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Purpose of Review: Environmental chemical exposures may disrupt child development, with long-lasting health impacts. To date, U.S. studies of early environmental exposures have been limited in size and diversity, hindering power and generalizability. With harmonized data from over 60,000 participants representing 69 pregnancy cohorts, the National Institutes of Health's Environmental influences on Child Health Outcomes (ECHO) Program is the largest study of U.S. children's health. Here, we: (1) review ECHO-wide studies of chemical exposures and maternal-child health; and (2) outline opportunities for future research using ECHO data., Recent Findings: As of early 2024, in addition to over 200 single-cohort (or award) papers on chemical exposures supported by ECHO, ten collaborative multi-cohort papers have been made possible by ECHO data harmonization and new data collection. Multi-cohort papers have examined prenatal exposure to per- and polyfluoroalkyl substances (PFAS), phthalates, phenols and parabens, organophosphate esters (OPEs), metals, melamine and aromatic amines, and emerging contaminants. They have primarily focused on describing patterns of maternal exposure or examining associations with maternal and infant outcomes; fewer studies have examined later child outcomes (e.g., autism) although follow up of enrolled ECHO children continues. The NICHD's Data and Specimen Hub (DASH) database houses extensive ECHO data including over 470,000 chemical assay results and complementary data on priority outcome areas (pre, peri-, and postnatal, airway, obesity, neurodevelopment, and positive health), making it a rich resource for future analyses. ECHO's extensive data repository, including biomarkers of chemical exposures, can be used to advance our understanding of environmental influences on children's health. Although few published studies have capitalized on these unique harmonized data to date, many analyses are underway with data now widely available., (© 2024. The Author(s).)

Most early maternal deaths are preventable, with many occurring within the first year postpartum (we use the terms "maternal" and "mother" broadly to include all individuals who experience pregnancy or postpartum and frame our recognition of need and policy recommendations in gender-neutral terms. To acknowledge limitations inherent in existing policy and the composition of samples in prior research, we use the term "women" when applicable). Black, Hispanic, and Native American individuals are at the most significant risk of pregnancy-related death. They are more commonly covered by Medicaid, highlighting likely contributions of structural racism and consequent social inequities. State-level length and eligibility requirements for postpartum Medicaid vary considerably. Federal policy requires 60 days of Medicaid continuation postpartum, risking healthcare coverage loss during a critical period of heightened morbidity and mortality risk. This policy position paper aims to outline urgent risks to maternal health, detail existing federal and state-level efforts, summarize proposed legislation addressing the issue, and offer policy recommendations for legislative consideration and future study. A team of maternal health researchers and clinicians reviewed and summarized recent research and current policy pertaining to postpartum Medicaid continuation coverage, proposing policy solutions to address this critical issue. Multiple legislative avenues currently exist to support and advance relevant policy to improve and sustain maternal health for those receiving Medicaid during pregnancy, including legislation aligned with the Biden-Harris Maternal Health Blueprint, state-focused options via the American Rescue Plan of 2021 (Public Law 117-2), and recently proposed acts (HR3407, S1542) which were last reintroduced in 2021. Recommendations include (i) reintroducing previously considered legislation requiring states to provide 12 months of continuous postpartum coverage, regardless of pregnancy outcome, and (ii) enacting a revised, permanent federal mandate equalizing Medicaid eligibility across states to ensure consistent access to postpartum healthcare offerings nationwide., (© Society of Behavioral Medicine 2024. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

System barriers to effective healthcare engagement and navigation contribute to healthcare disparities among Latino children with immigrant parents in the US. We evaluated a nine-minute educational video supporting healthcare navigation and engagement skills of Spanish-speaking Latino parents of infants. Participants viewed the video at their child's 2-month well-visit, completed a pre-and post-video knowledge evaluation, and answered open-ended questions on video style. A paired t test was used to examine differences in knowledge and open-ended responses were coded using an iterative, consensus-based process. Of the 79 participants, 63.3% had an education level below high school diploma/GED and 84.8% were at risk for limited health literacy. There was a significant gain in healthcare navigation and engagement knowledge after watching the video (p < 0.001). Parents expressed that the video was interesting and provided useful information. Parents valued the knowledge gained and preferred videos over written materials for receiving culturally and linguistically tailored health education. [ABSTRACT FROM AUTHOR]

