This is the third in a series of 3 posts on Child Safety
Post 1: Better Safe than Stupid...click here
Post 2: Dr. Singer, Practice what you Preach...click here
A recent report by the Center for Disease Control concerning childhood injury provides some very useful information. In a Washington Post article, titled “How Kids Get Hurt” author David Brown states, “Around the world, fatal injuries in children total 830,000 a year, a number equal to roughly all the children in Chicago. That’s 2270 a day, of which at least 1000 could have been prevented, experts say.”
Brown interviewed Julie Gilchrist, a physician and epidemiologist at CDC, and one of the authors of the report. Brown explains, “You won’t hear Gilchrist or her colleagues use the word accidents. That word, they say, implies that the events could not have been avoided and the damage could not have been prevented—exactly the opposite message they want to convey.”
STATS from David Brown:
**Childhood injuries cause the nation about $300 billion a year.
**In motor vehicle deaths, the risk that comes with age reflects numerous behaviors and vulnerabilities. As soon as a child is able to exert willpower, risk goes up. Of children four and younger who are killed, 30% are unrestrained. Of teenagers killed, more than half are not wearing seatbelts.
STATS from the CDC Childhood Injury Report:
INJURY DEATHS
**On average 12,175 children…zero to 19 years of age die each year in the United States from an unintentional injury.
**Males have higher injury death rates than females.
**Injuries due to transportation are the leading cause of death for children.
The leading causes of injury death differ by age group:
**For children less than one year of age, two thirds of injury deaths are due to suffocation.
**Drowning is the leading cause of injury death for those one to four years of age.
**For children five to nineteen years of age, the most injury deaths are due to being an occupant in a motor vehicle traffic crash.
NON-FATAL INJURIES
**An estimated 9.2 million children annually have an initial emergency department visit for an unintentional injury.
**Males generally have higher non-fatal injury rates than females.
**Injuries due to falls are the leading cause of non-fatal injury: each year, approximately 2.8 million children have an initial emergency department visit for injuries from a fall. For children less than one year of age, falls account for over 50% of non-fatal injuries.
Showing posts with label CDC. Show all posts
Showing posts with label CDC. Show all posts
Friday, January 22, 2010
Thursday, May 01, 2008
Parents-Tell Your Adult Children: Don’t Delay Childbearing by Dr. Alan Singer
Attribution: Journalists have permission to reproduce this column in full or in part, provided they attribute authorship to Dr. Alan Singer and this website www.FamilyThinking.com
Click here to see Dr. Singer's YouTube video on this column
Too many parents approach issues in their adult child’s life with the unspoken rejoinder, close your mouth and open your wallet. Parents often give no advice, even when they have serious concerns. Thirty years as a family therapist and 28 years as a father, have taught me that parents should voice their opinion to their adult child about two specific issues: getting married and not waiting numerous years before having children.
The Domino Effect
In recent years, the trend of delaying marriage has caused a domino effect on other trends which have a significant emotional cost for families and an enormous financial cost to society. The dominos are: delayed marriage—delayed childbearing—augmented infertility—elevated multiple births—increased rates of pre-term births and caesarian sections. My goal in this column is to describe these decisions to delay marriage and childbearing and the resulting consequences. I will offer some suggestions that parents might use in dealing with their adult child.
Of the 4.1 million births registered in the U.S. in 2005, 37 percent were born to unmarried women (CDC). Some of the reasons that couples cohabit include: convenience, economy of savings, preparation for the marriage commitment, and apprehension about the high divorce rate. But these couples are actually practicing non-commitment. Even if they eventually marry, they have less satisfying marriages and higher divorce rates than spouses who did not first live together (National Marriage Project). If the unmarried biological parents go their separate ways, where does that leave the children?
If I am perhaps describing your adult child, don’t you want the best possible family environment for your grandchild? Wouldn’t you consider voicing your opinion to your son or daughter, knowing the irrefutable research finding: the best environment to raise children is two biological parents in a low-conflict marriage? You might respond that you don’t want to “meddle” or times have changed and it’s not like the old days when parents spoke their minds. My response mirrors a recent mass e-mail: don’t be so open-minded that your brains fall out.
