Mental Health Diagnoses Among U.S. Children and Youth Continue to Rise at Alarming Rates

It follows the trend of mental health disorder rates rising globally. This isn’t progress — it shows that, whatever the newest low unemployment numbers in the “booming” economy are, there is an undercurrent of something gone seriously wrong in our societies.

The number of children and adolescents visiting the nation’s emergency departments due to mental health concerns continued to rise at an alarming rate from 2012 through 2016, with mental health diagnoses for non-Latino blacks outpacing such diagnoses among youth of other racial/ethnic groups, according to a retrospective cross-sectional study presented during the American Academy of Pediatrics National Conference & Exhibition.

“Access to mental health services among children can be difficult, and data suggest that it can be even more challenging for minority children compared with non-minority youths,” says Monika K. Goyal, M.D., MSCE, assistant division chief and director of research in the Division of Emergency Medicine at Children’s National Health System and the study’s senior author. “Our findings underscore the importance of improving access to outpatient mental health resources as well as expanding capacity within the nation’s emergency departments to respond to this unmet need.”

An estimated 17.1 million U.S. children are affected by a psychiatric disorder, making mental health disorders among the most common pediatric illnesses. Roughly 2 to 5 percent of all emergency department visits by children are related to mental health concerns. The research team hypothesized that within that group, there might be higher numbers of minority children visiting emergency departments seeking mental health services.

To investigate this hypothesis, they examined Pediatric Health Information System data, which aggregates deidentified information from patient encounters at more than 45 children’s hospitals around the nation. Their analyses showed that in 2012, 50.4 emergency department visits per 100,000 children were for mental health-related concerns. By 2016, that figure had grown to 78.5 emergency department visits per 100,000 children.

Toxins from Air Pollution Damage Child Development and Disproportionately Affect Those in Poverty

Air pollution causes health damage that’s too often overlooked, and the research that’s coming out has been showing this more and more lately.

Schoolchildren across the US are plagued by air pollution that’s linked to multiple brain-related problems, with black, Hispanic and low-income students most likely to be exposed to a fug of harmful toxins at school, scientists and educators have warned.

The warnings come after widespread exposure to toxins was found in new research using EPA and census data to map out the air pollution exposure for nearly 90,000 public schools across the US.

“This could well be impacting an entire generation of our society,” said Dr Sara Grineski, an academic who has authored the first national study, published in the journal Environmental Research, on air pollution and schools.

Grineski and her University of Utah colleague Timothy Collins grouped schools according to their level of exposure to more than a dozen neurotoxins, including lead, mercury and cyanide compounds.

The research found that:

  • Only 728 schools achieved the safest possible score.
  • Five of the 10 worst polluted school counties have non-white populations of over 20%
  • The five worst polluted areas include New York, Chicago and Pittsburgh, as well as Jersey City and Camden in New Jersey. One teacher in Camden told the Guardian that heavy industry was “destroying our children”.

Cash-strapped authorities have routinely placed schools on the cheapest available land, which is often beside busy roads, factories or on previously contaminated sites. Teacher unions worry that the Trump administration’s enthusiasm for charter schools, championed by education secretary Betsy DeVos, will diminish federal intervention to reverse this.

The study found that pre-kindergarten children are attending higher risk schools than older students – a stark finding given the vulnerability of developing brains.

Pollution exposure is also drawn along racial lines. While black children make up 16% of all US public school students, more than a quarter of them attend the schools worst affected by air pollution. By contrast, white children comprise 52% of the public school system but only 28% of those attend the highest risk schools. This disparity remains even when the urban-rural divide is accounted for.

Schools with large numbers of students of colour are routinely located near major roads and other sources of pollution, with many also grappling with other hazards such as lead-laced drinking water and toxins buried beneath school buildings

Grineski said there were a range of consequences. “We’re only now realizing how toxins don’t just affect the lungs but influence things like emotional development, autism, ADHD and mental health,” she said. “Socially marginalized populations are getting the worst exposure. When you look at the pattern, it’s so pervasive that you have to call it an injustice and racism.”

The research is “important and is consistent with other localized information we’ve seen over the years,” according to Stephen Lester, science director of the Center for Health, Environment and Justice, who wasn’t involved in the study.