Child health is defined by a complex, dynamic network of genetic, cultural, nutritional, infectious, and environmental determinants at distinct, developmentally determined epochs from preconception to adolescence. This network shapes the future of children, susceptibilities to adult diseases, and individual child health outcomes. Evolution selects characteristics during fetal life, infancy, childhood, and adolescence that adapt to predictable and unpredictable exposures/stresses by creating alternative developmental phenotype trajectories. While child health has improved in the United States and globally over the past 30 years, continued improvement requires access to data that fully represent the complexity of these interactions and to new analytic methods. Big Data and innovative data science methods provide tools to integrate multiple data dimensions for description of best clinical, predictive, and preventive practices, for reducing racial disparities in child health outcomes, for inclusion of patient and family input in medical assessments, and for defining individual disease risk, mechanisms, and therapies. However, leveraging these resources will require new strategies that intentionally address institutional, ethical, regulatory, cultural, technical, and systemic barriers as well as developing partnerships with children and families from diverse backgrounds that acknowledge historical sources of mistrust. We highlight existing pediatric Big Data initiatives and identify areas of future research. IMPACT: Big Data and data science can improve child health. This review highlights the importance for child health of child-specific and life course-based Big Data and data science strategies. This review provides recommendations for future pediatric-specific Big Data and data science research., (© 2022. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.)

This paper takes on a different address to youth fitness testing from previous literature by applying a cross-cultural comparison of youth fitness testing in both the US and China. Utilizing a modified version of Bronfenbrenner's Ecological Model, the chronosystem (historical evolution over time), and macrosystem (social and cultural vantage point) factors, in particular, are explored within the realm of youth fitness testing. From the lens of this model changes and characteristics of youth fitness testing practice are identified. It is concluded that both fitness testing batteries were revised periodically as time passes, even though more revisions and debates occurred in the US. Although both countries made the shift from skill-related fitness to health-related fitness, social and cultural values in both countries dictated the implementation styles of youth fitness testing and the use of the current youth fitness testing results. Future theoretical research on youth fitness testing should investigate the other three factors of the model.

Over the past decade the issue of food and in particular, food consumed within schools has come to encapsulate a broad range of concerns regarding children and young people's health and wellbeing. In Australia, the UK and more recently the USA, attempts to ameliorate a range of public health concerns have provided the impetus for an unprecedented proliferation of school food initiatives and legislative reforms governing the types of foods that may or may not be provided within schools. While academic enquiry in this area has largely focussed upon attempts to govern children, recent initiatives in the UK and Australia have begun to target parents in their attempts to promote healthy food practices. In this paper we interrogate the ways in which parents, or more specifically, mothers are positioned in relation to school food discourses in Australia and in the UK and suggest that school food has become a site through which an array of pedagogical opportunities are opened up to invoke particular subject positions premised on normative views of affective middle class motherhood. In short, we seek to explore the means through which mothers come to be regarded as legitimate targets of school food pedagogy. The paper draws on empirical data from Australia and the UK to compare a range of pedagogic techniques employed in the two countries. Drawing on governmentality studies we explore how school food pedagogies seek to regulate mothers and their children's food related choices. We consider school lunches and the various techniques that have been deployed in both countries to consider the moralising work that takes place around food and motherhood. (Contains 1 figure and 1 footnote.)

Comprehensive School Physical Activity Programs (CSPAP) coordinate physical activity opportunities for school-age children through physical education, programs offered before/after school and during the school day, and those facilitated through staff involvement and community engagement. An active school is considered to implement quality physical education and one additional CSPAP component. This paper aims to describe evidence-based school initiatives that have used a multicomponent approach to integrating CSPAP in schools. Common themes will be summarized to provide strategies and suggestions on creating, implementing, and sustaining a CSPAP in schools. The Let's Get Fit to Learn partnered with local underserved elementary schools to increase physical activity at school designed to improve or increase health and on-task behaviors. The Whole Communities-Whole Health is an equity-centered, community-engaged research project one outcome is to deeply integrate physical activity into the school curriculum. SWITCH (School Wellness Integration Targeting Child Health) is an evidence-based CSPAP designed to build capacity through a partnership with 4-H Youth Development. In Ireland, Active School Flag is a national initiative focused on self-reflection, action planning and collaboration at the school level and provides options for schools to achieve the "Flag." Multicomponent CSPAP purposefully links multiple points of intervention to maximize physical activity opportunities for children. Given the implementation of culturally relevant and contextually grounded learning opportunities in and around schools, the potential for impact and sustainability is high.

Utilizing the 2016 National Survey of Children's Health, this study illustrates that children with ASD have nearly 4 times higher odds of unmet health care needs compared to children without disabilities, whereas children with other disabilities had nearly 2 times higher odds of unmet health care needs compared to children without disabilities. Applying Andersen's Behavioral Model of health care utilization, this study estimates that enabling factors (e.g., access to health insurance, quality of health insurance, access to family-centered care, family-level stress, exposure to adverse childhood experiences, and parental employment) improved prediction of regression model for unmet health care needs by 150%. Policy and program implications are discussed and a new framework for responding to observed disparities is discussed.