Adult Children Do Listen
Please don’t misunderstand me: Parents should not tell their grown child everything on their minds. But, in matters that are crucial for their well-being, they must speak up. My three decades of research into family size decisions have shown that adult children are aware of and appreciably influenced by the attitudes of their parents. One of my own survey research findings is the importance of family-of-origin family size as a predictor of total family size. The decisions our parents made about family size tend to have a significant impact on our own decisions.
In fact, reliance on the advice of parents has been described in the National Survey of Student Engagement (2007) which questioned 313,000 randomly selected college students. The survey revealed that young adults follow the advice of both parents more than twice as much as they listen to friends. So, if your son or daughter informs you that he/she wants to live together with a “significant other” for a few years, possibly even have a child or two, don’t respond with that 1960’s expression, do your own thing.
The First Two Dominos
Couples, who do choose to marry, are waiting longer to do so. According to the Census Bureau, between 1970 and 2000, the median age at first marriage for women increased by 4.3 years to 25.1 years; for men the increase was 3.6 years to 26.8.
In tandem with the later age at first marriage, is the decision to delay childbearing. The mean age of mothers in the U.S. was 24.6 in 1970 which increased to 27.2 in 2000 (CDC). Approximately 20% of women wait until after 35 to begin having children (www.ASRM.org). Consider that birth rates for women 35-39 and 40-44 years (which have risen steadily in recent years) each increased 2% in just one year, 2005 (CDC).
Why do these delays occur? Education and career, which are positive trends, are important factors in women’s decisions to delay marriage and motherhood. From 1970 to 2000, the percent of women having completed four or more years of college nearly tripled and the female labor force participation rate increased by 39% (CDC 12/11/02). The availability of contraception allows couples to delay childbearing while strengthening their relationship, establishing careers, and amassing enough assets to settle down for a secure and comfortable future. But how emotionally secure and financially comfortable are they going to be down the road? Will their marital bond be able to withstand the stress imposed by infertility, multiple births, and pre-term infants?
Infertility
The decision to delay comes with consequences that take their toll on spouses and society. The miscarriage rate (34%) is triple for women 40-44, compared to those ages 20-29 (10%). The risk of having a Down Syndrome child increases from one in 1250 for a 25 year old mother, to one in 30 for a 45-year-old mother (ASRM). Infertility, the next domino, affects 7.3 million people in the U.S., representing 12% of the women in the reproductive age population (CDC). A healthy 30 year old woman has a 20% chance each month to get pregnant; a healthy 40 year old woman has a 5% chance each month (ASRM). Secondary infertility, which can follow the birth of one or more biological children, is more prevalent than primary infertility. The emotional toll from the long-term inability to conceive a child can be devastating to spouses. Common feelings include: frustration, jealousy, anger, isolation, sadness and guilt. Self-image and self-confidence are affected as well.
Frequent visits to physicians interfere with careers and regardless of which spouse has the physical problems, most of the tests and treatments focus on the woman’s body. People typically assume that infertility is the woman’s fault and that adds to the stress (Abby, Andrews and Halman. Journal of Marriage and Family, May 1992). The financing of infertility treatments is considerable. Each in vitro fertilization cycle costs more than $12,000 with many couples requiring multiple cycles. The total cost for all types of fertility treatments exceeds $3 billion per year.
Remember when your child was young; you didn’t want to spoil her by giving her everything she asked for at the mall. But you knew which gift she really wanted and you waited for the right occasion to give it. Now, imagine your feelings of helplessness, when your adult child wants nothing in this world more than to parent a child. You can be supportive and optimistic, but there is no department store that sells what you wish you could buy.
Multiple Births
The huge number of couples undergoing fertility treatments has tipped another domino, multiple births. About 45% of Assisted Reproduction Techniques pregnancies result in twins and 7% in triplets or more (March of Dimes). The birth rate for twins in the U.S. rose steadily between 1990 and 2004, climbing an average of 3% annually for a total increase of 42% since 1990, and 70% since 1980. “Two related trends have been closely associated with the rise in multiple births over the last two decades: the older age at childbearing (women in their thirties are more likely than younger women to conceive multiples spontaneously) and the widening use of fertility therapies” (CDC 12/5/07).
