THE HYPOTHESIS BEARNING IN MIND THE GENETIC TIES

Critically discuss the hypothesis bearing in mind genetic ties, parent and child health-related behaviours, health at birth and parental health as a determinant of children's health



Hypothesis bearing in mind genetic ties, parent and child health-related behaviours

Executive Summary

Synthesising evidence from existing studies and systematic reviews is essential if effective interventions to improve population health and reduce health inequalities are to be identified. We know already that there are few evaluations of “wider public health” interventions, such as policies which affect the social determinants of health and health inequalities. There is some suggestive evidence that certain categories of intervention may impact positively on inequalities, though further evidence is needed. There is evidence that the effects of employment change are experienced differently by employees in different occupational categories, and some evidence about how this may be addressed. This suggests that the workplace may indeed be an important setting in which inequalities may be addressed. There is some evidence that housing improvements may positively affect physical health, but the effects may be quite small. It is becoming clear that the most important determinants of public health and health inequalities are the wider, upstream determinants; this raises the real possibility that government policies in sectors other than health such as housing, education, transport and employment offer real opportunities to improve health and reduce the health gap. It is particularly important to assemble new evidence on the mechanisms by which policies within the above sectors may affect health; this will help identify points at which to intervene and will provide a framework for the development of new primary research. The harmful effects vary depending on a number of factors, including the circumstances, personal characteristics of the child, and the child's environment (Gelles, 1998), and may endure long after the abuse or neglect occurs. Researchers have identified links between child maltreatment with difficulties during infancy, such as depression and withdrawal symptoms, common among children as young as three who have experienced emotional or physical abuse, or neglect (Dubowitz et al, 2002). Heim and Nemeroff (2001) suggest that early childhood abuse and trauma can cause a persistent biological state, which is likely to function as a risk factor for the occurrence of mental disorders in later life. It follows that abuse in childhood should be recognised as an important risk factor for mental disorders (Agid et al, 2000). Persistent neglect can lead to serious impairment of health and development; children may also experience low self-esteem or feelings of being unloved and isolated. Prolonged and/or regular exposure to domestic abuse can, despite the best efforts of the parents to protect the child, seriously affect the child's development, health and emotional wellbeing in a number of ways. It poses a threat to unborn children (Bacchus et al 2002), because assaults on pregnant women frequently involve punches or kicks directed at the abdomen, risking injury to both mother and foetus (Jasinski, 2004).

Domestic abuse during pregnancy and the first six months of child ...