Risks for Children

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The pattern of child growth, including dependency on older individuals for food and protection, small body size, slow rate of growth, and delayed reproductive maturation, entails liabilities. Mild-to-moderate energy under-nutrition is, perhaps, the most common risk, with estimates that 28% of all children, equaling 150 million, are undernourished in developing nations (UNICEF, 2001). Undernutrition may be due to food shortages alone, but equally likely it is due to work loads and infectious disease loads placed on children that compromise their energy balance (Worthman, 1993). Viewed in historical perspective, unreasonable work loads for children and many childhood diseases are products of the agricultural and industrial revolutions (Sommerville, 1982; Tanner, 1981). Overnutrition, resulting in overweight and obesity, is also a problem in both the poor and rich nations. The World Health Organization estimates that worldwide, about one billion people are overweight or obese. Between 20 and 25 million are infants and children. Under- or overnutrition are serious threats to adequate growth, physical and cognitive development, health, and performance at school or work.

Another risk for children in the contemporary world is that of abuse and neglect. One estimate of the worldwide mortality from abuse and neglect is between 13 and 20 infants and children per 1,000 live births (Belsey, 1993). The incidence of all suffering from abuse and neglect is probably higher, but very difficult to estimate since data are not reported by most nations. Some industrialized nations do maintain statistics for non-fatal abuse and neglect of children. In the United States, for example, "in 1991 2.7 million abused or neglected children were reported to child protection agencies" (Kliegman, 1995). This is a rate of 38.6 children per 1,000.

One reason for child abuse and neglect is that the biology of infancy and childhood may not keep pace with the rapidity of technological, social, and ideological change relating to families and their offspring. It is now technologically possible to safely nourish infants without breast-feeding and this allows parents (mothers) an opportunity to pursue activities that separate the mother and her infant. Of course, mothers working away from their infants, be it in agriculture, industry, or other services, do not usually desire to neglect or abuse their infants. Where qualified caretakers are available, such as grandparents or older siblings, the infant may be well attended when the mother is working. When families live under difficult social, economic, and political conditions, especially poverty conditions, mothers may have no alternative but to leave an infant with unqualified caretakers, or even alone.

Reduced or absent breast-feeding may also allow a woman to have another baby sooner. Among the poor populations of the developing countries, short birth intervals (less than 23 months) compromise the health of both the infant and the mother (Huttly, Victoria, Barros, & Vaughn, 1992). A major negative effect on the infant is low birth weight, which is known to impair both physical growth and cognitive development during childhood and later life stages (Crooks, 1995; Garn, Pesick, & Pilkington, 1984; Kliegman, 1995).

In the populations of the more developed nations, such as among the U.S. middle-class, fewer than 20% of infants are breast-fed. In these same countries, the weaning process—from bottles and formula to solid "baby foods"—may begin by three months of age (Detwyller, 1995). This severely curtails the infancy stage of life history, when feeding is evolutionarily designed to be done mostly by breast or bottle. These "premature children" present a problem for care, as they are still biologically within the infancy stage of development and do not possess the physical or emotional capabilities of children. Societies in the developed nations have many programs and devices (e.g., day care for the infants, parent education classes, play equipment) to handle this conflict between biology and culture. Some arrangements work well, but when they do not succeed, and the infant reacts poorly, the frustrated parents or caregivers may respond with abusive or neglectful behavior.

A final example of the consequences of a changing world on the development of children concerns violence and warfare. In 1985 14% of all childhood deaths in the United States were due to violence, up from 4% in the 1960s. Nearly half of all childhood mortality in the United States was due to accidents (Fingerhut & Kleinman, 1989). The accident rate (due to motor vehicles, fires, and drowning) also represents a type of violence to which children are susceptible. Several studies have noted strong associations between socioeconomic status and childhood accidents, including research in the United States (Fingerhut & Kleinman, 1989) and England and Wales (Fox, 1977). Lower social class, especially poverty, is linked with a significantly higher death rate from all types of accidents (Kliegman, 1992).

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