“Children are facing risks that will affect their ability to learn,” he said. “It’s a serious problem that needs a serious government response.”

As scientists have pieced together evidence showing the link between air toxins and neurological harm, American cities are still largely wedded to a legacy that has juxtaposed certain neighborhoods with heavy traffic and hulking industry.

Only a handful of states require that schools are not placed next to environmental hazards. In 2010, the EPA issued national guidelines on picking school locations but backed away from imposing mandatory buffer zones.

The guidelines were deemed voluntary “after a whole lot of pushback from various financial and political interests,” according to Lester, who was part of a group advising the EPA.

[…]

Scientific endeavour is uncovering a jumble of neurological reactions to air pollution, from early onset Alzheimers to schizophrenia. Much of this work is in its infancy, but scientists say there is well established evidence that children are far more susceptible to pollutants than adults, with potentially severe consequences for their development.

[…]

“Before, we might have labelled a kid with bad behaviour as just being a bad kid,” said Keith Benson, who taught history in the Camden school system before becoming the head of the local teacher’s union.

“Now we are thinking about it another way. There’s no telling how much potential has been lost because of environmental issues, how many hopes were stunted because these kids were not close to clear air and water.”

U.S. Childhood Mortality Rate is 70% Higher Than Other Wealthy Countries

It is a moral disgrace for world history’s wealthiest country to have such a high child mortality rate. That’s part of the consequence of the U.S. lacking a national single-payer healthcare system, and it’s also a consequence of the U.S. Congress having prioritized support for the rich over reducing the plight of children.

American kids are 70 percent more likely to die during childhood compared with children in other wealthy, democratic nations, according to a peer-reviewed study published Monday by Health Affairs.

“This study should alarm everyone,” Dr. Ashish Thakrar, the study’s lead author and an internal medicine resident at Johns Hopkins Hospital and Health System, told CNN.

“The U.S. is the most dangerous of wealthy, democratic countries in the world for children,” he added. “Across all ages and in both sexes, children have been dying more often in the U.S. than in similar countries since the 1980s.”

The most common causes of death among children renews concerns about the American healthcare system, access to guns, and vehicle safety.

The risk of death is even higher for American infants and teenagers compared with their counterparts abroad. Babies in the U.S. are 76 percent more likely to die during their first year of life—often because of sudden infant death syndrome (SIDS) or complications related to being born prematurely—while 15- to 19-year-olds are 82 times more likely to die from gun violence, which Thakrar called “the most disturbing new finding.”

Thakrar and his fellow researchers examined the childhood mortality rates from 1961 to 2010 for the United States as well as 19 other nations in the Organization for Economic Cooperation and Development (OECD), including Australia, Canada, Japan, and several European and Scandinavian countries.

Thakrar told Vox‘s Sarah Kliff he believes the study’s findings are tied to a rise in childhood poverty in the U.S. during the 1980s, but also is in large part “the impact of our fragmented healthcare system” in the United States. For example, he said, “Mothers who are qualifying for Medicaid for the first time because they’re mothers might be seeing doctors for the first time. They might not have a family physician, or a clear support system.”

As numerous analyses and studies have shown over the years, the lack of a universal healthcare system in the U.S. has led to higher mortality rates and poorer healthcare outcomes than in countries that have robust systems that cover all people.

While the Republicans’ tax plan, which passed Congress and was signed by President Donald Trump late last year, partly dismantles the American healthcare system, lawmakers continue to put off refunding the national Children’s Health Insurance Program (CHIP)—which serves 9 million children—and Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program, which expired at the end September.

Although federal lawmakers passed a short-term spending measure that provided some funds for CHIP just before the New Year, states are continuing to warn recipients that without further funding, they will soon run out of money and no longer be able to provide necessary healthcare services.

“Multiple states have sent out letters warning families that their kids’ health insurance could end on January 31,” Kliff detailed in another article. “Congress did pass a temporary bill that it expected to extend CHIP’s life span until March—but it turns out they got the math wrong, and states may run out of funding as early as January 19. Eleven days from now.”

Thakrar told Kliff he is concerned about how funding instability for programs that provide healthcare to American kids will continue to impact childhood mortality rates in the United States.

