Embedded Files
Children are a gift to this world, and, as such, it is society’s responsibility to nurture and care for them. In the past, health was defined simply as the absence of disease; health was measured by monitoring the mortality and morbidity of a group. Over the past century, however, the focus of health has shifted to disease prevention, health promotion, and wellness. The World Health Organization (2011) defines health as “a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity.” The History of Child Health and Child Health Care In past centuries in the United States, the health of the country was poorer than it is today; mortality rates were high and life expectancy was short. When a flood of immigrants from Europe settled in the eastern American cities, infectious diseases were rampant due to crowded living conditions, inadequate and unsanitary food (e.g., contaminated milk), lack of any childhood immunizations, and harsh working conditions (including child labor). Devastating epidemics of smallpox, diphtheria, scarlet fever, and measles hit children the hardest. During this period, the prevalent view was that children were a commodity; their role was to increase the population and share in the work to be done. This view changed over the years. Public schools were established and the court system began viewing children as minors. The health of children began to receive more and more attention. As the end of the 19th century neared, doctors and scientists gained a much better understanding of the root causes of illness. This knowledge helped fuel public health efforts such as the campaign for safe milk supply, which lead to pasteurizing milk and to dispensing free milk in some cities (Richter, 2004). Compulsory vaccination programs began during this time. In the late 1800s some states mandated smallpox vaccination as a condition of school attendance. These public health efforts led to a decrease in infant and child deaths (Richter, 2004). In the late 19th and early 20th centuries, cities became healthier places to live due to urban public health improvements, such as sanitation services and treated municipal water (Richter, 2004). The threat of childhood diseases such as diphtheria, cholera, polio, and yellow fever began to take less of a toll on children (Richter, 2004). The turn of the 20th century brought new knowledge about nutrition, sanitation, bacteriology, pharmacology, medication, and psychology. Penicillin, corticosteroids, and increased numbers of vaccines, which were developed during this time, assisted with the fight against communicable diseases. Thus, by the end of the 20th century, unintentional injuries surpassed disease as the l leading cause of death for children older than 1 year (Richter, 2004). By the end of the 20th century, technological advances had significantly affected all aspects of health care. These trends have led to increased survivalrates in children. However, many children who survive illnesses that were previously considered fatal are left with chronic disabilities. For example, before the 1960s, extremely premature infants did not survive because of the immaturity of their lungs. Mechanical ventilation and the use of medications to foster lung development have increased survival rates in premature infants, but survivors are often faced with myriad chronic illnesses such as chronic lung disease (bronchopulmonary dysplasia), retinopathy of prematurity, cerebral palsy, and developmental delay. This increased survival has resulted in a significant increase in chronic illness relative to acute illness as a cause of hospitalization and mortality. In recent years there have been tremendous improvements in technology and biomedicine. This has created a trend toward earlier diagnosis and treatment of disorders and diseases. Throughout the 1990s remarkable progress was made linking genetics and pathophysiologic processes. For example, female fetuses diagnosed with congenital adrenal hyperplasia, a genetic disorder resulting in a steroid enzyme deficiency that can lead to disfiguring anatomic abnormalities of sexual characteristics, are able to receive treatment before birth. This can lead to fewer anatomic abnormalities and may even allow for normal female genitalia to develop (Mayo Foundation for Medical Education and Research, 2009). In addition, many genetic defects are being identified so that counseling and treatment may occur early. In addition to improvement in technology and biomedicine, a number of national and international organizations have been
Google Sites
Report abuse