Children's environment & health action plan for Europe
September 2003
The BMA has been active in the area of child health for some time and has produced a number of policy publications including Growing up in Britain: Ensuring a healthy future for our children (1999) British Medical Association. Growing up in Britain: Ensuring a healthy future for our children [1]; Injury prevention (BMA, 2001) [2]; Road transport and health (BMA, 1997) [3]; Towards smoke-free public places (BMA, 2002) [4].
Environmental tobacco smoke
The BMA and pregnant women. We have long supported legislation to ban smoking in public places as a necessary step in combating the dangers of second-hand smoke to non-smokers. Other policy includes public information campaigns on the health risks of passive smoking and health warnings on cigarette packets clearly explaining the real risks of passive smoking, including the risks to babies, children and pregnant women. A good general education is needed to help young women avoid taking up smoking and smoking during pregnancy.
Injury prevention
The BMA believes that injury prevention should be recognised as one of the major public health priorities in the UK. Although road traffic accidents are the leading cause of injury deaths throughout childhood, very young children are particularly vulnerable to injury within the home, including drowning, poisoning and fire. The UK has no single agency with responsibility for prevention of unintentional injury to children. We recommend that a national framework be set up that would be the responsibility of government, health authorities and local authorities.
We believe all relevant government departments should establish traffic free zones, safe walk to school routes and cycling lanes. We recommend the establishment of a comprehensive injury surveillance system that should include data from surveys of exposure to known avoidable hazards e.g child pedestrian exposure to non-traffic-calmed roads. Action should be taken to reduce the high rate of fatal and serious accidents suffered by cyclists, and to encourage participation in cycling as a healthy leisure activity and alternative mode of transport. The BMA strongly recommends that all cyclists, especially children, wear proper fitting helmets which as a minimum should be certified to the EN 1078 standard [5].
Full details on injury prevention policies to be included in final response.
Poor water quality
For many years, the BMA has campaigned for the fluoridation of mains water supplies. We support this policy on the grounds of effectiveness, safety and equity [6].
Nutrition
A government led strategy should be developed to improve the diets of infants and young children and help prevent anaemia, dental caries and obesity. Efforts should also be focused on increasing breastfeeding rates. We recommend that the school curriculum should include nutrition and cooking skills with a special emphasis on providing healthy meals on a low incomei.
In our publication Eating disorders, body image & the media British Medical Association [7] we recommend that health professionals should work with food manufacturers, and advertising agencies, to increase awareness of the key issues that affect young people.
Further details to be provided in the final response.
Mobility
Children should be encouraged to be active from an early age, for example walking or cycling to school and playing outsidei. However, we are aware that road traffic presents a major risk for children’s health and safety, and recommendations to reduce risk have been mentioned earlier.
Inadequate building standards and materials
The publication Housing and health: building for the future British Medical Association [8] states that children require a suitable home environment that provides security, stability and space to play and do homework. Children living in overcrowded or noisy homes may suffer sleep deprivation and educational disadvantage. Irritability and impairment of social relations are also possible consequences. Poor quality housing is also likely to impede parents’ ability to keep their children safe from injury. Children living in damp and mouldy environments are more likely to suffer respiratory problems, asthma and eczema. Recommendations include putting targets to remove all households from fuel poverty in place.
The BMA agrees that child health is determined by a complex interaction of social, economic and personal factors. Child health is marred by inequalities, for example the type of housing and neighbourhood they live in or the economic status of their family. Any successful intervention is likely to involve a combined package of social, economic and health policiesi. In 1999 we recommended the introduction of an independent Children’s Commissioner to ensure that any new government policies which may have an effect on children are evaluated with respect to their impact on children’s rights, interests and health. We are encouraged by the government’s proposals for an independent children’s commissioner, as part of a package of child protection measures in a green paper, and the BMA fully supports this.
References
1 British Medical Association. Growing up in Britain: Ensuring a healthy future for our children. London: BMJ Books 1999.
2 British Medical Association. Injury prevention. London: BMA 2001.
3 British Medical Association. Road transport and health. London: BMA 1997.
4 British Medical Association. Towards smoke-free public places. London: BMA 2002.
5 Briefing paper 'Cycling and cycle helmets' February 2004
6 Briefing paper 'Water fluoridation' December 2003
7 British Medical Association. Eating disorders, body image & the media. London: BMA 2000.
8 British Medical Association. Housing and health: building for the future. London: BMA 2003.