EPHA contribution to Public Service Review Journal
EPHA contributed to the Public Service Review Journal with an article on children’s health, analysing the current approach to children’s health and why healthy ageing starts with a childhood free of inequality.
Policymakers have not paid enough attention in recent decades to the child population. Whilst due attention given to such initiatives like Heathy and Active Ageing, one seems to forget that healthy and disability-free ageing starts with inequality and disability-free children.
The best way to achieve the goal of improved health through focusing on social determinants is to tackle them very early, starting from perinatal conditions. Early child development strongly influences the skills to cope with communicable and non-communicable disease and injury risks later in life, as the first years of life determine people’s health potential.
The article contributed by EPHA is in line with our recent Briefing on Children’s Health.
Just like for the adult population, there is a tendency for childhood health prevention and healthcare interventions on both individual and societal level to be tailored for more affluent strata in the population and to be highly health sector-led. This is based on an assumption that health problems occur only in its extreme – as a disease, a disability or an injury, and not rather as an accumulation of unfavourable socioeconomic health determinants – including policies.
So which policies – out of the health sector – should be considered? There is no simple answer as there is a myriad of directly and indirectly interlinked policies and processes that impact human health, especially those in a vulnerable and dependant position. Children live in families and communities and therefore social, family and care policies are of particular importance for their development and wellbeing.
Education and quality childcare, maternity and parental leave arrangements (developed on the public health grounds taking into account the evidence of the importance of breastfeeding uptake and retention, emotional development and female labour participation), or fiscal benefits (child allowance) – all promote children’s health long-term. In contemporary societies – especially in urban areas – up to 25% of children grow up in jobless or ’in-work poor’ houses. With human poverty comes impoverished habitats, environmental pollution, social disruption, distrust and finally crime.
The actions aimed at improving the health of children tend to be skewed towards the treatment of already existing ill-health conditions or, at its best, oscillating towards primary prevention (early diagnosis, screening). Public health spending in the field of research, innovation and technology is not always balanced around public versus private interests, trying to find solutions to real-life grand social challenges and equity issues.
To conclude, in the 21st Century, not enough is being done to tackle the vast inequalities in children’s health. Healthy and active ageing starts with a healthy childhood, and therefore a life course approach to any attempt to improve health is essential. We do need more attention to the individuals, especially in the contemporary political environment that takes GDP as a measure of a nation’s wellbeing – a crude measure if ever there was one. However, simultaneously we need greater focus on groups of people embedded in their families and communities, as well as wider social determinants of health.
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