In this year’s sixth annual survey of top health concerns conducted by the C.S. Mott Children’s Hospital National Poll on Children’s Health, adults rate ‘not enough exercise’ as the leading health concern for children in their communities. Childhood obesity and smoking and tobacco use were the second and third most commonly identified child health problems by adults across the United States.
As in past years, many of the top 10 health concerns relate to health behaviors for children and teens: exercise, childhood obesity, smoking and tobacco use, drug and alcohol abuse, teen pregnancy and bullying. Top health concerns this year also include stress, internet safety and child abuse and neglect.
‘Not enough exercise’ is new to the top of the list of biggest child health problems, as measured in the Poll. From 2007 to 2011, childhood obesity, drug abuse and smoking have consistently been rated as the top 3 health problems for kids from the perspective of adults (not just parents) across the United States.
This year, other child health concerns rated as a “big problem” include: sexting (19%), driving accidents (18%), sexually transmitted infections (17%), school violence (16%), unsafe neighborhoods (16%), attention deficit disorder (15%), chemicals in the environment (15%), depression (14%), suicide (13%), racial inequality (13%), autism (13%), gun related injuries (11%), hunger (9%) and food allergies (6%).
Similar to past editions of the top 10 list in the National Poll on Children’s Health, adults from different race/ethnicity backgrounds expressed different views about the top child health concerns in their communities, as shown in Figure 2.
Hispanic adults differed from blacks and whites in their comparatively high level of concern about childhood obesity, drug abuse, bullying, stress and teen pregnancy.
Black adults differed from Hispanics and whites in their comparatively high level of concern about smoking and tobacco use, racial inequality, gun-related injuries and unsafe neighborhoods.
Black and Hispanic adults both identified sexually transmitted infections as a greater concern for kids in their communities than did white adults.
Despite these differences, Hispanic, black and white adults agreed that ‘not enough exercise and obesity are two of the top three most pressing health concerns for kids in their communities. Other concerns that made the top 10 in all three groups included drug abuse, smoking and tobacco use, bullying, and teen pregnancy.
Highlights
- Adults rate ‘not enough exercise’ at the top of the list of big health problems for children in their communities.
- Other top health concerns include childhood obesity, smoking, drug abuse and bullying.
- Top child health concerns differ for black and Hispanic adults compared with white adults.
Implications
Every summer, the National Poll on Children’s Health reports the views of the American public about child health issues across the country, as a way to help set program priorities in medicine and public health and help officials see whether messages about specific health risks for children are reaching the public.
Results of this latest Poll indicate that adults now see lack of exercise for U.S. children as the health problem of greatest concern. While lack of exercise is certainly linked to the second most commonly identified concern—childhood obesity—exercise is a notable new top concern in the Poll’s annual top 10 lists for two reasons. First, the strong perception that lack of exercise is a threat to children’s health may reflect effective recent public health messages from programs such as First Lady Michelle Obama’s “Let’s Move” campaign. Second, exercise has other benefits besides the prevention of obesity—such as better attention and learning in school and an improved sense of well-being.
The strong connection of many of the top 10 child health concerns to health behaviors among children and adolescents underscores the importance of public programs and communication initiatives—for example, those designed to prevent drug abuse, tobacco use, alcohol abuse, and teen pregnancy. Given the high level of public concern about these health problems for youth, it is likely such programs will receive public support but also high public expectations for progress in prevention.
Findings from this Poll also reflect varied perspectives about child health concerns by race/ethnicity. For example, while Hispanic adults were more likely than black or white adults to express concerns about bullying and stress, black adults expressed greater concerns about racial inequality, gun-related injuries and unsafe neighborhoods, and white adults were comparatively more concerned about child abuse and neglect in their neighborhoods. Such differences of perspective offer key insights into ways that child health varies across communities, and emphasize a need for local programs that respect and address community-specific health priorities for youth.
Three big health issues for kids -Kids may face mental health issues as school begins amid a pandemic
Q: What might parents and teachers expect to see regarding children’s mental health as they begin school this fall?
