Thursday, January 3rd, 2013
Even in the aftermath of the Sandy Hook shooting, there are few topics more polarizing than gun control. But from the perspective of public health, I would hope everyone would agree that we have an urgent need to make children’s lives safer than they are right now.
Let’s look at some numbers. Using data from the Centers for Disease Control and Prevention (CDC), the Children’s Defense Fund generated the following statistics:
In 2008, 2,947 children and teens were killed by guns
In 2009, 2,793 children and teens were killed by guns
The majority (about 2/3) were homicide related; around 1/4 were due to suicide; and around 5% were accidental deaths.
If you peruse the CDC site – specifically the section on Injury Prevention and Control – you will note a few key points:
Injuries are the leading cause of death in the U.S. for individuals between 1 and 44 years old
3/4 of all deaths of young people are due to injuries – with homicide being the 2nd leading cause of death for 15-24 year-olds (motor vehicle accidents are the leading cause)
As noted by the CDC, in principle all the deaths due to injuries are preventable. While this goal is not achievable (we live in an unpredictable world), the public health perspective is to do everything we can to reduce the probability of injury and death. For example, with respect to motor vehicle accidents, we focus on a number of issues, including: enforcing speed limits; requiring safety belts; trying to ensure that babies, toddlers and kids are secured as safely as possible in motor vehicles; trying to prevent drinking and driving. We also take on new topics when they emerge, like the very real public health issues that have been raised in more recent years by cell phone use (including, of course, texting) in motor vehicles. Why am I belaboring this example? Because I don’t think many of us find the attempts to reduce mortality due to motor vehicle accidents to be controversial. It’s a public health issue – motor vehicle accidents are the leading cause of death in youth, so we have to try to find ways to reduce that morbidity. In the same way, we all can take as a starting point the need to reduce mortality attributable to firearms.
Now, I’m not here to resolve the issue – far from that. There’s plenty to debate, and to do this in a real way, we will need to consider a lot of perspectives. What has concerned me is the tendency we all have to polarize an issue – even in the face of the devastating tragedy at Sandy Hook Elementary – because it typically leads to no action at all. It’s not all about guns – or not at all about guns. It’s that grey area in between where we have to deal with the realities of how we will take on the firearms issue to try to make the world safer for our kids. Whether you are philosophically for or against gun control, reducing mortality due to firearms is a public health issue, and a part of the equation, as are other factors – including bringing a similar lens to mental health:
Sandy Hook Aftermath: Mental Health As A Public Health Issue
Epidemiology and Public Health via Shutterstock.com
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Monday, January 16th, 2012
The Centers for Disease Control and Prevention (CDC) recently released a report that provides the most up-to-date data on causes of death in the United States. This builds on prior research and continues to deliver a critical public health message for parents: the most frequent cause of death for children is accidents.
The CDC report is lengthy and they will eventually publish more user-friendly reports. But since the most recent data confirm prior reports, it’s worth your time to revisit prior findings published on the CDC website and look at a visual representation of the leading causes of death for kids. And note the following from that report (drawn from data collected a few years ago):
“For those age 5-34 in the United States, motor vehicle crashes are the leading cause of death…”
A breakdown of the newer statistics is available on the blog “The Incidental Economist.” Blogger Dr. Aaron Carroll – who is a pediatrician – provides a sobering review of the latest numbers which I encourage you to read. While there are many important issues covered by Dr. Carroll (including the frequency of homicide and suicide as causes of death at different ages), I’d like to focus on one of the findings from the latest data that he highlights: Car accidents is one of the most frequent causes of death across age groups (the CDC breaks down ages as: 1-4 years old; 5-14 years old; and 15-24 years old).
The reason I highlight this is that parents should be doing everything they can to make their kids as safe as possible when they are in the car. PLEASE NOTE THAT I HAVE REVISED THIS POST AS OF 10:04 PM EST ON JANUARY 16. MANY READERS FOUND THE PRIOR INFORMATION CONFUSING. TO MAKE SURE PARENTS HAVE THE MOST RECENT INFORMATION, PLEASE CLICK ON THIS LINK FOR GUIDELINES PROVIDED BY THE AMERICAN ACADEMY OF PEDIATRICS. THANK YOU TO ALL WHO HAVE SUGGESTED THAT THIS WOULD BE THE MOST HELPFUL LINK FOR READERS.
If you follow these guidelines, can you guarantee your child won’t be injured or killed in a car accident? Of course not. But you can be sure that you will be significantly reducing their risk of both. The CDC estimates that child safety seats reduce the risk of death in car crashes by 71% for infants and 54% for toddlers.
Look, I found car seats to be a major hassle when my daughter was young. I found it hard to figure out which ones were best. They were a pain to install. My daughter wasn’t thrilled about sitting in one. But I tried hard to get information from my pediatrician and my local police station. We were vigilant about using them. And a few years ago, we were happy we did. My wife and daughter were at a complete stop in traffic (the 4th of 5 cars waiting for a car to make a left turn) about a quarter mile from our home. A driver wasn’t paying attention and plowed into that line of cars with enough force to push five cars together. Fortunately my wife and daughter had appropriate safety restraints on and were not seriously hurt (the same could be said for all the other passengers in other vehicles). I can guarantee you it would have been much worse if they didn’t.
Luck and chance play a role in life – both bad and good. But as parents we might as well do everything we can to try to protect our kids. As Dr. Carroll said in his blog post:
We know what kills kids. We see the results every year… Let’s act on that.
PLEASE NOTE A NEW IMAGE OF THE AMERICAN ACADEMY OF PEDIATRICS HAS BEEN INSERTED. THE PRIOR IMAGE OF A BABY IN A CAR SEAT WAS REMOVED BY ME AS MANY READERS FOUND THAT IT COULD BE PROMOTING IMPROPER USAGE.
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Saturday, June 25th, 2011
In my last post, I suggested that early screening for autism is warranted and should continue. The many comments that were posted on my blog and on Parents Facebook page provided compelling arguments in favor of early screening. And a new study published in Pediatrics provides solid evidence that early screening is in fact leading to early intervention. Here are the key findings:
- Early diagnoses of Autism Spectrum Disorder (ASD) — defined as occurring before 36 months of age — increased in Massachusetts by 66% from 2001 – 2005
- 1 in 129 children born in Massuchusetts between 2001 and 2005 were enrolled in an early intervention program for ASD by 36 months of age
The researchers speculate that the increases in diagnoses and routing to early intervention came about in part via:
- Increased efforts by the Massachusetts Department of Public Health to support early identification of ASD
- The Centers for Disease Control and Prevention “Learn the Signs. Act Early” campaign
- The emphasis placed on early screening by the American Academy of Pediatrics which also encourages providers to conduct screenings
This paper adds to the evidence that early screening works — children are now identified earlier than ever and families receive services earlier than before.
Public health campaigns that provide new information to parents and new tools to caregivers are helping to make a difference in the fight against autism. Supporting research and clinical efforts to improve this process can help children and parents even more in the future. I encourage all parents to embrace “Learn the Signs. Act Early” as part of their regular visits with their pediatricians.
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