No Country Is Protecting Children’s Health, Major Study Finds
No country on Earth is doing what is necessary to protect the health and future of the world's children, a major new report has found.
The report, published in The Lancet Tuesday, is the work of a more than 40-expert commission convened by The Lancet, the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF). It found that children around the world were at risk from the ecological and climate crises, as well as from advertising that markets unhealthy items like processed foods, alcohol and tobacco products directly to children.
"[E]very child worldwide now faces existential threats from climate change and commercial pressures," former New Zealand Prime Minister and commission co-chair Helen Clark said in a WHO press release.
No country is adequately protecting children’s •health •their environment, and •their futures We must build a f… https://t.co/3ZHNbVRyic— World Health Organization (WHO) (@World Health Organization (WHO))1582102397.0
The report ranked 180 countries based both on "child flourishing" — how well they could feed, care for and educate children now— and "sustainability" — assessed based on greenhouse gas emissions and economic equality. It found that, while less developed countries had a hard time providing healthy lives for their children currently, developed countries threatened the future of all children with their higher greenhouse gas emissions.
For example, when it came to child flourishing, Norway, the Republic of Korea and the Netherlands performed the best, while the Central African Republic, Chad, Somalia, Niger and Mali fared the worst. However, when per capita carbon dioxide emissions were taken into consideration, Norway fell to number 156, the Republic of Korea to 166 and the Netherlands to 160. The U.S. ranked with Australia and Saudi Arabia as one of the 10 worst emitters. It was number 173 in terms of sustainability and number 39 in terms of child flourishing.
Only Albania, Armenia, Grenada, Jordan, Moldova, Sri Lanka, Tunisia, Uruguay and Viet Nam were both on track to meet 2030 per capita carbon dioxide targets and ranked in the top 70 for child flourishing.
"Climate change threatens our children's future so we must stop carbon emissions as soon as possible," University College London professor of global health and sustainable development Anthony Costello told The Guardian. "Our new index shows that not a single country performed well on both child development and emissions indicators."
The report's authors warned that if emissions rise past four degrees Celsius by 2100, which they are currently on track to do, this would have serious consequences for children's health because of sea level rise, heat waves, the spread of diseases like malaria and dengue and malnutrition.
@UNICEF @TheLancet @WHOSEARO @WHOEMRO @WHO_Europe @pahowho @WHOAFRO @WHOWPRO Children are among the most vulnerable… https://t.co/0dYl2dUT0a— World Health Organization (WHO) (@World Health Organization (WHO))1582105968.0
The report also warned about the consequences of advertising. Currently, children in some countries see as many as 30,000 television commercials every year, including ads for alcohol, junk food and sugary drinks, BBC News reported.
One new threat in this department is vaping. The number of children in the U.S. exposed to e-cigarette commercials rose more than 250 percent over a two-year period, WHO said.
Another emerging problem is the spread of advertising on social media, Costello told BBC News, though it is still insufficiently understood.
"We have few facts and figures about the huge expansion of social-media advertising and algorithms aimed at our children," he told BBC News.
In response to their findings, the commission called for "the birth of a new era for child and adolescent health," Lancet editor-in-chief Dr. Richard Horton told WHO. According to WHO, the commission recommended five specific actions:
1. Stop CO2 emissions with the utmost urgency, to ensure children have a future on this planet;
2. Place children and adolescents at the centre of our efforts to achieve sustainable development;
3. New policies and investment in all sectors to work towards child health and rights;
4. Incorporate children's voices into policy decisions;
5. Tighten national regulation of harmful commercial marketing, supported by a new Optional Protocol to the UN Convention on the Rights of the Child.
"It will take courage and commitment to deliver," Horton said. "It is the supreme test of our generation."
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It's going to be back-to-school time soon, but will children go into the classrooms?
The American Academy of Pediatrics (AAP) thinks so, but only as long as safety measures are in place.