The corona virus disease (COVID-19) pandemic disrupted daily life worldwide, and its impact on child well-being remains a major concern. Neighborhood characteristics affect child well-being, but how these associations were affected by the pandemic is not well understood. We analyzed data from 1039 children enrolled in the Environmental influences on Child Health Outcomes Program whose well-being was assessed using the Patient-Reported Outcomes Measurement Information System Global Health questionnaire and linked these data to American Community Survey (ACS) data to evaluate the impacts of neighborhood characteristics on child well-being before and during the pandemic. We estimated the associations between more than 400 ACS variables and child well-being t-scores stratified by race/ethnicity (non-Hispanic white vs. all other races and ethnicities) and the timing of outcome data assessment (pre-vs. during the pandemic). Network graphs were used to visualize the associations between ACS variables and child well-being t-scores. The number of ACS variables associated with well-being t-scores decreased during the pandemic period. Comparing non-Hispanic white with other racial/ethnic groups during the pandemic, different ACS variables were associated with child well-being. Multiple ACS variables representing census tract-level housing conditions and neighborhood racial composition were associated with lower well-being t-scores among non-Hispanic white children during the pandemic, while higher percentage of Hispanic residents and higher percentage of adults working as essential workers in census tracts were associated with lower well-being t-scores among non-white children during the same study period. Our study provides insights into the associations between neighborhood characteristics and child well-being, and how the COVID-19 pandemic affected this relationship., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Inc.)

There is an increasing support from international organizations and the research community for stepping beyond infant or child mortality as the most common child level social indicator and progressing towards an international measure of child development. The Early Development Instrument (EDI) is a teacher-completed measure of children's developmental health at school entry, which to date has been used in more than a dozen countries. The EDI includes five developmental domains (Physical Health and Well-being, Social Competence, Emotional Maturity, Language and Cognitive Development and Communication Skills and General Knowledge) and 16 subdomains. This paper examines the EDI's psychometric properties in four English-speaking countries (Canada, Australia, United States and Jamaica) by evaluating both the internal consistency and factor structures, as well as exploring the association between the EDI's Language and Cognitive Development Domain and a direct assessment of children's receptive vocabulary (Peabody Picture Vocabulary Test, PPVT). Overall, the factor loadings and internal consistencies of domains and subdomains were similar across the countries. The comparisons of the Language and Cognitive Development Domain with the PPVT showed high specificity and low sensitivity. The results of this paper indicate that the EDI, a measure of children's developmental status at school entry, demonstrates similar psychometric properties in a number of countries, thus building the evidence for the instrument to be added to the limited array of internationally comparable child social indicators.

One of every two children in the world lives in poverty, with no access to safe water, health services or adequate shelter to the extent that 25,000 children die every day. Thirty-seven million Americans, thirteen million of whom are children, live below the poverty level. Of the developed world, despite our wealth and sophistication, the United States has the most children who live in poverty. Rather than race, ethnicity or gender, it is poverty, socio-economic class and deprivation that account for poor performances in school, to the extent that young people from poor families are three times more likely to drop out of school. Alone, neither schools nor communities can adapt to or realize the overlapping and contextually interacting needs presented by students and their families. Collaboratively, where schools are beginning to offer quality, equitable education at the same site in which access to requisite health, social and human services for children and families are provided, both educational and psycho-social outcomes are enhanced. Using a holistic position and an ecological model of resilience, this paper would suggest that these community schools, serving as hubs of social justice, are mitigating the academic and nonacademic needs of vulnerable children and families. (Contains 64 footnotes and 2 tables.)

In the article, "Are the kids alright? Examining the intersection between education and mental health," Humphrey examines the zeitgeist of mental health service delivery within education. He posits that education and children's mental health services have undergone significant transformations, yet gaps in treatment remain. Moreover, there are critical questions to consider including the definition of "mental health," the varying prevalence of these problems, the delivery of evidence-based treatments, and how schools may meet the mental health needs of the children they serve. Humphrey concludes with an apparent contradiction faced by schools -- the competing responsibilities as: (1) the 'last bastion of hope for the resolution of the youth mental health crisis'; and (2) necessary conduits of government accountability testing. In this response article, the author examines the critical questions put forth by Humphrey with an American lens by reviewing evidence of school-based mental health services (SBMH) within the United States, and offer a differing conclusion about the potential and promise of serving the mental health needs of children in schools. [For "Are the Kids Alright? Examining the Intersection between Education and Mental Health," by Neil Humphrey, see EJ1247696.]

