Longevity In Health For Children

By Arvind M. Dhople, Ph.D., Professor Emeritus, Florida Tech

Over the past two decades, the world has made tremendous progress improving child and adolescent health and well-being.  But challenges persist.  Communicable diseases continue to endanger children and adolescents across the globe – and new health problems are on the rise, especially in areas affected by poverty.  Mental health conditions, developmental delays and disabilities, injuries and non-communicable diseases – including cardiovascular diseases, diabetes, preventable cancers and chronic respiratory diseases – pose threats to children and adolescents worldwide.  Unhealthy diets, inactive lifestyles, use of substances, and environmental hazards such as pollution also prevent millions of children and adolescents from surviving and thriving.  Millions of children are still growing up without adequate health-care services, nutrition, safe environments, and responsive caregiving.

                With the world’s population aging at an inexorable pace, understanding how people can live linger in health becomes increasingly crucial.  Fortunately, research has been helping to uncover how health in older ages is built upon health in childhood.  Dada show that approximately 55% of children and 80% of adolescents with obesity will go on to be obese in adulthood, and as links between obesity and diverse aspects of health become more evident – for example, with findings of an association between obesity and grey matter atrophy – such figures make for a worrying proportion of the population who faces future health issues related to both excess weight and cognitive decline.  Early action to prevent an increase in two major current health issues is clearly and urgently needed, and perhaps the solutions are already known.

                Breastfeeding is associated with a reduced risk of overweight and obesity, making it an even more important practice in light of the fact that, as of 2020, 39 million children younger than 5 years worldwide were overweight or obese.  The replacement of breastfeeding with commercial milk formulas is not the only cause of obesity in children; other factors, such as food insecurity in childhood and the intense marketing of energy-dense, nutrient-poor foodstuffs to children, are also known to be important drivers of increasing childhood obesity.  But what is notable about these factors is that they are all potentially addressable by adequate policy action.  Children cannot control the rules around marketing and food regulation, but adults can: governments and national health agencies must ensure that unhealthy food advertising does not target children and that food standards address the poor nutritional quality of many products marketed for children and adolescents.      

                But while millions of children worldwide are overweight or obese, many millions more are severely undernourished – a major consequence of which, stunted growth, affected an estimated 144 million children globally.  Stunting prevents children reaching their normal adult height and limits affected individuals’ physical capacity as adults.  Malnourishment decreases immunocompetenc and impairs cognitive, motor, and behavioral development, causing functional disadvantages in adults and profound economic implications for societies.  Yet undernutrition is far from being a problem with no solution: delayed umbilical cord clamping, micronutrient supplementation, early initiation and continuation of breastfeeding, and promotion of diverse diets and school feeding programs are only some of the interventions known to be effective in improving nutritional quality; but a lot more political will is necessary to make sure such actions are implemented at scale.

                If providing adequate nutrition to children worldwide has been such an unattainable goals, what is to be said of other essential health-care measures, such as childhood immunization?  Studies from around the world report persistent barriers to childhood immunization, and although some of these barriers stem from sociocultural factors, difficulties with the supply chain and availability of human resources and infrastructures continue to be obstacles to making essential vaccines reach more children.

                Even from only few examples, the interconnectedness of health in childhood and later in life is undeniable.  Ensuring health in older age requires building resilience on many levels, which cannot wait until adulthood.  A healthy older population begins with healthy children and adolescent: the time for governments to sow the fruits they want to reap now.  For the 2 billion children up to 10 years old, and 1.2 billion adolescents between the ages of 10 and 19, the extent to which society invests in their health and well-being will determine the future not just for them, but for everyone!