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Children continue to experience the burden of disease and suffer from the inequitable distribution of illness causing mortality and morbidity. Children are the most vulnerable members of the global community. Consequently, their health should be regarded as a valid indicator of the society’s wealth and potential. It is crucial to note that youth require not only nutrition, appropriate living conditions, and hygiene but also communication and healthy environment that enable harmonious growth and self-improvement. These life aspects, or their absence, transform in beliefs, values, and attitudes in adulthood, resulting in healthy populations worldwide. Currently, children need proper protection that can help to eliminate health care disparities, address a number of ethical issues, and alleviate the burden of chronic care, thereby producing a positive social change in the world.
Historical Perspective on Global Health of Children
Child poverty, abuse, slavery and labor in the past centuries actively promoted the growing enthusiasm on its eradication in the modern society. Since the late 19th century, the careful attention was paid to developing legislative strategies to address health care issues facing the children. At that time, Europe, Canada and the United States were youthful since the considerable proportion of the population was youngsters under the age of fifteen (Rosen, 2015). It is worth admitting that these children were susceptible to different diseases and conditions in ways that are hard to imagine nowadays. Needless to say, this susceptibility was not equally distributed among residents. Such factors as socio-economic status, gender, race, ethnicity and health status predetermined the degree of access to health care. Millions of children from low-income or immigrant families experienced severe discrimination on their road to adulthood (Rosen, 2015). Meanwhile, individuals with the financially stable status enjoyed the greatest extent of protection and health care opportunities.
Thus, in the early 20th century the numerous attempts have been made to promote the wealth of multi-racial and multi-class communities. Equality for children with diverse background was a primary target in many debates. More specifically, feminists heavily focused on elimination of girls’ abuse. Workers fought for education opportunities for their children. Ethnic minorities directed their efforts at addressing segregation and social division among youngsters (Rosen, 2015). Despite the difference in the objectives, these activists were united by the desire for social justice and better conditions for their offsprings.
The aforementioned problems resulted in two main responses from the governmental agencies. Children were either placed in specialized institutions and adopted by other families or provided with the continued assistance by public services and charities. In both instances, physical and psychological health of a child was central to developing appropriate action plan to address children’s problems. In reality, the youngsters simply traveled from one place of mistreatment to another. After the Second World War, public health work efforts were concentrated on enhancing health status of children. The implementation of social security in the developed countries ensured the improved life quality of children of immigrants and from low- and middle-income families (Rosen, 2015). The expansion of this reform significantly enhanced the physical well-being of children and considerably increased the life expectancy, especially in the Western World.
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Nevertheless, further health work still needs to be conducted to address preventable diseases in developing countries. The cases are, tragically, similar in these regions: a woman dies from postpartum bleeding because the hospital lacks the appropriate medication; a mother unsuccessfully attempts to help her newborn child to fight malaria; a youngster dies from pneumonia because there is no health care provider to timely diagnose the disease. The statistics considers the main cause of death of two thirds of children under the age of five to be infectious diseases (Holtz, 2016). Practically, all diseases could be treated or prevented by low-cost drugs, healthcare supplies, and medical equipment.
The Importance of Health Care Disparities
The majority of people living beyond the poverty line is children. The World Health Organization (2016) states that nearly 6 million children annually die before turning the age of five. The legacy of precarious living conditions is transmitted from one generation to another. Myriad economic and social issues affect children’s health all around the world. In many African countries with alarming rise in the child mortality rates, the prevalence of poverty is also rather high. Exposure to unclean water and poor sanitation results in children’s unfavorable health outcomes, such as infectious disease and death.
Education also plays an increasingly important role in health care disparities among children. Women and children who do not access proper education are more likely to die from illness than their more knowledgeable counterparts. Additionally, they are less likely to seek medical assistance when health issues arise (Holtz, 2016). The lack of education may also develop into the inadequate hygiene and domestic care and, eventually, the decreased use of medical services.
