Get Out(side)!

How many of us had mothers who would tell us to go outside after being too rambunctious in the house? If you consequently played outside a lot, you might be a healthier adult because of your mother’s orders. Some people claim more outside time increases creativity in children, but there are some concrete health benefits of getting outside:

1. Childhood obesity is on the rise – according to the CDC, for children ages 6-11 the prevalence of obesity has nearly tripled between 1980 and 2006. It’s a simple calories in-calories out equation. And the sedentary lifestyles of kids spending after school and weekend time watching TV and playing video games is half of that equation. It’s no secret that a child burns more calories playing “War” outside than playing “War” on a video game. And you know what? A child is more likely to spend time outside if it’s modeled for him by a parent. Just like a child is more likely to be sedentary if it’s modeled by a parent. So get outside and play TOGETHER!

2. According to a study in the Archives of Ophthalmology since the 1970’s, we’ve seen a 66% increase in the prevalence of Myopia (near sightedness). (See article in post from Monday, January 11^th) The cause? Partly genetics, but researchers at Ohio State University have found it may be partly due to low levels of outdoor activity. Don’t want to spend money on glasses and contacts until your child is 18? Get them outside!

3. An article published in Pediatrics in 2004 reported the more TV-time a child experienced between the ages of 1 and 3, the more likely they were to develop attention problems (e.g. ADD, ADHD) by the age of 7. Granted, kids are naturally hyperactive beings, but attention problems can significantly affect your child’s performance in school. Make an effort to turn your young child’s energy into productivity.

I acknowledge it’s not realistic for children in some locations to play outside every day, year-round (I grew up in Minnesota, I know firsthand). But knowing that increased outside time can lower a child’s risk of obesity, myopia, and attention disorders ought to motivate parents to encourage getting outside as much as possible.

While increased outside time can lower the risk of certain health issues, it can increase the risk of another: sunburn (and consequently skin cancer). Please be mindful that increased outside time means increased sun exposure, so please act accordingly (e.g. sunscreen, hats, sunglasses).

The Buzz on Nearsightedness (Myopia)

Something for parents to consider: spending time outdoors may help decrease a child's risk of developing myopia. Check out the story from NPR

"I'm healthy! I went to college!"

Back in May, a report was released by the Robert Woods Johnson Foundation that ranked states according to the gap between college graduates and non-college graduates who rate themselves in “less than very good” health. Meaning, the states ranked the highest had the smallest gap in self-reported health status between those with college degrees and those without. Top-ranked states were Delaware, Hawaii, and Maryland. Lowest-ranked states were California, West Virginia, and Kentucky.

Click Here to download the report.

This report is chocked full of other data about self-reported health status among American adults, but I want to focus on the relationship found between education and health status. What they found was that as education levels rise, health improves.

As someone who’s been in the health field for years, I can look at these finding and say “Well, duh!” But is it all that intuitive? Let’s deconstruct it:

College Education > More Knowledge > Awareness of Health Risks > Healthy Behaviors > Reporting Good Health

OR

College Education > Higher Income > Ability to Regularly Access Health Care Services (by health insurance or out-of-pocket expenses) > Reporting Good Health

OR

Both?

I think the gap between college-educated and non-college-educated folks is somewhat a combination of the two models proposed above, but I think the main factor is probably linked to income. We know that people with higher education levels get paid more (check census data: http://www.census.gov/hhes/www/macro/032008/perinc/new03_000.htm)

I would venture to say that most Americans have access to basic health knowledge. Most children learn basic health behaviors all through primary school, from teeth-brushing to healthy eating. And there are so many public service announcements and news reports related to health nowadays (providing you have a television), so the basic knowledge is there. However, people who make more money are more able to access healthier foods (fresh veggies cost more!), physical activity (e.g. gym membership), and regular health care.

One thing that concerned me about the release of this report is that the chairman of the commission that put out this report said that in order to improve our nation’s health we need to improve education quality and education attainment. I’m all for improving the nation’s schools and giving every child the opportunity to go to college if they want, BUT…

-Do we really know that education actually precedes health status? I mean, which came first, the chicken or the egg? Maybe kids who already value health and consider themselves to be healthy, physically and mentally, go to college. Many college-bound kids are able to stay on their parents’ health insurance during their college years and maybe they see health insurance and regular health care as important. Who knows?

-Maybe before correcting the educational system in the US we need to fix the health care system. We ought to consider striving toward getting every person, regardless of age, equal access to health care. We’ve missed the boat on folks who will not go back for an education, so why not seek to meet their current needs? In the coming years, people over 80 will become the fastest growing age group in America and people over 50 will represent 35% of the population. Let’s meet the ever-increasing need for access to health care.