Increased fetal risks include: higher chance of miscarriage, birth defects, and the mental/physical problems that can result from a premature delivery. Fetal mortality rates are higher for a number of groups, including: women who are 35 and over, unmarried women, and multiple deliveries. “Twins are 5 times and triplets are nearly 15 times more likely than singletons to die within a month of birth” (CDC 12/5/07). Maternal risks include high blood pressure, diabetes, and hemorrhaging”. Multiple gestation is associated with more depression, lack of sleep, financial difficulties, and marital discord (ASRM).
One method of reducing the risks is Multi-fetal Pregnancy Reduction. When there are four or more fetuses present, the number is reduced to one or two. This technique is used in an effort to increase the likelihood that the pregnancy will continue.
Remember when you taught your child decision-making, such as which friends she could invite for a sleepover or how she should spend her hard earned allowance. Did you imagine that one day you might be giving support to your child in her decision to proceed with multi-fetal pregnancy reduction?
Pre-Term Babies
More than half of twins are born pre-term and approximately half of twins and almost all higher order multiples start life with a low birth weight. Data from 2005 indicates the premature birth rate is continuing to rise, with more than 525,000 babies or 12.7% born prematurely (March of Dimes 12/5/07).
Preemies tend to encounter these difficulties: low birth weight, breathing problems, underdeveloped organs, risk of infection and risk of cerebral palsy (NICHD). Researchers, writing in the New England Journal of Medicine (1/17/02) concluded, “Very low birth weight participants had a lower mean IQ; educational disadvantage associated with very low birth weight persists into early adulthood.” And the emotional toll? Preemie families face a stressful new world. Parents may only enjoy a brief encounter with their baby before she is whisked away to the NICU for weeks, even months. And the financial toll? More than $26.2 billion per year. “Direct health care costs to employers for a premature baby average $41,610—15 times higher than the $2,830 for a healthy, full-term delivery. Additional costs to employers in lost productivity average $2,766” (March of Dimes, Cost to Business).
Remember when you taught your child patience, such as waiting for a mail-order gift to arrive or standing in line at Disney World. Now, imagine how you may need to give strength to your child as she waits patiently for her baby to come home after months in the NICU.
Caesarian Sections
The last domino is the soaring number of caesarian deliveries (1.25 million per year). The current c-section rate of 30.3 percent is triple the 10.4% c-section rate of 1975 (ACOG Stats and Facts 2007). Mothers of multiples are more likely to have c-sections and a growing number of doctors and patients are scheduling c-sections for their own convenience. The cost of a c-section ($13,441) is twice that of a vaginal delivery, with the national total exceeding $17 billion per year (ACOG). And the human price tag? Risks for mothers include: anesthesia, increased bleeding, chance of infection and blood clots in legs, pelvic organs, and lungs. Risks for the baby are inactivity from the anesthesia and possible breathing problems (March of Dimes).
Conclusion
The trends described above are not small blips on the radar screen; they are continents. They are years in the making and would take a major upheaval to reverse by even a percent or two. My real hope is that these trends will not continue to increase. I also hope that with the catastrophic divorce rate in the U.S. hovering at 50%, not one more marriage will succumb to the marital stress caused by these trends. But as long as parents are either too shy or too worried to put in their two cents, these emotionally devastating and costly trends may continue to surge.
Remember how it took courage to sit down with your pre-teen and explain the birds and the bees? Summon that courage again and tell your adult children your opinions on the importance of marriage and the timing of children.
Remember when your child was in grade school? You soccer moms and side-line dads, who ran yourselves ragged in your minivans because violin, astronomy, chess, swimming and painting weren’t enough—you also insisted that your child go to Math camp. Didn’t you believe that all the hyper-parenting was in your child’s best interest so that she would have the best chance to succeed in life? Do you want to see your adult child go through the frustration, pain and sometimes grief from the trends described above? And the possible negative consequences for your grandchild?
