The Rise In Chronic Conditions Among Infants, Children, And Youth Can Be Met With Continued Health System Innovations

Abstract

Since the early twentieth century, medical and public health innovations have led to dramatic changes in the epidemiology of health conditions among infants, children, and youth. Infectious diseases have substantially diminished, and survival rates for children with cancer, congenital heart disease, leukemia, and other conditions have greatly improved. However, over the past fifty years chronic health conditions and disabilities among children and youth have steadily risen, primarily from four classes of common conditions: asthma, obesity, mental health conditions, and neurodevelopmental disorders. In this article we describe the epidemiological shift among infants, children, and youth and examine sociodemographic and other factors contributing to it. We describe how health systems are responding by reorganizing and innovating. For children with rare complex conditions, concentrating subspecialty care at regional centers has been effective. For the much larger numbers of children with common chronic conditions, primary care providers have expanded diagnosis, treatment, and management options in promising ways.

Assessment Tools for Evaluation of Oral Feeding in Infants Younger Than 6 Months

“…35 The PEBPT was developed in a manner that supports content validity, but has no formal content validity testing. Lower breastfeeding satisfaction and bottle use were predictive of worse PEBPT score (R 2 =0.15, p <0.01). 35 Schlomer 39 found the internal consistency reliability for the PEBPT to be acceptable (0.81), but no further development or testing has been done.…”

“…1 As advancements in health care have allowed for increasing survival of critically ill newborns, the number of infants with oral feeding difficulty has been rising. 2 Infants who are born premature 3 and with congenital heart disease 4 are at particularly high risk for problematic feeding; however some infants who are otherwise apparently healthy also have difficulty with bottle- or breast-feeding. 1 …”

Decreasing Disparities in Child Development Assessment: Identifying and Discussing Possible Delays in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)

“…6 Poor and/or minority children with developmental delays are less likely to participate in Part C Early Intervention, 7,8 which provides free evaluations and services for young children with developmental delays, and are more likely to have unmet therapy needs. 9 These patterns of under-identification and service use are also true for specific developmental conditions: for instance, ASD, which affects one in 68 U.S. children, 10 is less commonly identified in early childhood for families that are low-income, Latino, or black.…”

Do children in foster care receive appropriate treatment for asthma?

“…The highest rates of asthma prevalence in the United States (9.5%) are among African American children aged 0 to 17 years and among children in families living below the poverty level (Akinbami et al, 2012;Perrin, Anderson, & Cleave, 2014). African American and low-income children are over represented in the foster care population (Child Welfare Information Gateway, 2011) and have disproportionately high rates of asthma prevalence (Scott, Smith, & Ellis, 2012).…”