“We’re seeing the effects of instability right now,” he said. “All across the country families are waiting to hear if CHIP will be reinstated, whether they’ll continue to have health insurance, their household visitations are at risk. Programs that have proven their benefit in the country still face constant instability.”

Fracking Endangers Localized Infant Health

The results of fracking are in actuality worse than the study details. The practice of fracking should be banned for a variety of reasons — including the contamination of drinking water reserves — and the dangers posed to infant health provide another example of why.

Health risks increase for infants born to mothers living within 2 miles of a hydraulic fracturing site, according to a study published Dec. 13 in Science Advances. The research team found that infants born within a half a mile from a fracking site were 25 percent more likely to be born at low birth weights, leaving them at greater risk of infant mortality, ADHD, asthma, lower test scores, lower schooling attainment and lower lifetime earnings.

“Given the growing evidence that pollution affects babies in utero, it should not be surprising that fracking, which is a heavy industrial activity, has negative effects on infants,” said co-author Janet M. Currie, the Henry Putnam Professor of Economics and Public Affairs at Princeton University.

“As local and state policymakers decide whether to allow hydraulic fracturing in their communities, it is crucial that they carefully examine the costs and benefits, including the potential impacts from pollution,” said study co-author Michael Greenstone, the Milton Friedman Professor in Economics and director of the Energy Policy Institute at the University of Chicago. “This study provides the strongest large-scale evidence of a link between the pollution that stems from hydraulic fracturing activities and our health, specifically the health of babies.”

Research: Children Uniquely Vulnerable to Sleep Disruption from Electronic Screens

The article notes that children and teens are particularly sensitive to their sleep quality being disturbed by screens, to which my initial recommendation would be to turn them off at least a half hour before sleeping when possible. Consistently having enough sleep is one of the most important aspects in maintaining human health, and the costs of deviating from this truth can be quite substantial.

With their brains, sleep patterns, and eyes still developing, children and adolescents are particularly vulnerable to the sleep-disrupting effects of screen time, according to a sweeping review of the literature published today in the journal Pediatrics.

“The vast majority of studies find that kids and teens who consume more screen-based media are more likely to experience sleep disruption,” says first author Monique LeBourgeois, an associate professor in the Department of Integrative Physiology at the University of Colorado Boulder. “With this paper, we wanted to go one step further by reviewing the studies that also point to the reasons why digital media adversely affects sleep.”

Of more than five dozen studies looking at youths ages 5 to 17 from around the world, 90 percent have found that more screen time is associated with delayed bedtimes, fewer hours of sleep and poorer sleep quality, the authors report.

Biological, neurological and environmental factors all play a role:

Because their eyes are not fully developed, children are more sensitive than adults to the impact of light on the internal body clock, the paper notes.

“Light is our brain clock’s primary timekeeper,” LeBourgeois says, explaining that when light hits the retina in the eye in the evening hours it suppresses the sleep-promoting hormone melatonin, delaying sleepiness and pushing back the timing of the body clock. “We know younger individuals have larger pupils, and their lenses are more transparent, so their exposure and sensitivity to that light is even greater than in older individuals.”

The authors point to one study that found that when adults and school-age children were exposed to the same amount and intensity of light, the children’s melatonin levels fell twice as much. Studies have also shown that short-wavelength “blue light” — ubiquitous in hand-held electronics — is particularly potent at suppressing melatonin.

[…]

The authors also note that children and adolescents who leave a phone or computer on overnight in their bedroom are significantly more likely to have trouble sleeping. More than 75 percent of youths have screen-based media in their bedrooms, 60 percent interact with them in the hour before bedtime, and 45 percent use their phones as an alarm.

“Digital Media and Sleep in Childhood and Adolescence” is one of 22 papers included in todays’ first-ever supplemental issue of Pediatrics to focus on screen time and youth health. In addition to summarizing past research, the papers set goals for future research, including looking at the impact of screen time on toddlers and preschoolers.

“The digital media landscape is evolving so quickly, we need our research to catch up just to answer some basic questions,” says Dr. Pam Hurst-Della Pietra, founder of the nonprofit Children and Screens, which helped orchestrate the issue.