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Viewpoint
June 22, 2020

Fostering Healthy Mental, Emotional, and Behavioral Development in Child Health Care

Author Affiliations
  • 1Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
  • 2Division of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
  • 3Pediatrics and Psychiatry, The Ohio State University College of Medicine, Columbus
  • 4Community Health, Nationwide Children’s Hospital, Columbus, Ohio
JAMA Pediatr. Published online June 22, 2020. doi:10.1001/jamapediatrics.2020.1485

Two contradictory trends have emerged over the past quarter century. New brain and behavior science fueled an explosion of evidence on the effectiveness of promotion and prevention for child mental, emotional, and behavioral health. Meanwhile, young people in the US increasingly are identified as experiencing depression, anxiety, and other behavioral disorders. Increases of youth self-harm,1 use of emergency departments and inpatient care for psychiatric crises, and a flood of students seeking assistance for anxiety in counseling services2 underscore the depth of the problem, which contrasts starkly with results of research documenting better outcomes with prevention programs.

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    2 Comments for this article
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    Paradigm Paralysis
    Paul Nelson, MS, MD | Family Health Care, P.C. retired
    The Agency for Healthcare Research and Quality within the Federal HHS Department regularly assesses household health spending along with many other issues by its Medical Expenditure Panel Survey. With this study, they arrive at estimates of national health spending by a substantial number of households. These studies reveal rank-ordered patterns of health spending from highest to lowest segments, each representing about 33 million citizens (about 10%). Results have been published for 2014, 2016, and in February this year, for 2017. Remarkably, the results of the three studies are virtually the same (Table One in each report - #497, #521, and #528)

    Using our nation's total health spending for 2019 ($3.92 Trillion), 50% of our nation's civilian, non-institutionalized population would have had an average level of health spending of $632 each. The data indicate that 66 million had no health spending. The population study represents a Power Law distribution of 82:18 (ie, 18% of civilians used 82% of health spending and vice versa).

    This Viewpoint represents information that is already understood and valued by all primary care physicians who care for children. If it is intended to somehow fix the current deficiencies that impact the developmental
    needs of our children, you have missed the opportunity to identify the best strategy for solving the problems of our nation's population health as well as its healthcare.
    CONFLICT OF INTEREST: None Reported
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    Website Resource
    David Dooley, BA | Advancing Parenting (Nonprofit)
    We host www.advancingparenting.org, a site about prevention of unsupportive and harmful parenting.
    CONFLICT OF INTEREST: None Reported
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