Critical to resolving the problem of health disparities among Latinos is examining the needs within ethnic subpopulations. This paper focused on the unique challenges encountered by one ethnic subpopulation -- Latinos of Mexican descent living in colonias. Findings reaffirm the importance of looking within ethnic subpopulations to understand the complexities of health disparities. This paper reports on data collected measuring access to health care among Latinos of Mexican descent living in several colonias in two southern Texas counties. Observations are based on data gathered from a nonprobability sample obtained through a face to face questionnaire focusing on health care access. Persons living in two Texas counties near the US border were included in this sample, and demographic data were compared to county, state and national statistics to examine the comparability of the sample to similar populations. Findings from this snowball sample, N=271, suggested lower rates of health insurance coverage compared to the Latino population nationwide, decreased patterns of preventive screenings for blood pressure, diabetes, cholesterol, cancers (ie, breast, cervical, and prostate), and regular access to health care in Mexico by slightly more than half the sample. Seeking care in Mexico may be a viable solution for many indigent people of Mexican descent living in close geographic proximity to the border because it surmounts the political, cultural, linguistic, or economic barriers to health care services in the United States. Nonetheless, there are longer term questions regarding quality of care and health and wellness for this group of people.

Objective: Children born premature are more likely to be from minoritized racial and ethnic groups and face chronic health and developmental problems. The medical home aims to comprehensively address health and social needs of all families. This study evaluates racial and ethnic disparities in the prevalence of a medical home among children born premature compared to children born full-term., Methods: A 2017-18 National Survey of Children's Health data set was used to calculate the medical home performance measure and subcomponents for children aged 0 to 17 born premature (n = 5633) or full-term (n = 45,819). Chi square and logistic regression assessed magnitude and significance of variations by race and ethnicity and prematurity status., Results: Prematurity prevalence differed by race and ethnicity (12.0% non-Hispanic Black [NHB], 12.8% Hispanic, 11.1% Multiracial/Other, 11.0% non-Hispanic White [NHW]). Minoritized children born premature had lower adjusted odds of receiving care in a medical home compared to NHW peers (eg, NHB adjusted odds ratio [aOR] 0.54 [95% confidence interval {CI}: 0.38-0.76] and Hispanic aOR 0.56 [95% CI: 0.40-0.79]). Differences were greater in magnitude among children born premature compared to full-term peers (eg, NHB premature aOR 0.54 [95% CI: 0.38-0.76] vs NHB full-term aOR 0.67 [95% CI: 0.58-0.78]), with similar results for "personal doctor/nurse" and "usual sick care.", Conclusions: Racial and ethnic disparities exist in the medical home among children born premature, some more pronounced than full-term peers. To deliver equitable care for all children, efforts are needed to expand access to and improve the medical home, including reliable routine and sick care and stronger family-provider relationships., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.)

Objective: To estimate the effects of prenatal public health insurance targeting noncitizens on the health of U.S.-born children of noncitizen mothers beyond birth outcomes., Data Sources and Study Setting: This paper uses the restricted version of the 1998-2014 National Health Interview Survey with state-level geographic identifiers., Study Design: The empirical strategy compares outcomes in states that adopted the Children's Health Insurance Plan (CHIP) Unborn Child Option with states that never adopted or adopted it at different times, controlling for differences in the pre-treatment period. I use a flexible event-study analysis to quantify the effects of the Unborn Child Option on noncitizen women's health insurance coverage, health care utilization, and their children's health., Data Collection/extraction Methods: All data are derived from pre-existing sources., Principal Findings: The study finds that the impact of the Unborn Child Option is a 4.7%-point increase in public health insurance coverage (p < 0.01) and 0.48 more doctor's office visits (p < 0.1) annually among noncitizens of childbearing ages. Subsequently, the reform leads to a 7%-point rise in the rate of parents reporting their 4-6-year-old children are in "excellent" or "very good" health (p < 0.01). While no improvements are evident at birth and at younger ages, observed health improvements begin to appear by preschool age., Conclusions: The study contributes to the literature by providing evidence that certain benefits of in-utero public health insurance targeting noncitizens may appear several years after birth, specifically around preschool age., (© 2023 Health Research and Educational Trust.)

One would like to believe that advances in science have resulted in improved outcomes for troubled youth. Trends in treatment have changed dramatically in two decades. Technology to understand the brain and its functions are highly advanced. But the United States is now medicating youth more than any other country. There is growing concern about the burgeoning use of psychotropic drugs to manage childhood behavior problems. Examining the commonly used stimulant and antipsychotic medications across the last 20 years indicates that people need to re-evaluate their methods of care for their most troubled youth. This article critiques this practice and calls for a reorientation toward relationship-based interventions. (Contains 1 graph.)

