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(2) LOW
INCOME SMOKERS SUPPORT SMUGGLING
TO MAINTAIN
HABIT
(3) DEPRIVED
AREAS SHOW GREATEST INCREASE
IN TEENAGE
PREGNANCIES
(4) CHILDREN
IN CARE ARE A GREATER RISK OF
DEATH
(5) HEALTH
SYSTEM FAILS CHILDREN EXPOSED TO
DEMOSTIC VIOLENCE
(1) ANTISOCIAL
CHILDREN ARE A FINANCIAL
DRAIN ON SOCIETY, BUT PARENTAL TRAINING
CAN HELP
(Financial cost of social exclusion:
follow up study of
antisocial children into adulthood)
http://bmj.com/cgi/content/full/323/7306/191
(Multicentre controlled trial of
parenting groups for
childhood antisocial behaviour in
clinical practice)
http://bmj.com/cgi/content/full/323/7306/194
(Commentary: nipping conduct problems
in the bud)
http://bmj.com/cgi/content/full/323/7306/194
Children who display antisocial behaviour
cost society 10
times more than those with no problems
and are at high risk
of lifelong social exclusion, concludes
a study in this week's
BMJ. However, a second study reports that
parental
training programmes can be a cost effective
way to nip
serious antisocial behaviour in children
in the bud.
In the first study, Scott and colleagues
tracked the costs to
the public sector of 142 children with
different levels of
antisocial behaviour, from age 10 to their
late 20s. By age
28, costs for individuals with serious
antisocial behaviour
were 10 times higher than for those with
no problems.
Crime incurred the greatest cost, followed
by special
educational provision, foster and residential
care, and state
benefits. Early interventions to reduce
antisocial behaviour in
childhood could result in large cost savings,
they conclude.
In the second study, the team identified
141 highly antisocial
children aged 3-8 years. The parents of
90 children
completed a training programme; the remaining
51 parents
received no such training. Children in
the training group
showed a large reduction in antisocial
behaviour, while
those in the control group did not change.
Although such parenting programmes are
only just beginning
to become available in the United Kingdom,
they show
promise as a cost effective way to reduce
the personal and
economic burden of antisocial behaviour
in children and to
prevent criminality and social exclusion,
conclude the
authors.
Contact:
Stephen Scott, Senior Lecturer in Child
and Adolescent
Psychiatry, King's College London, London,
UK
Email: s.scott@iop.kcl.ac.uk
(2) LOW INCOME
SMOKERS SUPPORT SMUGGLING
TO MAINTAIN HABIT
("They're doing people a service"
± qualitative study of
smoking, smuggling, and social deprivation)
http://bmj.com/cgi/content/full/323/7306/203
Low income smokers living in socially deprived
areas view
cigarette and tobacco smuggling as a positive
way of dealing
with the increasing costs of cigarettes,
concludes a study in
this week's BMJ. This suggests that they
may show little
support for tackling smuggling until more
government action
is taken to help them quit.
Researchers at the University of Edinburgh
interviewed 50
male and 50 female smokers, aged 25-40
years and living in
two socially deprived areas, about their
smoking behaviour.
They found that most smokers wanted to
quit but perceived
a lack of support to help them to stop
smoking. Strategies
to maintain smoking in the face of increasing
cigarette prices
and low income included buying contraband
products,
particularly in pubs.
Respondents viewed smuggling as a reasonable
response to
the perceived high prices of cigarettes
and considered that
smugglers were providing a valuable service.
Many smokers
criticised the government for its high
tobacco taxation and
the lack of local services to help them
stop smoking.
The government has already taken action
to reduce
smuggling, but more needs to be done,
say the authors.
Given that deprived areas have the highest
rates of smoking
and lowest levels of quitting, at the
very least it is essential
that smoking cessation services are expanded
to become
more accessible to disadvantaged smokers
in Britain, they
conclude.
Contact:
Amanda Amos, Senior Lecturer, Department
of Community
Health Sciences, University of Edinburgh
Medical School,
Edinburgh, Scotland
Email: amanda.amos@ed.ac.uk
(3) DEPRIVED AREAS
SHOW GREATEST INCREASE
IN TEENAGE PREGNANCIES
(Changing patterns of teenage pregnancy:
population based
study of small areas)
http://bmj.com/cgi/content/full/323/7306/199
From the 1980s to the 1990s rates of teenage
pregnancy in
Scotland increased more rapidly in areas
of greater
socioeconomic deprivation, finds a study
in this week's
BMJ. This finding has implications for
allocating resources
to achieve government targets in reducing
pregnancy rates
by 2010.
