Focus On Children

by Dr. Kim Marie Thorburn


The health of our children is our future. We all have an interest in it. Optimal health begins before birth and requires vigilance and action from parents and the rest of our community through all stages of growth and development. Growing Up Healthy, a partnership of the Spokane Regional Health District, Spokane Public Radio and The Pacific Northwest Inlander, funded in part by a grant from the Robert Wood Johnson Foundation, will provide a year of programming, news, commentaries and a community roundtable about health issues facing children in Spokane. Each month, there will be a focus on a different age group and health problems that stand out for that age. We kick off with a focus on birth and infants.


In public health, we measure the health status of populations to identify changes over time and make comparisons among groups. Communities can then understand where we need to improve and how to close gaps. Growing Up Healthy will deliver information about health trends and disparities for Spokane's children and youth. It is our hope that the project will spur action to bring about opportunities for optimal health for all of our children.


Children and youth (newborns to 18 years) make up about one-third of the population of Spokane County. Fully one-quarter of our children live in extreme poverty, the greatest source of difference in health status here. Poverty is associated with higher rates of alternative family structures (like single parents, usually moms), family violence, out-of-home placements, substance abuse, inadequate nutrition and poor access to health care. Robust economic development and social supports that provide fair opportunities and diminish barriers for all families are essential for the health of our children.


For many of the impacts to children's health, it is a matter of scale. Smaller, growing bodies are more susceptible to the effects of the environment. Developing minds readily take lessons modeled from adult behaviors. A safe and secure social structure is necessary for healthy progression through developmental steps.


The quality of the environment is important to both the acute and long-term health needs of children. Examples abound. Infants who live in secondhand smoke from cigarettes are at much greater risk of developing asthma. One-quarter of parent-age adults in Spokane smoke cigarettes. Our community also struggles with outdoor air quality because its geography creates stagnant air-trapping. This may contribute to the higher rates of asthma and other lung diseases among our children than the statewide average. About one-half of homes built before 1960 in Spokane County have lead-based paint, a toxin to children's developing brains that can lead to subtle or profound mental impairments, depending on the dose.


Healthy behaviors are necessary for good health. These include avoidance of substance abuse, postponement of sexual activity and use of safe sex practices, regular participation in physical and pro-social activities, use of seat belts and other safety measures, and good eating habits. Nearly 40 percent of Spokane high school students report that they smoke cigarettes, considerably higher than the statewide average of 28 percent. There is a healthy trend in teen pregnancy in our county, which has declined by more than two-fifths since the early 1990s. Nonetheless, sexually transmitted disease rates among teen girls are far higher than in any other age group.


Families, childcare, schools and opportunities for community involvement contribute substantially to the health of our children. Children who feel supported by their families and other important adults perform better in school and participate less in risky behaviors. Strong relationships among peers and with adults help to guard against despair, which contributes to a leading cause of death among teens -- suicide. Rates of completed suicide among Spokane teens are similar to the rest of the state, but hospitalization for suicide attempts is much higher.


Parents alone cannot provide the wholesome environment, behavioral modeling, social supports and safety and security that our children need to achieve optimal health. We hope the Growing Up Healthy project will stimulate community interest and action, providing opportunities for all of our children.





Dr. Thorburn is Health Officer at the Spokane Regional Health District