A: Worry or anxiety during this period would be expected and is a normal response. Children’s adjustment to the new school format, whether it’s remote or hybrid, would vary a lot based on age and a child’s individual personality or temperament, as well as the family’s overall experience of the pandemic. Both the disease aspects of the pandemic and also the economic stressors—if a parent or caregiver has lost a job, if there has been income or residential instability—are all part of the child’s experience and will play a role in the child’s adjustment. Some children could be experiencing the pandemic as a traumatic event—for instance if they’ve lost a grandparent or a loved one to COVID complications.
In younger kids, psychological distress might manifest as new or worsening behavioral problems, difficulty separating from parents or caregivers, or somatic symptoms such as aches and pains or changes in sleep or appetite. Older kids can also experience somatic symptoms, as well as fear, nervousness, stress, irritability, and hypervigilance. In the academic context, symptoms could include difficulty concentrating, difficulty with motivation, or school refusal.
A recent study in the U.S. that surveyed parents suggests that about 27% of parents and roughly 14% of children are experiencing worsening mental health problems during the pandemic. Rates of distress were highest among families with young children, who may have lost access to child care, and among single-parent families. We also know that some communities or subgroups have been disproportionately affected by the pandemic, including underresourced or minority communities, and children in these communities may be at higher risk for mental health concerns. Also, children with preexisting mental health concerns, children who have learning disabilities or any other challenges that have required individualized learning plans, and children with medical vulnerabilities may experience greater adjustment issues or mental health concerns at this time.
Q: What would you say are the biggest school-related stressors for kids right now?
A: Remote learning is a challenge. Children generally learn well when actively engaged and in environments where they feel safe and socially connected. While there’s a lot that one can do online—I think there’s been a huge surge in innovation and adaptation—remote learning requires a level of sustained attention and emotional regulation that is a very big demand, developmentally, for kids in middle school and younger. And it’s a demand on all sides: for students; for parents supporting their kids, having to act as IT technicians and part-time teachers while managing their own lives and their own jobs; and for teachers. It’s a big learning curve for everyone.
Right now, our physical safety as well as our social connectedness are being challenged. We’ve been calling it home schooling, but the reality is that it’s crisis schooling at home. Worries about safety activate the limbic system, which can interfere with learning in school. We are still in this mass disaster of global proportions. And emotional health affects academic learning.
On the positive side, at least for kids who have some hybrid schooling options, the opportunity to be able to see their friends and have some form of in-person social interaction is something that a lot of kids are looking forward to.
Q: What can parents and educators do to help kids during this tough time?
A: For parents, contacting your primary care provider for your child is always a good place to start, to get an initial consultation or evaluation. It’s also easier now to access telehealth services, including for mental health, because the rules and regulations around insurance coverage for telehealth have changed during the pandemic. However, there’s the issue of the digital divide—some families may not be able to access telehealth services reliably, so resources available through the school, such as school psychologists and social workers, and community-based resources, are very important.
Asian and Black Americans are reporting increased experiences of racism and discrimination amid the pandemic, and we’re hearing about discrimination and bullying among students as well. For parents, teachers, and caregivers alike, it is important to check in to help children understand that bullying and the stigma that comes with judging people, is harmful for everyone—particularly because it might keep people from seeking appropriate COVID-19 testing and care—and that people sometimes cope with their worries by blaming others.
In the classroom, whether in person or online, teachers can help by focusing on socialization and fostering a sense of community. Building social connections among peers into the school day intentionally, and finding ways to sustain those connections through the school year, will be important.
It’s also important for kids to take planned breaks from virtual classes. That means a real break—even if it’s just a quick walk—not just switching from computers to phones.
Parents and teachers can also provide realistic reassurance. Saying to kids “I’m sure things will be fine” is both global and nonspecific, and kids don’t really buy that. They are experiencing the pandemic in various ways, so it is important to be specific, and to talk with kids about why their school elected for either hybrid or fully remote and the steps that the school is taking for safety. The point is to talk with them in a transparent age-appropriate way, and to give realistic reassurance that parents and the school are doing everything they can in terms of following public health guidelines and balancing the children’s academic and social needs.