This paper examines the consequences of parental migratory strategies for children in three types of Mexican families: those living with their migrant parents in the United States, those living with parents who migrated and returned to Mexico, and those living in Mexico with parents who have never migrated. Using data on 804 children from the Health and Migration Survey (HMS), we found significant differences in children's health across the three types of families. Results also revealed robust effects on child health of the size of immediate and extended social networks and migration experience after controlling for potential mediators such as mother's general health, receipt of social support, and child's age and sex. Findings suggest that social networks and migration affect children in complex ways, offering health benefits to those with migrant parents in U.S. households but not to those living with parents who migrated in the past and returned to Mexico.

The current state of physical fitness in American youth is unknown. While evidence exists that obesity levels are increasing in children and youth, data on declines in physical fitness measures (i.e., cardiorespiratory and musculoskeletal fitness) are lacking. Tracking of physical fitness components has been poorly done. Surveillance of behaviors known to relate to health-related fitness (e.g., physical activity, sedentariness) and actual health-related fitness outcomes (e.g., cardiorespiratory fitness, body composition, musculoskeletal health, and, perhaps, blood lipids, cholesterol, etc.) are important to measure. Both behaviors and outcomes are important to measure--if they are not measured, people perceive them as "not" important. In this paper, the author asserts that it is time that well defined, valid measures of health-related fitness components are identified and procedures are developed that permit surveillance and tracking of physical fitness components in children and youth. Development of surveillance systems should include many interested parties, the medical profession, professional organizations (e.g., AAHPERD and ACSM), governmental agencies (e.g., PCPFS, CDC, and HHS), teachers, epidemiologists, research scientists, measurement experts, and parents. It will be difficult to arrive at the appropriate process and measures to obtain. Nonetheless, it is an important task. It is time to initiate surveillance that results in meaningful data with which to make evidenced-based decisions about fitness levels that impact curricular and health decisions. (Contains 4 tables and 4 figures.)

Aimed at eliminating the barriers to learning wrought about by poverty, Minneapolis and other urban school districts educate a substantial portion of poor and disadvantaged children and go nearly anywhere to hold parenting classes, homeless shelters, neonatal care units, high schools, and even jails. This article details the early childhood education program of Minneapolis Public School and other urban school districts that specifically looks into the factors that children need in order to raise their learning performance.

Recent evidence has emerged that in Britain, like the United States, many children below minimum school-leaving age are working. Often, the work is illegal. Research in the United States suggests that many risk accidents and other hazards to health. Evidence from Britain is of a more fragmentary nature, but enough exists to suggest a need for greater vigilance. (Author/EV)

An interview with Christopher Schenk, Britain's Inspector of Schools, reveals his impressions of the differences and similarities of early childhood education in Britain and the United States. Topics included teaching methods, at-risk children, standardized tests, early intervention, family involvement in the schools, funding, and health care. (MDM)

Childhood obesity rates in America have tripled in the last three decades. Almost one in three children are considered overweight or obese. Pediatricians are now treating children for adult diseases like type II diabetes and hypertension. All parents want the best for their children. They want children to succeed in school, fulfill their dreams, and take this country to new heights. To get them there, parents know children need plenty of healthy food and exercise to help get them ready to learn. But parents know that's often easier said than done. That is why in 2010, Let's Move!, a nationwide initiative with a simple goal: to end childhood obesity within a generation, was launched. To achieve its goal, Let's Move! is working with people from every sector of the society--concerned parents and individuals across this country, businesses and elected officials, faith leaders and educators, doctors and athletes.

Examines whether U.S. public is underinvesting in its children. Several measures indicate a deterioration in the well-being of children in the past few decades, and some measures suggest a decline in crucial inputs from parents to children (i.e., parenting hours). Ways to increase society's investment in children are discussed. (SLD)

Comments on three articles (see records EJ733583, EJ733584, and EJ733585) on the status of children's mental health services in the United States, which appeared in the September 2005 issue of the "American Psychologist." The current authors suggest that, although this series of articles provides important information, the articles fall short in meeting the mark of comprehensively describing the solutions necessary to effectively address the crisis facing children's mental health in this country.