Final Thoughts
It is vital to remember the "context" that a parent would have this discussion with an adult child. You cannot just spring this topic on your grown child out of nowhere. You need to communicate and demonstrate the values of marriage and parenthood to tweens and teens, long before they are ready to be independent. Second, you have to convey to your grown children that you are willing to help them raise their children, to the extent that you are able. You cannot simply give lip service to the trends and consequences described here; you need to step up to the plate and offer your services and resources. Be willing to put your time, energy, and money where your mouth is, not only for the personal joy of bouncing a grandchild on your lap, but so your grandchildren can reap the benefits of significant contact hours with YOU....their grandparents. Don't you want to help your adult child start a family while you are young and have the energy and health to be helpful in addition to joyful? So please don't be cheap. Your offer to help your children financially in the early years of marriage can make all the difference in the world to a young couple who is determined to be self-sufficient. I’d like to change the rejoinder to open your mouth and open your wallet too.
When your newlyweds tell you they are in no hurry to start a family, will you be prepared to respond? Children do respect the opinions of their parents, and truly need to hear them.
Please comment on this column at DrAlanSinger@aol.com
Click here to see Dr. Singer's YouTube video on this column
Too many parents approach issues in their adult child’s life with the unspoken rejoinder, close your mouth and open your wallet. Parents often give no advice, even when they have serious concerns. Thirty years as a family therapist and 28 years as a father, have taught me that parents should voice their opinion to their adult child about two specific issues: getting married and not waiting numerous years before having children.
The Domino Effect
In recent years, the trend of delaying marriage has caused a domino effect on other trends which have a significant emotional cost for families and an enormous financial cost to society. The dominos are: delayed marriage—delayed childbearing—augmented infertility—elevated multiple births—increased rates of pre-term births and caesarian sections. My goal in this column is to describe these decisions to delay marriage and childbearing and the resulting consequences. I will offer some suggestions that parents might use in dealing with their adult child.
Of the 4.1 million births registered in the U.S. in 2005, 37 percent were born to unmarried women (CDC). Some of the reasons that couples cohabit include: convenience, economy of savings, preparation for the marriage commitment, and apprehension about the high divorce rate. But these couples are actually practicing non-commitment. Even if they eventually marry, they have less satisfying marriages and higher divorce rates than spouses who did not first live together (National Marriage Project). If the unmarried biological parents go their separate ways, where does that leave the children?
If I am perhaps describing your adult child, don’t you want the best possible family environment for your grandchild? Wouldn’t you consider voicing your opinion to your son or daughter, knowing the irrefutable research finding: the best environment to raise children is two biological parents in a low-conflict marriage? You might respond that you don’t want to “meddle” or times have changed and it’s not like the old days when parents spoke their minds. My response mirrors a recent mass e-mail: don’t be so open-minded that your brains fall out.
Adult Children Do Listen
Please don’t misunderstand me: Parents should not tell their grown child everything on their minds. But, in matters that are crucial for their well-being, they must speak up. My three decades of research into family size decisions have shown that adult children are aware of and appreciably influenced by the attitudes of their parents. One of my own survey research findings is the importance of family-of-origin family size as a predictor of total family size. The decisions our parents made about family size tend to have a significant impact on our own decisions.
In fact, reliance on the advice of parents has been described in the National Survey of Student Engagement (2007) which questioned 313,000 randomly selected college students. The survey revealed that young adults follow the advice of both parents more than twice as much as they listen to friends. So, if your son or daughter informs you that he/she wants to live together with a “significant other” for a few years, possibly even have a child or two, don’t respond with that 1960’s expression, do your own thing.
The First Two Dominos
Couples, who do choose to marry, are waiting longer to do so. According to the Census Bureau, between 1970 and 2000, the median age at first marriage for women increased by 4.3 years to 25.1 years; for men the increase was 3.6 years to 26.8.