Keeping Schools Safe<p>What will safer schools look like?</p><p>In a <a href="https://jamanetwork.com/journals/jama/fullarticle/2766822" target="_blank">JAMA article</a> published last month, <a href="https://www.jhsph.edu/faculty/directory/profile/1781/joshua-m-sharfstein" target="_blank">Dr. Joshua Sharfstein</a>, a pediatrician and professor at the Johns Hopkins Bloomberg School of Public Health, outlined suggestions — many of which are similar to AAP's.</p><p>Remote learning protocols must stay in place, especially as some schools stagger home and in-building learning. If another shutdown needs to occur, children will rely on distance learning completely, so it must be easy to switch to, he said.</p><p>He suggested giving parents a daily checklist to document their child's health. Kids should be screened quickly on arrival and be given hygiene supplies. Maintenance staff should use appropriate PPE and have regular cleaning schedules. A notification system should be in place if a case is identified, Sharfstein recommended.</p><p><a href="https://www.albany.edu/rockefeller/faculty/erika-martin" target="_blank">Erika Martin</a>, PhD, an associate professor of public administration and policy at University at Albany, said nutrition assistance and health services should be included. She called for tutoring programs with virtual options as well as technology access.</p>
Supporting Staff<p>Teachers and staff will be affected by safeguarding measures, noted <a href="https://directory.sph.umn.edu/bio/sph-a-z/rachel-widome" target="_blank">Rachel Widome</a>, PhD, an associate professor of epidemiology and community health at University of Minnesota.</p><p>"In order for all of the in-school precautions to work well, we'll be asking a lot of teachers and staff," Widome told Healthline. In addition to their usual workload, they'll now be asked to monitor mask-wearing, ensure children are keeping distance, and be aware of any symptoms.</p><p>Along with Sharfstein, Widome called for an increase in financial support. More employees will likely be required so teachers and staff members can keep up with the added demands.</p>
Should Kids Go Back?<p>While these guidelines may help get some schools to reopen, many people don't think children should go back to school over fears they could contract the disease and spread it to other vulnerable family members like grandparents, infant siblings, or their parents.</p><p>In a <a href="https://pediatrics.aappublications.org/content/early/2020/07/08/peds.2020-004879" target="_blank">Pediatrics</a> commentary, <a href="https://www.md.com/doctor/william-raszka-md" target="_blank">Dr. William V. Raszka, Jr.</a>, an infectious disease specialist at The University of Vermont Medical Center, argued that schools should open because school-aged children are far less important drivers of COVID-19 than adults.</p><p>But he says the risk and benefit is not equal among all students ages 5 to 18.</p><p>"Elementary schools are arguably higher priority for face-to-face schooling, since younger children are at lower risk for infection and transmission, and since parental supervision of younger children's distance learning may be particularly challenging," added Sorensen, who penned a <a href="https://jamanetwork.com/channels/health-forum/fullarticle/2767411" target="_blank">June article in JAMA</a> with reopening tips. "That means middle and high schools are more likely to emphasize distance learning."</p><p>Specific student populations, such as special education students and students with disabilities, would also benefit greatly from more time spent in face-to-face environments, Sorensen said.</p>
What Parents Can Do<p>Parents should ask for and receive frequent updates from schools about plans for the fall. They should also be informed about plans if and when COVID infections are identified, Sharfstein said.</p><p>"I'd like to see parents investing now, during the summer, in doing things that can slow and stop the spread of the virus in their communities," Widome said.</p><p>"Now is a good time for kids to practice wearing masks and get used to them as they may be wearing them for longer stretches if school starts up in person," Widome suggested.</p><p>She recommends parents try different mask designs and materials to see what children are more comfortable wearing.</p><p>"If you are using cloth face coverings, it's good to have extras on hand," Widome added.</p><p>Parents should model healthy behavior at home and while out in public — another thing that could affect how well children adapt to reopening practices, Sorensen said.</p><p>"Children may want to know more about face coverings," added <a href="https://www.linkedin.com/in/leescott/" target="_blank">Lee Scott</a>, chairwoman of the Educational Advisory Board at <a href="https://www.goddardschool.com/" target="_blank">The Goddard School</a>. "Dramatic play, such as creating or wearing a face covering, may help some children adjust to this concept." Schools can also show children photos of what faculty members look like in their masks so the students are familiar with that appearance.</p><p>Johns Hopkins University recently released its eSchool+ Initiative, a slew of resources surrounding education during the pandemic. These include a <a href="https://equityschoolplus.jhu.edu/reopening-checklist/" target="_blank">checklist for administrators</a>, report on <a href="https://equityschoolplus.jhu.edu/ethics-of-reopening/" target="_blank">ethical considerations</a>, and a tracker of <a href="https://equityschoolplus.jhu.edu/reopening-policy-tracker/" target="_blank">state and local reopening plans</a>.</p>
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