Question

Improving the well-being of infants and children is an important public health goal. Their well-being determines the health of the next generation and can help predict future public health challenges for families, communities, and the health care system. Describe two social and two physical determinants of -child health; potential impacts of each on the health status of infants and children; and two possible interventions to promote healthier lives.

Answer 1

Ans) During childhood, infancy is the most vulnerable period. Important determinants of infant health operate even before a child is conceived.

A woman's general health, her socioeconomic and family circumstances, and her intentions regarding pregnancy all influence the health of the children she bears. During pregnancy, maternal health, nutrition, lifestyle, and socioeconomic and physical environments have an even more immediate influence on infant health. Once children are born, their healthy physical and psychosocial development continues to be subject to a variety of influences.

- Low birth weight is also associated with increased risk of long-term health impairments. Thus, prevention of low birth weight is an important goal.

- In addition, factors such as poverty, lower levels of maternal education, unintended pregnancy, and delayed prenatal care are associated with increased rates of low birth weight. Many low birth weight infants require costly medical care.

Low birth weight can occur because of an early, preterm birth or slow growth during a normal period of gestation. Steps such as cessation of maternal smoking and adequate maternal nutrition have been shown to reduce the risk of slow fetal growth. The risk of mortality is higher for preterm births, but evidence for interventions that can reduce their occurrence is mixed. Some evidence suggests that vaginal or intrauterine infections may be contributing to preterm births.

- Early and continuing prenatal care can help identify risks for low birth weight and may help ensure that both mothers and infants receive care that can improve survival even if low birth weight cannot be averted. Prenatal care can also provide benefits to mothers and infants that do not translate into changes in birth weight.

After the neonatal period, infant health is influenced strongly by family resources. A loving and caring home with educated parents makes an important contribution to healthy infant development and, therefore, future capacity to become a well-functioning adult. Among factors affecting physical health, injury is a leading preventable cause of mortality and morbidity. Parental knowledge of and attention to injury prevention have documented benefits for children. Immunization also is a well-recognized means of protecting health and is a marker for adequate use of well child care.

Promoting healthy psychosocial development is also important. For example, factors influencing the home environment, such as increased parental workforce participation that creates a need for nonparental child care, can have important consequences for infant well-being.

- Children are the future of a community, and their well-being depends on a variety of factors. Protecting and improving infant health is a complex task that involves individual families plus health care, public health programs, and social programs that support families. Communities may also want to address factors such as educational attainment and employment of parents. Coordination of these various efforts can encourage optimal use of resources on behalf of infants.