Introduction Since 2001, the Health Resources and Services Administration’s Maternal and Child Health Bureau (HRSA MCHB) has funded and directed the National Survey of Children’s Health (NSCH) and the National Survey of Children with Special Health Care Needs (NS-CSHCN), unique sources of national and state-level data on child health and health care. Between 2012 and 2015, HRSA MCHB redesigned the surveys, combining content into a single survey, and shifting from a periodic interviewer-assisted telephone survey to an annual self-administered web/paper-based survey utilizing an address-based sampling frame. Methods The U.S. Census Bureau fielded the redesigned NSCH using a random sample of addresses drawn from the Census Master Address File, supplemented with a unique administrative flag to identify households most likely to include children. Data were collected June 2016-February 2017 using a multi-mode design, encouraging web-based responses while allowing for paper mail-in responses. A parent/caregiver knowledgeable about the child’s health completed an age-appropriate questionnaire. Experiments on incentives, branding, and contact strategies were conducted. Results Data were released in September 2017. The final sample size was 50,212 children; the overall weighted response rate was 40.7%. Comparison of 2016 estimates to those from previous survey iterations are not appropriate due to sampling and mode changes. Discussion The NSCH remains an invaluable data source for key measures of child health and attendant health care system, family, and community factors. The redesigned survey extended the utility of this resource while seeking a balance between previous strengths and innovations now possible. [ABSTRACT FROM AUTHOR]

Though preventable, children with disabilities have a high risk of victimization, contributing to worsening health conditions. Hence, this study examined the exposure of school-age children with mental, emotional, developmental, or behavioral (MEDB) disorder to bully victimization. This study used the 2018 National Survey of Children's Health (NSCH) data of 23,494 children ages 5–17 to estimate multilevel logistic regression with fixed and random effects. Children's health conditions were treated as level one variables, while family poverty level and neighborhood characteristics such as vandalism and presence/absence of recreational centers were treated as level two variables. The paper presents the prevalence of bullying victimization among children with at least one disorder (MDBB = 39.5%), anxiety (20.6%), depression (10.8%), ADD/ADHD (18.3%), behavioral problems (14.9%), learning disability (11.9%), Tourette syndrome (0.5%), developmental delay (10.1%), Autism spectrum disorder (4.6%), speech disorder (10.7), and intellectual disability (1.6%), respectively. Bullying victimization was positively associated with anxiety (AOR = 1.995, 95% CI = 1.634–2.436), depression (AOR = 2.688, 95% CI = 2.031–3.557), developmental delay (AOR = 1.804, 95% CI = 1.422–2.288), but inversely associated with Autism spectrum disorder (AOR = 0.614, 95% CI = 0.399–0.946). Neighborhood disorganization and poverty were also associated with bullying victimization. The NSCH data suggests that children with disabilities in the US had a higher prevalence rate of victimization. Consequently, effective bullying prevention strategies that can protect and improve children's quality of life with special needs should be prioritized. [ABSTRACT FROM AUTHOR]

Objective: To assess the national and state prevalence of being "Healthy and Ready to Learn" (HRL) and associated sociodemographic, health, family and neighborhood factors., Methods: Cross-sectional analysis of the 2016 National Survey of Children's Health, a nationally representative parent-reported survey administered by web and paper June 2016 to February 2017. Four domains were constructed from 18 items through confirmatory factor analyses: "Early Learning Skills", "Social-Emotional Development", "Self-Regulation", and "Physical Well-being and Motor Development." Each item and domain were scored according to age-specific standards as "On-Track", "Needs Support", and "At Risk" with overall HRL defined as "On-Track" in all domains for 7565 randomly selected children ages 3 to 5 years., Results: In 2016, 42.2% of children ages 3 to 5 years were considered HRL with the proportion considered "On-Track" ranging from 58.4% for Early Learning Skills to 85.5% for Physical Well-being and Motor Development"; approximately 80% of children were considered "On-Track" in Social-Emotional Development and Self-Regulation, respectively. Sociodemographic differences were mostly non-significant in multivariable analyses. Health, family, and neighborhood factors (ie, special health care needs status/type, parental mental health, reading, singing and storytelling, screen time, adverse childhood experiences, and neighborhood amenities) were associated with HRL. HRL prevalence ranged from 25.5% (NV) to 58.7% (NY), but only 4 states were significantly different from the U.S. overall., Conclusions: Based on this pilot measure, only about 4 in 10 US children ages 3 to 5 years may be considered "Healthy and Ready to Learn." Improvement opportunities exist for multiple, modifiable factors to affect young children's readiness to start school., (Published by Elsevier Inc.)

