from Prof. Michael Crawford
My professional concern about Government is the inequality of health and child poverty about which much time has been spent on pushing through legislation on "Child Poverty".
There is no such thing as child poverty without there being maternal poverty and almost certainly poverty of the father.
People are using their emotions not logic. The image of the child engenders emotions which lead to remedial and educational programmes in large measure. This is closing the stable door after the horse has bolted.
As well as being President of the McCarrison Society, I am a trustee of the Mother and Child Foundation. At an inaugural conference held at the Royal Society of Medicine in 1990, Dr Mark Belsey, then Director of Maternal and Child Health at WHO in Geneva, said:
"The interest of the child is served by many institutions from UNICEF to Save the Children Fund, the ubiquitous Institutes of Child Health and many other organizations. -- But -- there is no voice for the mother!".
Negect and lack of guidance during puberty and in pregnancy can lead to multiple nutrient deficits, as we have seen in the East End of London. These threaten the mother, in terms of both her physical and mental health. Pregnancy-induced diabetes is on the rise, as is maternal depression and anaemia. In developing countries, the neglect is life threatening. (see www.mother-and-child.org)
As far as the child is concerned, his or her capability at school and potential for jobs is decided before birth, as the bulk of brain division and its capacity is built early in pregnancy. Moreover, brain development is dependent on maternal health and nutrition.
Low birthweight and fetal malnutrition is the strongest predictor of diabetes, heart disease and stroke, as well as poor attention and performance at school, and behavioural pathology (1)..
The incidence of low birthweight was 6.6% in England in 1953; for the UK, as a whole, 6.6% in 1973; and 7.6% in 2002. UNICEF put it at 8% in 2005. Despite all the advances in medicine and science, of which we are proud, the strongest predictors of physical and mental ill health was actually increased in the UK. It is the worst in Western Europe and nearly twice that of the Scandinavian countries, and about the same as Romania.
These figures demonstrate the blind spot and lack of logic in addressing poverty and inequality at its roots. Poor maternal health and nutrition can be seen at school with no teaching on the subject. In a study we did in Hackney schools, nearly a third of the girls, at puberty, were deficient in iron, a key nutrient for a successful pregnancy (2). As a follow up, we found pregnant women in Hackney were seriously deficient of many micro-nutrients (3,4).
Out of these figures comes the adverse impact of this neglect on the health of the mother, both physical and mental. You may have seen the BBC London news item (on 23rd Apr 2010) when the results of our recent study showed the appalling state of maternal nutrition in the East End, but that attention to nutrition can reduce the number of babies born small for gestational age, the highest risk factor (5).
Poor maternal nutrition and health leads to a stunting of health and brain capability of the new born, who grows up to repeat the process, resulting in a cycle of deprivation (6).
This elementary fact has been ignored by successive governments, despite being informed of the issue by many of those professionally concerned.
What can you do?
There needs to be new initiative in education where we can empower children with knowledge, and a new paradigm in maternity services to inform and assist women in pregnancy about these matters, especially in the most vulnerable people, which are usually those in inner cities.
Why we should worry?
An added reason for this concern is the fact that brain disorders have now overtaken all other burdens of ill health. In the EU, the audit revealed a cost of €386 billion. In the UK, where we have had questions asked in the Upper House, the cost in 2007 was £77billion, greater than heart disease and cancer combined. Many of us attribute this rise to preventable adverse nutrition, especially of young girls and women during puberty and pregnancy, for which there is good evidence specific to the brain. Moreover, people at the National Institutes of Health in the USA estimate that the greatest rise is in children.
No party, thus far, has remotely addressed this issue, which is of a most serious nature. In a 1972 publication, I predicted the rise in brain disorders, unless attention was given to the brain specific essential fats in the food chain. There is a common nutritional factor here in the fats required by the brain and arteries and heart. However, the brain is better protected, as it is defined in the womb. Thus there is a time lag between the arteries and brain being affected by bad diets. If brain disorders continue to rise this century, as heart disease did last, then we are looking at the worst social and health threat ever.
(1) Black D, Morris J, Smith C, Townsend P. Inequalities in health: report of a Research Working Group. London: Department of Health and Social Security, 1980
(2) Doyle, W., Jenkins, S., Crawford, M.A., Puvandendran, K. (1994) Nutritional status of schoolchildren in an inner city area. Arch. Dis. Child. 70: 376‑381.
(3) Doyle, W., Crawford, M.A., Wynn, A.H.A. and Wynn, S.W. (1989) Maternal Nutrient Intake and Birth Weight. J. Hum. Nutr. and Diet. 2: 407 ‑ 414.
(4) Wynn, S.W., Wynn, A.H.A., Doyle, W. and Crawford, M.A. (1994) The association of maternal social class with maternal diet and the dimensions of babies in a population of London Women. Nutr. Health 9: 303‑315
(6) Birch HG & Gussow JD “Disadvantaged Children” 1970 Harcourt, Brace & World Inc. NY.