African American and Latinos children have significant lower health care opportunities compared to whites. They are less likely to have satisfactory oral health and visit a dental specialist for preventative measures. Most children that belong to ethnical minorities do not have health insurance and possess greater odds of suffering from chronic conditions as long as they do not receive appropriate medical care. Even though legal attempts have been made to increase insurance-coverage rates, the large proportion of African American and Latino children continue to be uninsured (Lau, Lin, & Flores, 2012). The following tendency is associated with the increase in burden of chronic care and long-term treatment.
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Female children typically confront more access barriers than their male counterparts. In such global areas as Asia, India and China, the birth of a son is generally more preferable that may ultimately lead to inadequate care of female children and infanticide. The low status of females is strongly associated with greater risks of health problems, such as discrimination on the basis of gender and exposure to HIV (Holtz, 2016). Given the diversity of the world’s children who live in precarious conditions, have no insurance, face gender-based violence and represent ethical minorities, inequalities amplify the necessity to address health care disparities.
In 1990, the World Declaration on Survival, Protection and Development of Children was introduced to produce a meaningful change in the reality of childhood all around the globe (Fukuda-Parr, 2017). It was an attempt to make a universal appeal in order to enhance the quality of life and the access to care for all children. The regulatory guideline promotes a view that children are dependent and innocent, and their childhood should be filled with harmony, learning, playing, and peace (Fukuda-Parr, 2017). Improving children’s health status and eliminating malnutrition is a central goal of the declaration. The lives of millions children can be saved as long as their diseases are readily preventable. The guideline aims at addressing the sufferings of children, thereby contributing to harmonious growth of their human potential. The key priority is to make the world’s children aware of their fundamental opportunities, needs, and rights. Therefore, the regulation strives to make respect for children’s physical, emotional and social well-being genuinely universal. Nonetheless, the given goals require continued efforts displayed by all countries by means of international cooperation.
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In 2003, Strategic Directions for Improving the Health and Development of Children and Adolescents was developed and implemented (Holtz, 2016). The following regulatory guideline identified priority areas that should be carefully considered while addressing health problems of children worldwide. The main area of interest is not only on physical development of children and adolescents but psychological well-being as well. Furthermore, the document suggests three guiding rules to be taken into account in devising strategic tools and actions (Holtz, 2016). More specifically, the report powerfully promotes respect of children’s rights, a life-course strategy that views a life as the continuum from birth to adulthood, and the use of the systematic model to address health issues and accessibility of necessary treatment options and interventions.
Ethical Issues in Global Health Care
Health care providers confront innumerable ethical considerations on a daily basis, and this is particularly the case with the moral issues concerning children. The problem arises when a research involves those who are not capable of taking decisions on their own. Therefore, children in health care researches raise certain moral concerns. Specifically, it is increasingly difficult to evaluate children’s capacity to comprehend what the research implies and thus, whether their informed consent is valid enough for them to take part. Moreover, the ethical dilemma may appear due to coercion by investigators or parents, which may lead to the abuse of the children’s fundamental rights. Conflicting needs and beliefs of children and parents may become another critical ethical consideration. While parents’ values should be taken into account, the effects of the treatment on the participants’ health are central to any research efforts (Fleischman, 2016). Nevertheless, there is still a little agreement on whether it is necessary to avoid placing a child in health jeopardy in researches or it is vital to involve children in studies to gain the valuable knowledge about how to effectively utilize these interventions for this age group.
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In most cases, children are incapable of making complex medical decisions, which is why their parents are entitled with the authority to choose the course of action on the former’s behalf. As a rule, parents know the most about their children and understand their unique needs and challenges. The given capacity makes them well suited to decide what is in the best interests of their children. Given the fact that some treatment decisions may impact the well-being of the entire family, parents can incorporate beliefs, issues and preferences in the decision-making. Nevertheless, when an older child objects to the treatment approved by his or her parents, an ethical dilemma may be brought to the surface. The preferences of an older child should be regarded with special care. If a health care provider believes a child is competent enough to choose the treatment option on his or her own, further discussion should be encouraged to resolve the issue in question (Fleischman, 2016). If this strategy does not work, a provider should ensure that the older child’s voice has been heard and support his or her argument. In the complicated situations, a judicial proceeding or an ethics consultation may be required.