In tandem with the later age at first marriage, is the decision to delay childbearing. The mean age of mothers in the U.S. was 24.6 in 1970 which increased to 27.2 in 2000 (CDC). Approximately 20% of women wait until after 35 to begin having children (www.ASRM.org). Consider that birth rates for women 35-39 and 40-44 years (which have risen steadily in recent years) each increased 2% in just one year, 2005 (CDC).
Why do these delays occur? Education and career, which are positive trends, are important factors in women’s decisions to delay marriage and motherhood. From 1970 to 2000, the percent of women having completed four or more years of college nearly tripled and the female labor force participation rate increased by 39% (CDC 12/11/02). The availability of contraception allows couples to delay childbearing while strengthening their relationship, establishing careers, and amassing enough assets to settle down for a secure and comfortable future. But how emotionally secure and financially comfortable are they going to be down the road? Will their marital bond be able to withstand the stress imposed by infertility, multiple births, and pre-term infants?
Infertility
The decision to delay comes with consequences that take their toll on spouses and society. The miscarriage rate (34%) is triple for women 40-44, compared to those ages 20-29 (10%). The risk of having a Down Syndrome child increases from one in 1250 for a 25 year old mother, to one in 30 for a 45-year-old mother (ASRM). Infertility, the next domino, affects 7.3 million people in the U.S., representing 12% of the women in the reproductive age population (CDC). A healthy 30 year old woman has a 20% chance each month to get pregnant; a healthy 40 year old woman has a 5% chance each month (ASRM). Secondary infertility, which can follow the birth of one or more biological children, is more prevalent than primary infertility. The emotional toll from the long-term inability to conceive a child can be devastating to spouses. Common feelings include: frustration, jealousy, anger, isolation, sadness and guilt. Self-image and self-confidence are affected as well.
Frequent visits to physicians interfere with careers and regardless of which spouse has the physical problems, most of the tests and treatments focus on the woman’s body. People typically assume that infertility is the woman’s fault and that adds to the stress (Abby, Andrews and Halman. Journal of Marriage and Family, May 1992). The financing of infertility treatments is considerable. Each in vitro fertilization cycle costs more than $12,000 with many couples requiring multiple cycles. The total cost for all types of fertility treatments exceeds $3 billion per year.
Remember when your child was young; you didn’t want to spoil her by giving her everything she asked for at the mall. But you knew which gift she really wanted and you waited for the right occasion to give it. Now, imagine your feelings of helplessness, when your adult child wants nothing in this world more than to parent a child. You can be supportive and optimistic, but there is no department store that sells what you wish you could buy.
Multiple Births
The huge number of couples undergoing fertility treatments has tipped another domino, multiple births. About 45% of Assisted Reproduction Techniques pregnancies result in twins and 7% in triplets or more (March of Dimes). The birth rate for twins in the U.S. rose steadily between 1990 and 2004, climbing an average of 3% annually for a total increase of 42% since 1990, and 70% since 1980. “Two related trends have been closely associated with the rise in multiple births over the last two decades: the older age at childbearing (women in their thirties are more likely than younger women to conceive multiples spontaneously) and the widening use of fertility therapies” (CDC 12/5/07).
Increased fetal risks include: higher chance of miscarriage, birth defects, and the mental/physical problems that can result from a premature delivery. Fetal mortality rates are higher for a number of groups, including: women who are 35 and over, unmarried women, and multiple deliveries. “Twins are 5 times and triplets are nearly 15 times more likely than singletons to die within a month of birth” (CDC 12/5/07). Maternal risks include high blood pressure, diabetes, and hemorrhaging”. Multiple gestation is associated with more depression, lack of sleep, financial difficulties, and marital discord (ASRM).
One method of reducing the risks is Multi-fetal Pregnancy Reduction. When there are four or more fetuses present, the number is reduced to one or two. This technique is used in an effort to increase the likelihood that the pregnancy will continue.
Remember when you taught your child decision-making, such as which friends she could invite for a sleepover or how she should spend her hard earned allowance. Did you imagine that one day you might be giving support to your child in her decision to proceed with multi-fetal pregnancy reduction?
