Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005....
-
Upload
sheila-mace -
Category
Documents
-
view
215 -
download
2
Transcript of Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005....
![Page 1: Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.](https://reader038.fdocuments.in/reader038/viewer/2022110319/56649c735503460f949257df/html5/thumbnails/1.jpg)
Children’s health in Greenland;Interdisciplinary efforts necessary
Reykjavik, June 2, 2005.Henning Sloth Pedersen, MD, PhD
![Page 2: Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.](https://reader038.fdocuments.in/reader038/viewer/2022110319/56649c735503460f949257df/html5/thumbnails/2.jpg)
Experiences
• Primary and secundary health care in Greenland in 18 years
• Associated professor, Institute of Public Health, University of Aarhus, Denmark
• Mentor at James Cook University, Townsville, Australien, in Indigenous and Remote Area Health
• Advisor at WHO, Environmental and Occupational Health Impact Assessment and Surveillance
• Advisory Board for EU’s 7th frame programme for Environmental Research
Nuuk
![Page 3: Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.](https://reader038.fdocuments.in/reader038/viewer/2022110319/56649c735503460f949257df/html5/thumbnails/3.jpg)
The Future of Children andYouth in theArctic
1992-2001
Norway
Sweden
Finland
Denmark
Iceland
Canada
USA
Russia
![Page 4: Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.](https://reader038.fdocuments.in/reader038/viewer/2022110319/56649c735503460f949257df/html5/thumbnails/4.jpg)
Infant mortalityno of death per 1,000
0
5
10
15
20
25
Greenland 1997 Greenland 2004 Scandinavia
![Page 5: Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.](https://reader038.fdocuments.in/reader038/viewer/2022110319/56649c735503460f949257df/html5/thumbnails/5.jpg)
Tuberculosis among children (1992-2001), 0-24 years old
USA
Can
ada
Gre
enla
nd
Icel
and
Swed
en
Fin
land
cases/100,000
TotalIndigenous
![Page 6: Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.](https://reader038.fdocuments.in/reader038/viewer/2022110319/56649c735503460f949257df/html5/thumbnails/6.jpg)
Age of mother2002, 940 births
0
50
100
150
200
250
300
15-19 20-24 25-29 30-34 35-39 40-44 45-49
![Page 7: Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.](https://reader038.fdocuments.in/reader038/viewer/2022110319/56649c735503460f949257df/html5/thumbnails/7.jpg)
Teen mothers
• Increased rates of lower birth weights
• Pre-eclampsia (intoxication)• Social problems more common
(education, housing, single, income….)
![Page 8: Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.](https://reader038.fdocuments.in/reader038/viewer/2022110319/56649c735503460f949257df/html5/thumbnails/8.jpg)
Other health problems
• Weight problems increasing rapidly• Diabetes type 2 seen among children• Infections in general more prevalent
(lung, ear)• Serious dental problems• Smoking prevalent (8% of 11 years old,
and 65% of 15-19 years smoke cigarettes regularly)
• Allergi rapidly increasing
![Page 9: Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.](https://reader038.fdocuments.in/reader038/viewer/2022110319/56649c735503460f949257df/html5/thumbnails/9.jpg)
Contaminantspercent > safety threshold
0
1020
3040
5060
7080
90
100
lead mercury araclor 1260
survey, West Coast; >=18 years oldAMAP, umbilicalcordblood; 1995.
![Page 10: Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.](https://reader038.fdocuments.in/reader038/viewer/2022110319/56649c735503460f949257df/html5/thumbnails/10.jpg)
Better health parameters
• Less cancer• Less congenital disorders• Less drug abuse• Less alcohol abuse• Less fatal injuries
• Solvent abuse as Nordic countries (high in USA)
![Page 11: Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.](https://reader038.fdocuments.in/reader038/viewer/2022110319/56649c735503460f949257df/html5/thumbnails/11.jpg)
Self assessment of healthpercent, 11 years old, bad/not good
0 5 10 15 20 25 30 35
Sweden
Germany
Denmark
USA
England
Greenland
Russia
boysgirls
![Page 12: Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.](https://reader038.fdocuments.in/reader038/viewer/2022110319/56649c735503460f949257df/html5/thumbnails/12.jpg)
Never hungry to bed or in school
percent, in social class,11-17 years old, 2002
0
10
20
30
40
50
60
70
Low Mid-low Mid-high High
![Page 13: Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.](https://reader038.fdocuments.in/reader038/viewer/2022110319/56649c735503460f949257df/html5/thumbnails/13.jpg)
Education
• 60% of those leaving elementary school are not able to continue education
![Page 14: Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.](https://reader038.fdocuments.in/reader038/viewer/2022110319/56649c735503460f949257df/html5/thumbnails/14.jpg)
No. of police reports of violence
per 10,000 inhabitants
0
20
40
60
80
100
120
140
160
1998 1999 2000 2001 2002 2003
GreenlandDenmarkFaroe Island
![Page 15: Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.](https://reader038.fdocuments.in/reader038/viewer/2022110319/56649c735503460f949257df/html5/thumbnails/15.jpg)
No. of police reports of sexual crime
per 10,000 inhabitants
0
10
20
30
40
50
60
70
80
90
1998 1999 2000 2001 2002 2003
GreenlandDenmarkFaroe Islands
![Page 16: Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.](https://reader038.fdocuments.in/reader038/viewer/2022110319/56649c735503460f949257df/html5/thumbnails/16.jpg)
Summary of health characteristics
• Typical for ”Indigenous health”, caused of rapid transition of the society.