Background: The purpose of this article was to examine the association of sleep duration and physical activity and their interactions on mental health disorders in American children aged 6-17 years., Methods: Data were analyzed from the combined 2017-2018 National Survey of Children's health. Ultimately, a total of 36370 children aged 6-17 years were selected as the samples. Weighted logistic regression models were used to estimate odds ratios and 95% confidence intervals., Results: Insufficient sleep duration was associated with an increased risk for current anxiety, depression, and behavior/conduct problems (odds ratio = 1.449, 1.991, 1.375; 95% confidence interval: 1.313-1.702, 1.648-2.406, 1.162-1.627). Insufficient physical activity was associated with an increased risk for current anxiety (odds ratio = 1.448; 95% confidence interval: 1.230-1.706) and depression (odds ratio = 1.743; 95% confidence interval: 1.304-2.329). In addition, additive interactions between sleep duration and physical activity were observed on current anxiety and depression., Conclusions: Insufficient sleep duration and insufficient physical activity in children were associated with mental health disorders. There is a synergistic interaction effect between insufficient sleep duration and insufficient physical activity on current anxiety and current depression., Competing Interests: The authors declare that there is no conflict of interest regarding the publication of this paper., (Copyright © 2021 Shiting Xiang et al.)

Surgical procedures are performed in the United States in a wide variety of clinical settings and with variation in clinical outcomes. In May 2012, the Task Force for Children's Surgical Care, an ad hoc multidisciplinary group comprising physicians representing specialties relevant to pediatric perioperative care, was convened to generate recommendations to optimize the delivery of children's surgical care. This group generated a white paper detailing the consensus opinions of the involved experts. Following these initial recommendations, the American College of Surgeons (ACS), Children's Hospital Association, and Task Force for Children's Surgical Care, with input from all related perioperative specialties, developed and published specific and detailed resource and quality standards designed to improve children's surgical care (https://www.facs.org/quality-programs/childrens-surgery/childrens-surgery-verification). In 2015, with the endorsement of the American Academy of Pediatrics (https://pediatrics.aappublications.org/content/135/6/e1538), the ACS established a pilot verification program. In January 2017, after completion of the pilot program, the ACS Children's Surgery Verification Quality Improvement Program was officially launched. Verified sites are listed on the program Web site at https://www.facs.org/quality-programs/childrens-surgery/childrens-surgery-verification/centers, and more than 150 are interested in verification. This report provides an update on the ACS Children's Surgery Verification Quality Improvement Program as it continues to evolve., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2020 by the American Academy of Pediatrics.)

Objective: This paper examines the joint impact of maternal employment and childcare during infancy on childhood weight at ages three and five in the context of weak social support for early childhood care and education., Method: Using three waves of longitudinal data from the Growing-Up in Ireland survey (n = 8,393 age three, n = 8,039 age five), propensity score matching is used to address the endogeneity of employment and childcare decisions. Selection on observables is used to assess potential bias arising from selection on unobservables whereby unobserved characteristics of the mother or child may jointly influence child weight and maternal employment and childcare., Results: Full-time maternal employment at nine months combined with either formal or informal childcare increases the likelihood of being overweight at three years by 8.1% and 5.9% respectively, but only for children of highly educated mothers. Similar results are observed for part-time employment coupled with informal (7.5%) or parental (8.0%) care. The results for mothers with lower levels of education are either not significant or favourable. While the majority of the effects dissipate by age five, there is some evidence that full-time maternal employment coupled with informal care increases the risk of being overweight at both ages three and five for children of higher-educated mothers. An assessment of selection bias finds that the estimates of full-time employment combined with formal childcare by well-educated mothers are a lower bound, such that the true effect on child weight may be understated., Conclusions: The findings for Ireland are consistent with studies from the United States and the United Kingdom, and are in contrast to findings from the rest of Europe, suggesting the role of institutional factors, such as the lack of subsidised, universal, high-quality childcare., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Policy Points: Historically, reforms that have increased the duration of job‐protected paid parental leave have improved women's economic outcomes. By targeting the period around childbirth, access to paid parental leave also appears to reduce rates of infant mortality, with breastfeeding representing one potential mechanism. The provision of more generous paid leave entitlements in countries that offer unpaid or short durations of paid leave could help families strike a balance between the competing demands of earning income and attending to personal and family well‐being. Context: Policies legislating paid leave from work for new parents, and to attend to individual and family illness, are common across Organisation for Economic Co‐operation and Development (OECD) countries. However, there exists no comprehensive review of their potential impacts on economic, social, and health outcomes. Methods: We conducted a systematic review of the peer‐reviewed literature on paid leave and socioeconomic and health outcomes. We reviewed 5,538 abstracts and selected 85 published papers on the impact of parental leave policies, 22 papers on the impact of medical leave policies, and 2 papers that evaluated both types of policies. We synthesized the main findings through a narrative description; a meta‐analysis was precluded by heterogeneity in policy attributes, policy changes, outcomes, and study designs. Findings: We were able to draw several conclusions about the impact of parental leave policies. First, extensions in the duration of paid parental leave to between 6 and 12 months were accompanied by attendant increases in leave‐taking and longer durations of leave. Second, there was little evidence that extending the duration of paid leave had negative employment or economic consequences. Third, unpaid leave does not appear to confer the same benefits as paid leave. Fourth, from a population health perspective, increases in paid parental leave were consistently associated with better infant and child health, particularly in terms of lower mortality rates. Fifth, paid paternal leave policies of adequate length and generosity have induced fathers to take additional time off from work following the birth of a child. How medical leave policies for personal or family illness influence health has not been widely studied. Conclusions: There is substantial quasi‐experimental evidence to support expansions in the duration of job‐protected paid parental leave as an instrument for supporting women's labor force participation, safeguarding women's incomes and earnings, and improving child survival. This has implications, in particular, for countries that offer shorter durations of job‐protected paid leave or lack a national paid leave entitlement altogether. [ABSTRACT FROM AUTHOR]

