9.2.6. Future developments
EU influence on the health of children and young people is
at first sight limited, since Member States are largely responsible for the
implementation of healthcare in their respective countries. However, evidence
can act as a tool for change, whilst the enhanced collection of comparative
data on children, including gender segregated research, can highlight
anomalies.
Moreover, and importantly, the health sector and health
services are not the only determinants of health – indeed, they arguably
represent only a small part. Policies on planning and urban design, transport,
environment, social policy and poverty alleviation, employment, and education
are just some of the other kind of policies which may have an impact on
children’s health. Hence, the recent European Commission thrust towards
considering Health in All Policies, not least under the Finnish Presidency in
2006 (Ståhl et al, 2006; Council of the European Union, 2006), and through the
Rome Ministerial Conference on 18 December 2007
The European Parliament and Council have recently adopted
a Second Programme of Community Action in the Field of Health 2008-2013
(European Parliament and Council, 2007). The proposed programme includes health
promotion and prevention and specifically includes children’s health.
Top priorities / key areas for a European action plan:
A number of important child health information initiatives
are already being sponsored by DG SANCO, including the Scientific Platform on
behavioural determinants of obesity, and projects on child safety and perinatal
health. Given that background, and the current WHO initiatives, the following
are further issues which remain to be addressed, which form suggested
priorities for Commission action:
·
Measuring and monitoring
health, well being and morbidity of children.
It is a priority to study the
pattern of health of children, their physical and mental well being and its
compromises, and identifiable morbidity of a transient or permanent nature.
This is a higher priority than the analysis of patterns of child mortality. It
is also essential to focus on health and well being of children, the positives,
as well as on illness as the negatives. This will encourage coverage of
positive mental health and measurement of mental well being, harmonising with
other European priorities but measured specifically for children of different
ages;
·
Child impairment,
disability, and special needs
Measurement and impact assessment
of impairment and disability in children differ significantly compared to
adults. The impact of disability on children’s lives at different stages of
development varies. The development of a variation for children of a
measurement tool based on the ability to perform activities of daily living is
a priority;
·
Intentional harm and
injury to children
The improvement of information and
pooling of information from across Europe is a priority. In addition, it is
necessary to define “intentional harm” and provide a platform to support and
harmonise efforts to establish statistical reporting systems in hospitals and
primary care to seek improved identification and measurement of the problem.
The health of the child begins in the womb, hence parental
nutrition, education, and health-related behaviour are major child health
determinants. Attention also needs to continue to be paid to the psycho-social
and economic determinants of health. These should include the promotion of
accessible, clean and attractive environments, education and the prevention of
disease. It has been seen that in the absence of disease, immunisation has lost
priority. Programmes will need to be reviewed to counter renewed outbreaks.
In later life, the health and development of children and
of their enduring health-related behaviour, are heavily influenced by societal,
commercial and peer pressures. Promotion of health and healthy lifestyles and
environments for children needs to move higher up the European and political
agenda, if Europe is to be seen as a responsible and caring community.
