eating (Children’s packed lunch - Appendix 2)
- Activity: Being fit (Yoga - Appendix 3)
Healthy eating is a main concern of the school in question as the borough of the area has recently put forward an investigation into the obesity levels. The school began to be concerned about what is in children’s packed lunches. So, this led to an intervention on educating children about what healthy food is, as well as informing parents (Appendix 2).
Obesity is when children are over the healthy weight limit. There are several causes for this which includes: genetic factors, family history, psychological and nutritional factors. Obesity has become an epidemic hence it needs to be tackled at an early stage of a child’s life. 15% of children in this country are considered overweight, which is a dramatic increase from a few decades ago when obesity in children was only 4% (REF). There are many risks from childhood obesity such the risk of heart disease and childhood diabetes.
This has led the researcher to create activities to help children to acknowledge how important health should be. The activities are to promote healthy eating with regard to packed lunches. However, the schools lunches are very good using fresh ingredients and a varied selection of foods that children can choose from. School policy requests that children should have a healthy lunch with a balanced selection of healthy food.
Although children have school dinners and are eating healthily, the researcher noticed there are still problems with packed lunches. This made the researcher believe that parents should be educated about their children in what they want and should have in their packed lunch.
Activity One - The Healthy Cafe
To gain knowledge of healthy foods the researcher set up a cafe near the home corner (Appendix?). The cafe had a round table, kitchen and variety of fruits. There was a menu created, this is for the customers (children) and there was waiters (children) to take orders (appendix?).
The activity was successfully completed over two to three weeks. The parent’s feedback was very good as they commented that their children would favour an apple, pear and water rather than sweets or coke. There was also a change in their packed lunches which led to a new policy in school. Children were no longer to have unhealthy foods and drinks. This was not acceptable for some parents as they had said that, ‘their children will not eat’ so the new policy was withdrawn for three weeks. After this time it was decided that children should bring in a healthy lunch box at least once a week.
Macleod and Kay (2008) states that, ‘ill-health or harmful lifestyle choices in childhood can lead to ill-health throughout life, which creates health, financial and social burdens for countries today and tomorrow’. The information inspired the researcher to create a yoga activity, due to having concern for children who suffer diseases from obesity at the school. (Macleod and Kay, 2008, p.226). The healthy eating was an ongoing process but the yoga was only completed once every week as well as involving some parents (appendix?). As Macleod and Kay (2008, p.227) mention, health in childhood determines health throughout life and into the next generation. They go on to say that the period between birth and 5 years and over is the critical age for letting children understand that being healthy can be fun. This was another reason why the researcher chose to introduce yoga, so it can be fun and something the children can enjoy.
How health influences children’s learning
BBC news (2009) provided information that the number of obese children in the UK has risen dramatically in recent years. The Health Survey for England (Joint Health surveys Unit on behalf of the recent... Department of Health, 2012) says that 8.5 per cent of 6-year olds and 15 per cent of 15-year-olds were obese, with others also being overweight. The issue of obesity led the researcher to involve parents to have concern for being fit at home with the children (See appendix ? to see the activity).
At the school the researcher found that young children begin to understand more about health and their own bodies through engaging in the above activities, having a balanced diet, healthy eating and learning more about the body in staying fit. This guided researcher to formulate the yoga activity. Taylor and Woods (2005) mention that when children have healthy experiences in a setting where there are opportunities for energetic play, for quiet contemplation and for bodily relaxation they will make better progress. The children will hopefully develop an understanding of how physical activities, food and drink, sleep, safety and hygiene are vital to life. (recent , p.131-251).
As physical skills develop, children can also engage in activities like yoga to build their ability to act independently in their environments (Recent,, p.189-248). With more awareness, children are more take greater self-care and consideration to their health as they grow older. It may support young children to be healthier and stay safe. Developing a healthy lifestyle is increasingly important for young children in the 21st century, with greater risks to their wellbeing associated with obesity, junk food, and sedentary lifestyles. (Tickell, 2011, p.44).
Activities that support good health should be developed by the children, parents and early year’s professionals concerned, so that all children develop to the highest possible level in terms of health. (recent:P.248). Yogo is one activity that all adults can take part in and encourage young children to get involved in outside of school hours.
There are various magazines promoting health, many of these relate specifically to child health matters and play an important role in informing parents about current child health practices and child care issues. The internet also provides a multiplicity of sites and information about child health (recent p.248).
The important thing that was understood from the assignment in part one is that indeed there are a variety of factors and reasons leading to poor health. Although biological disorders do play a role in poor health in children in the 21st Century, social, economic and environmental factors are more important than biological disorders with regards to causes of poor health in children, as stated by Hall. (2003) The researcher therefore agrees with Halls statement.
Part 2 looked at strategies to tackle poor health, namely obesity in young children. The base school found the activities useful to promote and encourage good health in children.
Practitioners need to work together with parents to reduce the risk of child obesity. They should take a vital role in deciding what food should is suitable for packed lunches and have activities placed in schools to encourage greater care of one’s health. As a Practitioner we can recommend parents to visit their doctors and have regular checkups. Practitioner could recommend a doctor to come in to the school and have a session on healthy living and healthy eating.
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Dupas, Pascaline (2010). ìShort-Run Subsidies and Long-Run Adoption of New Health Products: Evidence from a Field Experimentî. NBER Working Paper 16298.
Macleod I. and Brudenell Janet Kay (2008): Advance Early Years. 2nd Ed. London: Heinemann.
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