Pre-Term Babies
More than half of twins are born pre-term and approximately half of twins and almost all higher order multiples start life with a low birth weight. Data from 2005 indicates the premature birth rate is continuing to rise, with more than 525,000 babies or 12.7% born prematurely (March of Dimes 12/5/07).
Preemies tend to encounter these difficulties: low birth weight, breathing problems, underdeveloped organs, risk of infection and risk of cerebral palsy (NICHD). Researchers, writing in the New England Journal of Medicine (1/17/02) concluded, “Very low birth weight participants had a lower mean IQ; educational disadvantage associated with very low birth weight persists into early adulthood.” And the emotional toll? Preemie families face a stressful new world. Parents may only enjoy a brief encounter with their baby before she is whisked away to the NICU for weeks, even months. And the financial toll? More than $26.2 billion per year. “Direct health care costs to employers for a premature baby average $41,610—15 times higher than the $2,830 for a healthy, full-term delivery. Additional costs to employers in lost productivity average $2,766” (March of Dimes, Cost to Business).
Remember when you taught your child patience, such as waiting for a mail-order gift to arrive or standing in line at Disney World. Now, imagine how you may need to give strength to your child as she waits patiently for her baby to come home after months in the NICU.
Caesarian Sections
The last domino is the soaring number of caesarian deliveries (1.25 million per year). The current c-section rate of 30.3 percent is triple the 10.4% c-section rate of 1975 (ACOG Stats and Facts 2007). Mothers of multiples are more likely to have c-sections and a growing number of doctors and patients are scheduling c-sections for their own convenience. The cost of a c-section ($13,441) is twice that of a vaginal delivery, with the national total exceeding $17 billion per year (ACOG). And the human price tag? Risks for mothers include: anesthesia, increased bleeding, chance of infection and blood clots in legs, pelvic organs, and lungs. Risks for the baby are inactivity from the anesthesia and possible breathing problems (March of Dimes).
Conclusion
The trends described above are not small blips on the radar screen; they are continents. They are years in the making and would take a major upheaval to reverse by even a percent or two. My real hope is that these trends will not continue to increase. I also hope that with the catastrophic divorce rate in the U.S. hovering at 50%, not one more marriage will succumb to the marital stress caused by these trends. But as long as parents are either too shy or too worried to put in their two cents, these emotionally devastating and costly trends may continue to surge.
Remember how it took courage to sit down with your pre-teen and explain the birds and the bees? Summon that courage again and tell your adult children your opinions on the importance of marriage and the timing of children.
Remember when your child was in grade school? You soccer moms and side-line dads, who ran yourselves ragged in your minivans because violin, astronomy, chess, swimming and painting weren’t enough—you also insisted that your child go to Math camp. Didn’t you believe that all the hyper-parenting was in your child’s best interest so that she would have the best chance to succeed in life? Do you want to see your adult child go through the frustration, pain and sometimes grief from the trends described above? And the possible negative consequences for your grandchild?
Final Thoughts
It is vital to remember the "context" that a parent would have this discussion with an adult child. You cannot just spring this topic on your grown child out of nowhere. You need to communicate and demonstrate the values of marriage and parenthood to tweens and teens, long before they are ready to be independent. Second, you have to convey to your grown children that you are willing to help them raise their children, to the extent that you are able. You cannot simply give lip service to the trends and consequences described here; you need to step up to the plate and offer your services and resources. Be willing to put your time, energy, and money where your mouth is, not only for the personal joy of bouncing a grandchild on your lap, but so your grandchildren can reap the benefits of significant contact hours with YOU....their grandparents. Don't you want to help your adult child start a family while you are young and have the energy and health to be helpful in addition to joyful? So please don't be cheap. Your offer to help your children financially in the early years of marriage can make all the difference in the world to a young couple who is determined to be self-sufficient. I’d like to change the rejoinder to open your mouth and open your wallet too.
When your newlyweds tell you they are in no hurry to start a family, will you be prepared to respond? Children do respect the opinions of their parents, and truly need to hear them.
Please comment on this column at DrAlanSinger@aol.com
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