Sleep deaths and other evidence show U.S. has far to go on kids’ health

Many grown-ups may love to grin, coo, and snuggle with babies and little kids, telling themselves that they’d bust through walls for the sake of adorable youngsters’ well-being. But evidence indicates the nation has a far way to go to better children’s health.

Although the U.S. spends more per capita than most wealthy, democratic nations on kids’ health care, American kids have lagged in the beneficial outcomes. Indeed, youngsters in this nation have a 70 percent greater chance of dying before adulthood than do their peers in industrialized nations.

As the Vox news site summarized the statistical analysis published in the medical journal Health Affairs, “Since 1961, America’s poor performance [in caring for the young] accounts for more than 600,000 excess child deaths — deaths that wouldn’t have happened if these kids were born into other wealthy countries.”

The United States is the sad leader in childhood deaths among nations in the Organization for Economic Cooperation and Development (OECD), a 20-nation group that includes Canada, Australia, France, Sweden, and the United Kingdom. The researchers found that:

While child mortality progressively declined across all [studied OECD] countries, mortality in the U.S. has been higher than in peer nations since the 1980s. From 2001 to 2010 the risk of death in the U.S. was 76 percent greater for infants and 57 percent greater for children ages 1–19. During this decade, children ages 15–19 were eighty-two times more likely to die from gun homicide in the U.S.

Parents, educators, politicians, and policy-makers must deal with significant factors that harm and kill older youngsters, including guns, drugs, and vehicle wrecks, the experts said. They also need to do more to improve infant care, so more babies can access medical services more easily and readily, and without complications due to poverty or fragmented delivery systems.

If those policy ideas sound too abstract, just consider some of the real problems in kids’ care that various news organizations have reported recently.

Lack of home nurses strands ill babies in costly hospital care

Bloomberg News, for example, says that a dearth of one kind of nurses — trained specialists who also happen to be relatively low paid — helps to strand hundreds of thousands of sick infants in costly hospitals rather than letting them go home with their families. Instead of receiving what may be extensive care from home nurses at relatively low hourly wages, chronically ill kids rack up what can be six-figure medical bills in hospitals — sums that stagger families, insurers, and hospitals.

Social programs like Medicaid are supposed to help. But too few practitioners want to take on the long hours, stress, lower pay and other professional rewards to serve as home nurses. And excess bureaucracy, red tape, and mounting medical expenses too often force mothers, especially, to give up jobs to take care of their sick babies, though this may further impoverish their families.

Sleep deaths a renewed concern

Meantime, when there are major health initiatives that can benefit the young — such as the national campaign to reduce babies’ deaths during sleep — these can be hard to sustain. As CBS News reported about new data from the federal Centers for Disease Control and Prevention:

Many parents still regularly risk their babies’ lives as they put them to bed …. Analyzing data from the states, the CDC found that parents continue to practice unsafe habits that have been associated with sleep-related infant deaths, including sudden infant death syndrome (SIDS): 1 in 5 mothers place [their] baby to sleep on his or her side or stomach … 2 in 5 leave loose bedding and soft objects in the baby’s sleep area, most often bumper pads and thick blankets … 3 in 5 sometimes share their bed with their baby. These practices contribute to about 3,500 sleep-related deaths of U.S. babies every year.

The CDC has posted extensive and helpful information about research-based best practices to keep babies’ slumbers safer The agency, along with groups like the American Academy of Pediatrics, urges parents to always place babies on their back whether for naps or night time sleep. They should rest on a firm sleep surface, such as mattress in a safety-approved crib, and their snoozing spot should be free soft objects, including bedding (blankets and pillow), toys, and bumper pads. Parents should not have sleeping babies share their bed, though they may share the room.

Pediatricians and public health experts, starting in the 1990s, waged an extensive public information battle to get these and other safety ideas into parents’ hands. It worked for a while. But Dr. Brenda Fitzgerald, the CDC’s director, says the agency’s recent research, including extensive parental surveys, shows that, “unsafe sleep practices are common. We need to reinvigorate [the] important work [of] getting safe-to-sleep messages to all audiences.”

In my practice, I see not only the major harms that patients suffer while seeking medical services but also the significant injuries that can be inflicted on babies and children. The young not only are among our society’s most vulnerable, they also are our future — and it’s not smart to short-cut ways that we can help them grow up healthy and strong.

Why can’t Congress OK poor kids’ health insurance plan?

That’s why it’s important for taxpayers to ask why President Trump and the members of Congress can’t put aside partisan wrangling — mostly on the majority GOP side — and reauthorize the Children’s Health Insurance Program, aka CHIPs. It covers nearly nine million children whose working poor parents earn too much for Medicaid, but not enough to afford other coverage. The program expired in September, and states across the nation are trying to help kids in need as CHIPs funding evaporates.

Lawmakers insist they have struck a deal on the program. But they’re putting youngsters, families, and health providers through the wringer needlessly by not voting on CHIPs — even as the Congressional Budget Office, Congress’ own nonpartisan financial analysts, has revisited what this program would cost. The CBO found, due to lawmakers’ actions on other health-related matters in the tax bill vote, that CHIPs would cost much less than once projected: $800 million over nine years versus an earlier estimate of $8.2 billion. The program also would shave $6 billion off the federal deficit.

Voters may be well served to remember this brusque handling of not just the CHIPs program but also revelations about Alex Azar, the president’s nominee to head the giant federal Health and Human Services Department. Azar’s likely to be confirmed by the Senate, and he has told lawmakers in his hearings that he, of course, wants U.S. health care to better serve Americans at lower costs, though his views on lowering drug costs may differ from the president’s.

Big Pharma’s patent ‘game:’ drug testing on kids

Azar is a longtime Big Pharma executive. The news site Politico, to its credit, has pointed out that during his time as a chief at Eli Lilly, the company faced a big problem with an expiring patent for a top-producing drug. So, the firm, critics say, decided to “game” the system. Lilly earned six months more of protections for its $2-billion-a-year product by testing it in a novel way on children with a rare disease. The company made clear its financial stake and potential fiscal benefit. It said it did not think the experiment had much hopes for Duchenne muscular dystrophy, a muscle wasting disease in boys which has no cure and kills many by young adulthood.

Still, the company, with Azar as one of its top leaders, went ahead. It conducted a trial giving young Duchenne patients Cialis, an erectile dysfunction medication. The drug did not perform for the sick. It did for the company’s bottom line.

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