Promoting health in children and young people: identifying priorities.

March 2005 Vol 125 No 2 The Journal of The Royal Society for the Promotion of Health JRSH Health improvement programmes need to be grounded in knowledge of the epidemiology of health problems, their prevalence and incidence, their impact on mortality and quality of life, and their determinants, as well as knowledge about evidence-based solutions.1(pp.11-52) Different approaches to establishing health needs, however, lead to different priorities for action. The traditional public health approach starts with mortality statistics and these lead to the conclusion that injury prevention should be the number one priority for child public health. Examination of data on causes of illness in children suggests a rather different priority that of asthma. Information on the quality of life impact of health problems and diseases in childhood is growing, but has not yet reached the stage of enabling league tables to be drawn. Information of this sort can, however, be gleaned from surveys of childhood disability. The most comprehensive of such surveys, carried out in the UK in the 1980s, showed emotional and behavioural problems to be both the most common and the most disabling of childhood health problems.2 These and other child mental health problems are currently on the increase in the UK.3 Children’s health is important in its own right, and also because many risk factors for poor adult health have their origins in childhood. Consideration of the common causes of premature mortality and disability in adulthood suggest that childhood risk factors for heart disease, cancer and musculoskeletal and mental health problems should be high on the list of priorities. This line of thinking takes us to childhood nutrition and physical activity which are already on the public health agenda because of the current epidemic of childhood obesity. It also takes us to adolescent smoking. The childhood origins of mental health problems include parenting and the quality of the relationship parents make with their children,4 Promoting health in children and young people: identifying priorities