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"Burden of Chronic Care"
Young population is the frequent victims of unhealthy lifestyle as well as water and air pollution. The lack of physical activity, the use of tobacco and alcohol and the unhealthy eating choices eventually result in the development of chronic diseases. The worldwide burden of chronic care is constantly increasing, and the number of children who died due to noncommunicable diseases is rising. High burden of care for chronically ill children prompts the financial resources being shifted from public organizations to home care. Parents caring for their chronically ill offspring often make personal sacrifices, damaging their own well-being and health status. The burden associated with chronic care may lead to the numerous psychological, physical and social troubles in the families of caregivers (Proimos & Klein, 2012). Health care programs should take into account caregiving experience in order to minimize the impacts of chronic diseases on the lives of children and their relatives.
The statistics regarding the chronic care burden is alarming. Nearly 25% of overweight children demonstrate signs of diabetes before reaching the age 15 (Proimos & Klein, 2012). The likelihood of recovery from childhood cancer is significantly lower in developing countries. Furthermore, mental health illnesses and suicides account for the increased morbidity and mortality rates. Finally, 90% of children diagnosed with congenital heart disease lack appropriate health care services (Proimos & Klein, 2012). However, risk factors, such as substance abuse, the elevated blood pressure, the increased level of cholesterol and obesity partnered with low economic and social status, which contribute to chronic conditions, can be readily modifiable. A pediatric perspective should be adopted to prevent the most common illnesses in the world’s inhabitants. It should be noted that a life-course strategy to prevention can considerably decrease the burden of chronic care resulting in significant improvements in global productivity, clinical results, and health care savings.
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Healthcare Productivity and Economic Costs
The last decades have seen the increase in the economic costs related to childhood obesity. Notably, the lifetime costs of caring for an overweight child reaches $19,000, compared to those of a child with normal body mass index (BMI) (Global Health Institute, 2014). Medical expenditures for all American children who are ten years old can equate to approximately $14 billion (Global Health Institute, 2014). Meanwhile, the possibility of a child with normal BMI becoming overweight in adulthood decreases the economic costs to nearly $13,000 per overweight/obese child (Global Health Institute, 2014). Therefore, decreasing the rates of childhood obesity is central to global health initiatives and is associated with considerable economic benefits. The given findings highlight the financial ramifications of inaction and the possibility of substantial savings from continued efforts that timely prevent or delay overweight. Addressing obesity will also help to reduce the risks of developing other related chronic conditions. It is worth noting that the aforementioned estimates do not include the indirect costs associated with obesity, such as decreased productivity and absenteeism.
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Increased economic costs can be also related to the burden of injuries among young children worldwide. The global costs of the injuries in this share of population range from approximately $500,000 to $9,000,000 annually (Lao, Gifford, & Dalal, 2012). Unintentional injuries often cause the increased length of stay, the decreased number of healthy days, and greater economic costs. These expenditures epitomize a large financial burden on the society, further promoting disparities between low-income and high-income countries.
In the last decades, health care productivity has been improved since the return on investment in youth’s health dramatically increased. The global health community views youth as a highly valuable economic investment (Cabral, de Moura, & Berkelhamer, 2012). Allocating substantial resources to children’s health outcomes eventually has pushed to the emergence of a larger number of educated and productive adults, contributed to positive demographic tendencies, and suggested that improving health in childhood is more preferable as long as disabilities during this age stage are likely to permanently affect the well-being of an individual.
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Millions of children continue to die from preventable and treatable diseases because of the limited opportunities and increasing disparities in the provision of basic health care services. Even though the considerable progress has been made in children’s protection in past decades and centuries, youth continues to confront tough challenges nowadays. Such ethical dilemmas as children in researches and medical decision-making still require clarity and the proper resolution. Treating chronic conditions epitomize serious economic and public health issue that requires innovative and collaborative approaches. Prevention is widely regarded as the key strategic tool to improve the situation. Nonetheless, the goal can be achieved only when inequities are properly addressed. The value of all children should be highlighted with the continued effort to improve their well-being.
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