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Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD.

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Presentation on theme: "Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD."— Presentation transcript:

1 Children’s health in Greenland; Interdisciplinary efforts necessary Reykjavik, June 2, 2005. Henning Sloth Pedersen, MD, PhD

2 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

3 The Future of Children and Youth in the Arctic 1992-2001 Norway Sweden Finland Denmark Iceland Canada USA Russia

4 Infant mortality no of death per 1,000

5 Tuberculosis among children (1992-2001), 0-24 years old

6 Age of mother 2002, 940 births

7 Teen mothers Increased rates of lower birth weights Pre-eclampsia (intoxication) Social problems more common (education, housing, single, income….)

8 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

9 Contaminants percent > safety threshold

10 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)

11 Self assessment of health percent, 11 years old, bad/not good

12 Never hungry to bed or in school percent, in social class,11-17 years old, 2002

13 Education 60% of those leaving elementary school are not able to continue education

14 No. of police reports of violence per 10,000 inhabitants

15 No. of police reports of sexual crime per 10,000 inhabitants

16 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”.

17 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

18 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)

19 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)

20 Haemophilus influenza meningitis No of cases

21 Risk factors and diseases Diabetes Fertility Obesity Diet Infections We treat symptoms and diseases, and have research Projects monitering risk factors.

22 Risk factors and diseases Diabetes Fertility Obesity Diet Infections Pollution Unemployment Violence Housing -factors outside the health sector’s traditional domaine influence health

23 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

24 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.”

25 Health care expenditure per capita on average 1985-95

26 Miscaring of children

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28 Health sector Education Social sector THE FAMILY SECTORIALISM Inequality, family fragmentation, immorality Abuse, violence, miscaring, mental disorders, asocial behaviour

29 Health sector Education Social sector THE FAMILY INTERDISCIPLINARITY Inequality, family fragmentation, immorality Abuse, violence, miscaring, mental disorders, asocial behaviour

30 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

31 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)

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