Research carried out at Glasgow University
investigated the
impact of socioeconomic deprivation on
teenage pregnancy
and the extent of local variation in Scotland,
and how both
had changed between the 1980s and 1990s.
Among teenagers aged less than 18, the
annual pregnancy
rate increased in more deprived areas,
but there was no
change, on average, among teenagers in
more affluent areas.
Among 18-19 year olds, the pregnancy rate
decreased in
more affluent areas and increased in more
deprived areas.
The results also show that in the 1990s,
socioeconomic
deprivation explained more than half of
the local variation in
rates of teenage pregnancy, more than
double the amount
explained by deprivation in the 1980s.
Improved access to contraception and sex
education may
play important roles in helping to reduce
unwanted teenage
pregnancies, but the increased impact
of deprivation in the
1990s suggests other social processes
behind the patterns
of change, concludes the author.
Contact:
Alice McLeod, National Evaluation of Sure
Start, Birkbeck
College, London, UK
Email: a.mcleod@psychology.bbk.ac.uk
(4) CHILDREN IN
CARE ARE A GREATER RISK OF
DEATH
(Mortality in children registered
in the Finnish child welfare
registry: population based study)
http://bmj.com/cgi/content/full/323/7306/207
Children in care are more likely to die
before age 18
compared with the general population of
the same age,
conclude researchers from Finland in this
week's BMJ. The
results indicate the need for continuing
attention to be paid
to the transition period from foster care
to independence.
The study analysed deaths among all children
in Finland
who were taken into care between 1991
and 1997. During
the study period 106 individuals (32 females
and 74 males)
died. In both sexes, this represents a
higher death rate than
would have been expected in the general
population and in
the most socially disadvantaged groups
in Finland.
Substance misuse, accidents, and suicide
accounted for the
higher death rate in this group. Deaths
related to alcohol and
drug misuse also occurred at a higher
rate than expected.
Deaths from illness can be attributed
to an increase in acute
and chronic health conditions and developmental
delays
among children in foster care, add the
authors.
The child protection system does not cause
the deaths, but
it fails to protect adolescents from self
endangering
behaviour both within the system and during
adaptation to
independent living, say the authors. Continuing
attention
needs to be paid to the transition period
from foster care to
independence, they conclude.
Contact:
Mirjam Kalland, Researcher, Save the Children,
Helsinki,
Finland Mobile: +358 40 76 77 225 Email:
mirjam.kalland@pela.fi
(5) HEALTH SYSTEM
FAILS CHILDREN EXPOSED TO
DEMOSTIC VIOLENCE
(The health of children in refuges
for women victims of
domestic violence: cross sectional
descriptive survey)
http://bmj.com/cgi/content/full/323/7306/210
(Editorial: Reaching all children)
http://bmj.com/cgi/content/full/323/7306/176
Children whose mothers are victims of domestic
violence
are at high risk of physical and psychological
ill health, yet
these children are being failed by the
health system, finds a
study in this week's BMJ. New strategies
are urgently
needed to meet the needs of these largely
"invisible"
children.
Researchers in Cardiff assessed 148 children
living in
refuges for women victims of domestic
violence. Records
from the child health system were incorrect
or unavailable
for over half the children and uptake
of routine health
assessments and immunisations was low.
Nineteen per cent of children aged 3-4
years had
developmental problems and almost half
the children aged
3-15 years displayed probable mental health
difficulties.
Concerns about physical, emotional and
behavioural
wellbeing was expressed by mothers of
113 (76%)
children.
Child health surveillance should be accessible
to all children
yet, in effect, these children form a
largely invisible
population, outside the health system
and poorly served by
it. We are concerned that, without dedicated
services to
which these families can be referred,
many fall through the
system.
The authors argue that time spent in a
refuge provides a
window of opportunity to review the health
and
developmental status of these children.
Specialist health
visitors could provide support and advocacy
and facilitate
access to mainstream services, they conclude.
Contact:
Judith Shankleman, Sure Start Health Visitor,
Splott Clinic,
Cardiff, Wales
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