Different times, different problems
Obesity, asthma and diabetes have replaced polio, measles and other infectious diseases as the biggest health problems facing school-ageD youngsters
By Rebecca Kuzins 01/17/2013
With reports of childhood obesity now flooding the media, it’s hard to remember a time when concern about overweight kids was far surpassed by public anxiety about polio, measles and other infectious diseases. But in the 1960s and 1970s, thousands of American children suffered from these illnesses, some of which were, as yet, untreatable.
“Health care issues since the 1960s have moved from acute preventable diseases — those eliminated by vaccines — to chronic, manageable conditions like diabetes, obesity or asthma,” said Kelly Hardy, director of health policy for Children Now, an Oakland-based children’s advocacy organization.
The Centers for Disease Control and Prevention (CDC) has compiled a list of 16 diseases prevented by childhood vaccines, including diphtheria, tetanus and mumps. The incidences of these diseases has been dramatically reduced and, in some cases, virtually eliminated.
For example, in the 1960s and 1970s, one of every 250 American students was infected with the Haemophilus influenzae type b bacteria, according to James D. Cherry, a physician specializing in pediatric infectious diseases and the Distinguished Professor of Pediatrics at UCLA’s Geffen School of Medicine. In the same period, Cherry added, there were about 20,000 reported cases of the disease annually; 50 percent of these cases resulted in meningitis and “of these, the death rate was 7 percent. At least another 20 percent had some neurological complications, including deafness or retardation.”
Today, however, Cherry said this type of flu is “virtually gone” because of vaccines commonly in use in the last 20 years.
Cherry also noted similar declines in measles because of a vaccine introduced in 1963: “Before then, there were about 500 deaths a year due to measles, and 1,000 other [children] had encephalitis, with many becoming brain-damaged.” He added that in 1963, 20,000 babies suffered “severe damage” from German measles (rubella), another disease for which there is now a vaccine. Similarly, the Salk vaccine, introduced in 1957, and the Sabin oral vaccine, introduced in 1962, had a “pretty dramatic effect on polio.”
Children today are more likely to suffer from chronic diseases than infectious illnesses. Ann Rector, coordinator of health programs for the Pasadena Unified School District, cites obesity, asthma and diabetes as the district’s major health problems.
Asthma, she added, is the “most chronic disease,” affecting 1,600 children, or about 8 percent of the district’s students. Many of the children also suffer from allergies. “I grew up in the 1960s, and I don’t remember peanut and food allergies,” she said. “All of a sudden, everyone’s allergic to something.”
Rector said incidents of Type 1 and Type 2 diabetes are also increasing, with the latter often resulting from obesity. Each year, the state compiles statistics comparing California students’ heights and weights with CDC-recommended measurements. Recent data, Rector said, concluded that “48 percent of the district’s students were outside of the healthy fitness zone. They’re not necessarily obese, but they are overweight.”
School health directors, like Rector, are now more apt to examine the impact of the environment, family and society on children’s health than they were 40 or 50 years ago. For example, in Pasadena’s public schools, Rector said it is more common for poor children to be obese than those from wealthier families. “It’s a hard struggle here,” she said about the district. “A lot of the health problems follow poverty.”
However, children of all economic backgrounds are more likely to be covered by health insurance today than they were in the 1960s. Hardy attributed the increase to “the creation and expansion” of two government-funded programs for low-income people: Medi-Cal (California’s name for the federal Medicaid program), and the Healthy Families Program, which this year will be consolidated into Medi-Cal.
Data from the US Census demonstrates this increase in health insurance coverage. In 1987 (the first year for which data is available), about 7.6 million California children under the age of 18 had some type of health insurance, compared with 9.2 million in 2011 — a 21 percent increase. In 1987, 16 percent of the state’s children were uninsured, compared with 10.8 percent in 2011; 68 percent had private insurance in 1987, compared with 54.6 percent in 2011; and 17.7 percent were covered by Medi-Cal in 1987, compared with 38.5 percent in 2011.