But a new article from University of Michigan Health System pediatrician Matthew M. Davis, M.D., M.A.P.P., suggests the age-old adage might actually be stunting the growth of research regarding the health of children and adolescents.
In an editorial published today in the Journal of the American Medical Association Pediatrics, Davis argues that saying “children are not small adults” disconnects child and adult health concerns and initiatives, when children’s and adults’ health are inseparable.
“I am concerned that, unintentionally, this slogan may be leading organizations like Congress (through the National Institutes of Health) and private foundations to spend less money on children, not more,” says Davis, associate professor of pediatrics and internal medicine at the U-M Medical School and associate professor of public policy at the Gerald R. Ford School of Public Policy.
“Adults are the age group that our U.S. healthcare system and research currently focus on most,” Davis says. “Child health research does not have to be different for it to be just as worthy as adult-focused research. Instead, thinking about the life course path of health and illness emphasizes how vital it is to study how to promote good health and healthy habits in childhood and adolescence.”
Another way to view child and adult health is through the burden of disease, Davis says. Every year a disproportionate amount of money is given to adult health researchers while less money is given to child-oriented studies – often based on the argument that “most children are healthy; most adults are not,” Davis says.
In his editorial, Davis provides national data about the amount of healthcare spending for very sick children compared with well children, and very sick adults versus well adults.
“Even though fewer children and adolescents than adults have serious illness, children and adolescents who are sick are just as bad off compared with their peers as are adults who are sick,” Davis says.
Thus, Davis argues, physicians should prioritize health research based on ill versus well and not old versus young.
Davis says although it might be difficult, health researchers and research funders must embrace long-term studies to fully investigate the connections between child and adult health and to improve the population’s health and health policy. He points to successful longitudinal studies in other fields such as economics that have followed national cohorts for decades and have yielded useful information over time.
“Child health researchers must embrace a revised mantra of long-term connectedness, examining individuals as they age from childhood to adulthood to better preserve health throughout the course of life,” Davis says. “Research regarding children’s health has the potential for long-term gains, unlike research focused solely on adults.”
Disclosure: None reported
Citation: “Stunting the Growth of Child Health Research: A Need to Reframe ‘Children Are Not Small Adults’” Journal of the American Medical Association Pediatrics (2013)