Children most in need — seeing beyond their size

The Cambridgeshire Primary Care Trust released its 2007-2008 Joint Strategic Needs Assessment for its children and young people last month. While the outcomes for most children are good, it said, they found that one in every 30 child is a “child in need,” due to neglect, physical or sexual abuse, disability or dangerous home settings from such things as violence or drug abuse. Their needs assessment identified 3,500 children most at risk and who needed additional help in order for them to have a chance of attaining “a reasonable standard of health and development.” Not unexpectedly, these children were primarily in the most disadvantaged areas.

“By identifying these children and young people early on, we aim to ensure we have the right services to meet their needs, and by meeting their needs, we will ensure more make a successful transition to adult and working life, able to support their own children effectively,” said the report. By being aware of children’s needs and coordinating services, “we will make best use of scarce resources when identifying priorities for action and when commissioning activity.”

After having read that troubling report just weeks ago, today’s announcement from the Cambridgeshire Primary Care Trust, which is responsible for the management and planning of primary health care in the area, came as a surprise. It just prioritized funding for ... a Childhood Obesity Czar.

As Cambridge News reports:

'Tsar' to advise on child obesity

...The fitness adviser will oversee the fight against bulging waistlines of children in the district, which has some of the UK's highest obesity levels. The "obesity tsar" will also train teachers, youth workers, teaching assistants and other professionals working with children on how to promote fitness, healthy eating and exercise in the lives of children. The post will be funded for two years by a £32,000 Government grant and will be run by the Cambridgeshire Primary Care Trust.

Funding for the Healthy Children, Healthy Weight project is set to be approved on Monday at a meeting of East Cambridgeshire District Council's External Partnership Review Committee, which is allocating £1.4 million of Government cash to various community projects. Cllr Ron Bradney, the committee's vice-chairman, said... “We need to get everyone in our community moving - from primary school children and teenagers to adults and pensioners and this project is an excellent start.”

According to the Council, “nearly one in four children aged four to five needed to shed a few pounds.” (!) They based this on their government statistics from the National Child Measurement Programme. (Remember yesterday’s poll?)

According to the Council’s head of corporate strategy, Steve Thornley: “By catching children early, we can stop them becoming overweight,” he claimed. “Studies show that if we wait for them to become obese adults, it is much harder to change their attitudes and lifestyle.” No research was provided in support of an ability to prevent the natural diversities in children’s sizes through early interventions, or that such 'healthy weight' programs benefit their health.

The evidence suggests that Cambridgeshire children’s figures are not their most pressing health concerns. Blaming fat is easier, most certainly, than addressing the more difficult, underlying issues that most impact disparities among kids’ health. But getting kids to eat 'right' and exercise is not about health.

Last week, the Eastern Region Public Health Observatory (ERPHO) released its annual health profile for the East of England region and found it already is “one of the healthiest regions in England,” and most specifically, “Cambridgeshire is one of the healthiest parts of the region.”

Children there, on average, enjoy better health and well being than average kids across the rest of England, said the report. Overall, 86% participate in regular PE and sports. But, it noted, there is a most significant issue. Growing up in poverty has the most profound impact on children’s health and wellbeing, it said. Most affected by poverty were one in three children living in Norwich and Luton.

Going back to the Cambridgeshire Primary Care Trust’s latest needs assessment, it reported:

Children and young people living in the most deprived of wards in Cambridgeshire on average are:

· more likely to have a low birth-weight, which can be associated with other health problems

· more likely to have poor educational achievement, which is associated with poorer lifetime health and economic achievement

· more likely to be admitted to hospital as an emergency, particularly for respiratory or gastrointestinal illness

Smoking in Cambridgeshire, about one in six girls and one in ten boys (age 14-15 years) smoke regularly...

Chlamydia is a sexually transmitted infection, which can lead to pelvic infections and infertility. Between 1995 and 2004 the rate of Chlamydia in young people (aged 16-24 years) has more than trebled nationally. Uptake of our screening programme is low, as in the rest of England and around 8% of those tested are positive both locally and nationally...

Over 1,250 children provided the primary care [for parents with disabilities and health problems who had no access to needed support services], equating to nearly 1 child per 90 dependent children...

From national prevalence information, around 3,500 children in Cambridgeshire could have some form of disability. The lack of a disability register and robust information on children with disabilities makes accurate numbers of children with more severe and complex needs difficult to source...

So, were these needs, identified as most crucial for needy children, the ones prioritized? No. As Cllr Ron Bradney, vice-chairman of the Cambridgeshire committee funding the new obesity czar, told the Cambridge News: “Our children are among the heaviest in the region and we need to make them more healthy and active.” Mr. Thornley said this project is “all about setting up a programme that will improve training for professionals dealing with children, who can make a difference to these children's lives.”