-Keeping in mind, access to health care and education alone will not fix the problem. Both issues need to be tackled to move toward improving the health status of the American people.

Don't Fix What Ain't Broke

One of the major political and public health issues facing our country today is Children’s Health Insurance. There has been a big push to cover all children in the US. It would be huge if we could figure out how to provide adequate and equal access to health services for all American children.

In recent years, there’s been some forward progress. But I learned recently that some states, such as North Carolina, are looking to take a big step backward by cutting school-based dental programs for children.

According to the CDC (www.cdc.gov) and ADA (www.ada.org), findings from several scientific studies show that school-based sealant programs work. These programs reach children at high risk for tooth decay, especially those who don’t have access to private dental care. Why would a state see an effective program as expendable?

Here’s why states should NOT cut school-based dental services:

1. According to the CDC, tooth decay (dental disease) is the most common health problem for school-aged children.

2. According to the state oral health survey in North Carolina, 1 in 4 children entering kindergarten show obvious signs of tooth decay. In many states, the percentage of 3rd graders with untreated tooth decay is upwards of 44%!

3. Recent studies conducted by researchers at Harvard and the University of Puerto Rico found a link between periodontal disease and obesity. These findings also have implications for links between oral health and heart disease and type 2 diabetes. Therefore, we ought to think of school-based dental services as preventive health services that extend beyond the teeth.

I’m not an economist, I’m a health educator. Do I understand that states have budget shortfalls? Yes. Do I understand why a state would cut a program that is effective and is good for the health of its future workforce? No. In my opinion, the economic returns of keeping a program of this nature far outweigh the costs…

Healthiest Nation in One Generation

I think this little video is very clever - check it out!



To find out more, visit http://www.generationpublichealth.org/

May is Asthma Awareness Month!

Did you know that asthma is the most common chronic disease among children? Approximately 6.7 million children are currently living with asthma in the United States (CDC, 2009). Asthma disproportionately affects:

• African Americans
• People with lower income
• People living in urban areas

Unfortunately, children with asthma must live with this condition for their entire lives. If asthma is poorly controlled, it can lead to:

• Restricted activity
• More sick days (from school or work)
• Emergency room visits
• Decreased quality of life

However, if asthma is properly and effectively controlled, children with asthma can live healthy and active lives no different from children without asthma. Here are some tips for helping your child control his or her asthma and avoid hospital visits:

• Visit the doctor regularly
• Develop an asthma action plan with your primary care provider
• Make sure your child regularly takes any prescribed asthma controller medication
• Always carry a rescue inhaler wherever you and your child go
• Identify your child’s asthma triggers (e.g. dust mites, mold, pets, pollen, cigarette smoke, etc.)
• Help your child avoid contact with their asthma triggers

*Note: If your child experiences an asthma attack that cannot be alleviated by a rescue inhaler, take them to the emergency room immediately.

These tips may seem simple, but in practice, they carry some degree of difficulty and I’ll tell you why. Controlling a child’s asthma often relies on a behavior change with the parent or other members of the household. This can include reminding a child to take their medication, quitting smoking, regular cleaning, or getting rid of a pet. As with any behavior change, there are a number of internal and external factors that come into play, such as time, motivation, and social support.

I once worked on an asthma control pilot study targeting children with asthma and their caregivers who lived in rural mountain areas of North Carolina and were on Medicaid. Participants came in and developed an asthma action plan and a set of short-term goals related to reducing asthma triggers with their health care provider. Participants were supposed to return one and three months later for follow-up on their goals and other variables, such as use of rescue inhaler and emergency room visits. But participants never returned . When we found out why, it primarily came down to lack of finances, time, and knowledge.

· Follow-up visits required a parent to take off work – they could not afford to take time to not work

· Follow-up visits required round-trip drive times of up to 2 hours due to the mountainous, rural landscape

· Parents did not see a reason to bring their child into the doctor for follow-up if the child was not experiencing any immediate asthma complications

But there’s hope! There is some recent research regarding caregiver behavior change. A study published in the Archives of Pediatric and Adolescent Medicine in March 2009 by Fisher, et al showed that asthma coaches were effective in reaching low-income parents of African American children (http://archpedi.ama-assn.org/cgi/content/abstract/163/3/225 ). Asthma coaches consisted of trained community members who provided information and social support by regular contact (monthly or bi-weekly) with parents over a two year time period. As a result, parents who had regular contact with asthma coaches experienced 50% less hospitalizations among their children compared to a control group.

There are two things I’d like you to ponder:

1. Our choices and health behaviors as parents can have a significant impact on the health status of our children.

2. Could social support be the key ingredient that’s been missing from the medical model?

Hmmm...