Our purposes with this policy statement and its accompanying technical report are to review and highlight emerging child health concerns related to the use of colorings, flavorings, and chemicals deliberately added to food during processing (direct food additives) as well as substances in food contact materials, including adhesives, dyes, coatings, paper, paperboard, plastic, and other polymers, which may contaminate food as part of packaging or manufacturing equipment (indirect food additives); to make reasonable recommendations that the pediatrician might be able to adopt into the guidance provided during pediatric visits; and to propose urgently needed reforms to the current regulatory process at the US Food and Drug Administration (FDA) for food additives. Concern regarding food additives has increased in the past 2 decades, in part because of studies in which authors document endocrine disruption and other adverse health effects. In some cases, exposure to these chemicals is disproportionate among minority and low-income populations. Regulation and oversight of many food additives is inadequate because of several key problems in the Federal Food, Drug, and Cosmetic Act. Current requirements for a "generally recognized as safe" (GRAS) designation are insufficient to ensure the safety of food additives and do not contain sufficient protections against conflict of interest. Additionally, the FDA does not have adequate authority to acquire data on chemicals on the market or reassess their safety for human health. These are critical weaknesses in the current regulatory system for food additives. Data about health effects of food additives on infants and children are limited or missing; however, in general, infants and children are more vulnerable to chemical exposures. Substantial improvements to the food additives regulatory system are urgently needed, including greatly strengthening or replacing the "generally recognized as safe" (GRAS) determination process, updating the scientific foundation of the FDA's safety assessment program, retesting all previously approved chemicals, and labeling direct additives with limited or no toxicity data., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2018 by the American Academy of Pediatrics.)

At the start of the twenty-first century, two arms of U.S. immigration policy shape the lives of families and children. The first, enforcement practices, lead to the involuntary separation of parents and children-or the fears of this outcome-when the United States government detains and forcibly removes the parents of U.S. citizen children. The second, the policies which restrict migration to the United States, cause children to experience both long and short term separations when their parents migrate without them. In this paper I use interviews collected between the years of 2003-2006 and 2009-2012 with children and their parents or guardians in both the United States and in Mexico to assess the meanings these two types of separations have for families and the potential impacts for children's well-being. I find that enforcement practices create economic and emotional hardship due to feelings of uncertainty, while restrictive immigration policies lead to resentment among children even post-reunification., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a food assistance program designed to help pregnant (or postpartum) women and young children consume a nutritious diet. With WIC's emphasis on providing healthy foods, and food being (generally) a communal commodity, age-ineligible children may benefit from living with a WIC participant. This paper used data from the third National Health and Nutrition Examination Survey to examine whether age-ineligible children who lived in WIC households were in better health than similar children who lived in households that did not participate in the program. Results suggested that older males received a health benefit as a result of living in a WIC household; however, no similar effect was found for younger males or for female children. [ABSTRACT FROM AUTHOR]

This paper examines the consequences of parental migratory strategies for children in three types of Mexican families: those living with their migrant parents in the United States, those living with parents who migrated and returned to Mexico, and those living in Mexico with parents who have never migrated. Using data on 804 children from the Health and Migration Survey (HMS), we found significant differences in children’s health across the three types of families. Results also revealed robust effects on child health of the size of immediate and extended social networks and migration experience after controlling for potential mediators such as mother’s general health, receipt of social support, and child’s age and sex. Findings suggest that social networks and migration affect children in complex ways, offering health benefits to those with migrant parents in U.S. households but not to those living with parents who migrated in the past and returned to Mexico. [ABSTRACT FROM AUTHOR]