When is a child an adult?

September 18, 2019

When does childhood end? That's the question international researchers are asking as they chart age cut-offs for paediatric services around the world.

Adolescent Health Professor at the Murdoch Children's Research Institute and the University of Melbourne Susan Sawyer says previous research has found that global health systems do not meet adolescents' needs.

"Yet pediatricians are well placed to provide age-appropriate care to adolescents - especially if they are trained in adolescent medicine," she says.

"The World Health Organization defines adolescents as aged being 10 to 19 years, however there's been little research into the age of patients that pediatricians actually treat and how this varies across the world."

The researchers developed an online survey to explore these questions and obtained responses from 1,372 pediatricians in 115 countries. They report the results in a policy paper, 'The Age of Paediatrics'*, published in The Lancet Child and Adolescent Health.

"There was a striking difference in the upper age by country and disappointingly only a handful of countries had a mean upper age of 19 years," Prof Sawyer says.

"South Africa had the lowest upper age at 11.5 years, it seems pediatrics is yet to embrace adolescence. The US had the highest upper age, with 19.5 years."

Despite similar health care systems, Australia's mean upper age of pediatric care was 17.8 years while New Zealand's was 15.6 years.

"The world mean is 17.4 years," says Prof Sawyer. "This average has increased over the past 20 years, rapidly in some countries."

"The discipline of pediatrics has historically focused on very young children, largely neglecting adolescents, but the pattern of disease across childhood and adolescence is changing. Public health interventions and medical advances have seen the mortality rate of young children fall dramatically.

"This is not mirrored in adolescents, whose more complex disease burden remains relatively unchanged. The World Health Organization estimates that more than one million adolescents die every year.

"Young people face childhood and adult health burdens, including chronic physical conditions like diabetes and asthma, mental health disorders, anaemia, rising levels of obesity, interpersonal violence, diarrheal and bronchial illnesses, drug and alcohol abuse, sexually transmitted disease and road trauma."

Co-author Professor Jonathan Klein from the University of Illinois and Coordinator of the International Pediatric Association Executive Committee said few nations paid sufficient attention to including adolescent heath within pediatric training.

"To meet the health needs of young people, a diverse workforce is required including pediatricians, family physicians, nurses, and community and school health workers, all schooled in adolescent health.

"The evidence is clear. Our health care systems need to be more attuned to the needs of adolescents and young adults," he said. "Improving adolescent care is a critical step if we hope to reach the United Nations' Every Woman, Every Child, Every Adolescent promises (#EWECisMe), and achieve the 2030 Sustainable Developmental Goals (#SDGs; #Globalgoals)

Prof Sawyer says investment in adolescent health training is most needed in countries with a low upper age, a large number of adolescents, or an upper age that has only recently risen.

"Yet, a poor report card on the quality of adolescent health training across the world suggests that investments to improve adolescent health care are universally required."
Available for interview:

* Prof Susan Sawyer, Murdoch Children's Research Institute, University of Melbourne

* https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(19)30266-4/fulltext

Media Contacts:

Christine Tondorf, Bridie Byrne

MCRI Communications Advisor, MCRI Communications Advisor,

+613 9936 6197 or 0413 307 092 +613 9936 6211 or 0403 664 416

Murdoch Childrens Research Institute

Related Health Articles from Brightsurf:

The mental health impact of pandemics for front line health care staff
New research shows the impact that pandemics have on the mental health of front-line health care staff.

Modifiable health risks linked to more than $730 billion in US health care costs
Modifiable health risks, such as obesity, high blood pressure, and smoking, were linked to over $730 billion in health care spending in the US in 2016, according to a study published in The Lancet Public Health.

New measure of social determinants of health may improve cardiovascular health assessment
The authors of this study developed a single risk score derived from multiple social determinants of health that predicts county-level cardiovascular disease mortality.

BU study: High deductible health plans are widening racial health gaps
The growing Black Lives Matter movement has brought more attention to the myriad structures that reinforce racial inequities, in everything from policing to hiring to maternal mortality.

Electronic health information exchange improves public health disease reporting
Disease tracking is an important area of focus for health departments in the midst of the COVID-19 pandemic.

E-health resource improves men's health behaviours with or without fitness facilities
Men who regularly used a free web resource made significantly more health changes than men who did not, finds a new study from the University of British Columbia and Intensions Consulting.

Mental health outcomes among health care workers during COVID-19 pandemic in Italy
Symptoms of posttraumatic stress disorder, depression, anxiety and insomnia among health care workers in Italy during the COVID-19 pandemic are reported in this observational study.

Mental health of health care workers in china in hospitals with patients with COVID-19
This survey study of almost 1,300 health care workers in China at 34 hospitals equipped with fever clinics or wards for patients with COVID-19 reports on their mental health outcomes, including symptoms of depression, anxiety, insomnia and distress.

Health records pin broad set of health risks on genetic premutation
Researchers from the University of Wisconsin-Madison and Marshfield Clinic have found that there may be a much broader health risk to carriers of the FMR1 premutation, with potentially dozens of clinical conditions that can be ascribed directly to carrying it.

Attitudes about health affect how older adults engage with negative health news
To get older adults to pay attention to important health information, preface it with the good news about their health.

Read More: Health News and Health Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.