• Indigenous Peoples: 6,000 tribes; 300,000,000 individuals.
• Same pattern among certain ”ethnic minorities”.
![Page 17: Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.](https://reader038.fdocuments.in/reader038/viewer/2022110319/56649c735503460f949257df/html5/thumbnails/17.jpg)
Pregnancy programme
• 1,000 birth anually in Greenland• 100-120 more in Nuuk now, mainly
because of history of complicated delivery before
• In Nuuk: 6 midwifes (before 3)• 1 midwife – supervisor for labour
assistents outside Nuuk• 1 midwife – contact for patients outside
Nuuk
![Page 18: Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.](https://reader038.fdocuments.in/reader038/viewer/2022110319/56649c735503460f949257df/html5/thumbnails/18.jpg)
Pregnancy programme
• As soon as possible: need for social help?
• Guidance and close control of risk patients
• BMI>27 or blood glucose increased: control for diabetes
• Help to quit smoking (almost 50% quit smoking in pregnancy)
![Page 19: Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.](https://reader038.fdocuments.in/reader038/viewer/2022110319/56649c735503460f949257df/html5/thumbnails/19.jpg)
Skolemad væsentlig for indlæringen
Initiatives in the health sector
• Smoking prevalence decrease, but not among children
• Alcohol consumption decrease, but no major problem among children
• Sexual abuse of children programme• Drink water, quit soda pops• Food and life style guide for children• Lunch in the schools (probably)
![Page 20: Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.](https://reader038.fdocuments.in/reader038/viewer/2022110319/56649c735503460f949257df/html5/thumbnails/20.jpg)
Haemophilus influenza meningitis
No of cases
0
1
2
3
4
5
6
93 94 95 96 97 98 99 2000 2001 2002
![Page 21: Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.](https://reader038.fdocuments.in/reader038/viewer/2022110319/56649c735503460f949257df/html5/thumbnails/21.jpg)
Risk factors and diseases
Diabetes
Fertility
Obesity
Diet
Infections
We treat symptoms and diseases, and have researchProjects monitering risk factors.
![Page 22: Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.](https://reader038.fdocuments.in/reader038/viewer/2022110319/56649c735503460f949257df/html5/thumbnails/22.jpg)
Risk factors and diseases
Diabetes
Fertility
Obesity
Diet
Infections
Pollution Unemployment
Violence Housing
-factors outside the health sector’s traditional domaine influence health
![Page 23: Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.](https://reader038.fdocuments.in/reader038/viewer/2022110319/56649c735503460f949257df/html5/thumbnails/23.jpg)
Risk factors and diseases
Diabetes
Fertility
Obesity
Diet
Infections
Pollution Unemployment
Violence Housing
The generator:Social gap, culture, education
Health parameters and other parameters have common cause
![Page 24: Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.](https://reader038.fdocuments.in/reader038/viewer/2022110319/56649c735503460f949257df/html5/thumbnails/24.jpg)
Cindy Kiro, Maori from New Zealand
• “It is now widely accepted that the major determinants of health are outside the direct influence of the health sector.”
![Page 25: Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.](https://reader038.fdocuments.in/reader038/viewer/2022110319/56649c735503460f949257df/html5/thumbnails/25.jpg)
Health care expenditureper capita on average 1985-95
0 500 1000 1500 2000
Finland
Faroe Island
Denmark
Sweden
Norway
Icaland
Greenland
Euro
![Page 26: Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.](https://reader038.fdocuments.in/reader038/viewer/2022110319/56649c735503460f949257df/html5/thumbnails/26.jpg)
Miscaring of children
![Page 27: Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.](https://reader038.fdocuments.in/reader038/viewer/2022110319/56649c735503460f949257df/html5/thumbnails/27.jpg)
Miscaring of children
![Page 28: Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.](https://reader038.fdocuments.in/reader038/viewer/2022110319/56649c735503460f949257df/html5/thumbnails/28.jpg)
Health sector
EducationSocial sector
THE FAMILY
SECTORIALISM
Inequality, family fragmentation, immorality
Abuse, violence, miscaring, mental disorders, asocial behaviour
![Page 29: Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.](https://reader038.fdocuments.in/reader038/viewer/2022110319/56649c735503460f949257df/html5/thumbnails/29.jpg)
Health sector
EducationSocial sector
THE FAMILY
INTERDISCIPLINARITY
Inequality, family fragmentation, immorality
Abuse, violence, miscaring, mental disorders, asocial behaviour
![Page 30: Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.](https://reader038.fdocuments.in/reader038/viewer/2022110319/56649c735503460f949257df/html5/thumbnails/30.jpg)
• SECTORIALISM• Short-term• Not necessary to
understand and involve culture
• Treating symptoms• Monitoring risk factors• Specialist runned• Sectors in competition
with each other• ”Not my problem”• The family passive• Tell what to do
• INTERDISCIPLARITY• Long-term• Necessary to understand
and involve culture• Treating causes• Monitoring causal factors• Holistic runned• Sectors support each
other
• ”How can I help”• The family integrated• Teach how to do
![Page 31: Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.](https://reader038.fdocuments.in/reader038/viewer/2022110319/56649c735503460f949257df/html5/thumbnails/31.jpg)
Children’s health in Greenland;
interdisciplinary efforts necessary• Give a man a fish,
and he will have food for that day.
• Learn him to fish, and he will have food forever
(Ksuan-Tsu)
![Page 32: Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.](https://reader038.fdocuments.in/reader038/viewer/2022110319/56649c735503460f949257df/html5/thumbnails/32.jpg)