Growing Up in Crisis
INTRODUCTION
This report is not intended to alarm, but to put the child to old age health trajectory into the context of planetary dysregulation and its secondary effects. Currently, children are experiencing multiple stressors or pathways of poor health; forced displacement, family separation, pollution of water, land, and air, acute weather events, malnutrition, poverty, and a global pandemic that is causing long term effects (source, source, source).
"growing up in a world of crises means growing up under conditions that impair health and development, not only in the short-term but over the whole life course.”
SCENE SETTING
One could argue that ‘children growing up in crisis’ is not new: there always have been crises. This, of course, is true, and by no means do we want to downplay past and ever-existing crises, such as conflict and war, or poverty.
Yet, it seems that, right now, several global crises are clashing, affecting the whole world's child population. Moreover, some of the long-standing crises are getting worse. For example, globally, environmental pollution (i.e., pollution of the air, the water, and the soil) is getting worse (source), negatively affecting both human health and the health of the planet.
Further, the number of children who are forcibly displaced (e.g., due to conflicts or disasters) is at a peak and further increasing, with over 30 million children worldwide forcibly displaced in 2020 (source).
Adding to the severity of today’s global crises is that they not only happen at the same time but also aggravate each other. For example, pandemic, war, and climate change have all increased levels of global poverty, one of the most detrimental, long-standing crises in the world (source).
INITIAL QUESTIONS & THOUGHTS
We should consider how we better support childhood health in order to create a healthy adulthood.
As time moves forward the planetary dysregulation will get worse, especially, as governments continue to ignore it. How will this affect the childhood to old age health trajectory?
We should consider how the types of childhoods relate to geriatric health (dementia, diabetes, cardiovascular diseases, Parkinson’s disease).
What is happening to our planet is creating an acute childhood health crisis, how does healthcare need to evolve in response?
PATHWAYS TO POOR HEALTH IN CONTEXT TO THE PLANETARY DYSREGULATION
Here we briefly identify the various pathways of stress or trauma that can lead to poor health outcomes in children. They relate directly to planetary dysregulation or its secondary effects. Planetary dysregulation is the impaired ability of planetary systems to maintain the processes required for self-regulation, particularly due to unsustainable exploitation of ecosystems and chronic exposure to industrial contamination. Planetary dysregulation can contribute to loss of habitats, food shortages, and experiencing acute weather events, and being at continual risk for pathogens.
The identification of these pathways is to illustrate the multiple stressors and trauma affecting children.
Secondly, as planetary dysregulation continues without systemic intervention, the threat to children’s health will continue to rise. It seems redundant to say, but we should prioritise the health of children as they are our future ancestors, who have imaginations and futures to fulfil.
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In 2020 9.8 million children were displaced due to acute weather events. This means that children will lose community, face family separation, be forced into long and violent refugee journeys, face poverty and food deprivation (source).
Childhood Health Risks
The refugee journey presents various points of trauma that can lead children to developing a myriad of long term mental health issues. They are often faced together - such as sleep disorders, depression, complex PTSD, and anxiety (source).
Family separation is experienced due to immoral immigration policies and lack of support for displaced peoples. It is an acute trauma with life long consequences. Due to the dysregulation of the stress response, family separation can lead to a wide range of diseases from diabetes, cardiovascular diseases, respiratory complications, and obesity.
Losing community, poverty, and food insecurity all present various forms of stress on the mind and body, which can dysregulate the stress response and in turn change the function of the endocrine, immune, and digestive systems.
Considerations
Various countries around the world will need to take child refugees and so far there are no systemic health care systems or practices to support the mental and physical health of these children.
Ensuring that the forced displacement journey is humane will require multiple government collaboration.
How will the ageing trajectory be for children facing displacement? Will life expectancy change? Will it put them more at risk for poor geriatric health?
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Food production is under threat due to floods, hurricanes, heat disrupting soil quality, drought etc. In turn this will make food more scarce and more expensive. When this is combined with low wages, it creates a food crisis. In the UK 15% of households with children reported food insecurity between January–July 202. By 2050 it is estimated that 25 million children will experience food deprivation world wide.
Childhood Health Risks
Food deprivation has a full system effect in children. It affects brain, muscle, digestive, endocrine, immune, and reproductive function (source).
In turn this can lead to a wide range of diseases that can last a lifetime.
There is increasing research linking childhood malnutrition to dementia later in life (source).
Considerations
Prioritising and safeguarding local food systems.
Funding for systemic and multi-connected food banks and community kitchens.
Specialised medical care that concentrates on treating the health effects of malnutritionon
Due to its colonialism debt and continual imperialism of countries like the UK and United States, they should be at the forefront of supporting global food supply chains. This includes funding research on new growing methods, land restoration, honouring Indigenous Land treaties, and supporting Indigenous Land Back processes.
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The costs of everyday essentials are rising faster than average household incomes. The rise in costs is measured by inflation (source). Higher costs affect all people, but, of course, those already living in (deep) poverty are affected most (source). The cost-of-living crisis means that ever-more families cannot afford everyday essentials (e.g., a nutritious meal or electricity).
Childhood Health Risks
The poverty landscape creates various opportunities for experiencing trauma and stress. Without proper support, this can lead to a dysregulation of the stress response, which can lead to a wide range of diseases (source).
Considerations
Solidarity and active support of worker unions that are asking for fair wages.
Policies that protect worker rights.
The abolition of capitalism as it requires system poverty in order to survive.
Policies that support quality of life rather than the generation of capital.
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As planetary dysregulation continue so will discrimination and oppressions. Who has access to food, shelter, and basic human needs will be those that are supported by the supremacy culture. Discrimination based on race, gender, sexuality, and class will become more acute. (source)
Childhood Health Risks
Discrimination and oppression of any kind ostracises and alienates people. There are mental health consequences through the pathways of loneliness, violence, and exemption from life supporting resources. There is robust research that links discrimination and oppression to PTSD, depression, obesity, and general unwellness.
Considerations
Reframing of discrimination of any kind be it racism, mysognoy, transphobia, etc as a health risk for children and their families.
Including discrimination and oppression in health assessments for children.
Put funding to structurally dismantle supremacy.
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The contamination of our ecosystems (the soil, the water, and the air) due to air, noise, heat, and light pollution. Pollution does not only affect health and development directly but also the rest of the planet, thereby causing planetary dysregulation (source).
Childhood Health Risks
All pollutants present a load to our stress response, which can be a pathway to various mental and physical diseases (source). Children are especially vulnerable as they can spend a lifetime in a polluted environment, meaning that their bodies are polluted in many cases from the womb. This can cause acute health consequences from poor brain development, cardiovascular diseases, childhood diabetes and obesity, to depression, anxiety, and psychosis. For example, air pollution is responsible for the deaths of 1.7 million children. It can also put the child at risk of developing dementia later in life. (source, source, source, source)
Considerations
Policies that support health rather than capital advancement.
Health practitioners should factor pollution exposure into child developmental and health assessments.
Build homes, schools, and play areas away from polluted areas.
Consider how growing up in polluted environments affects health in adulthood and old age.
Create zero tolerance policies to stop industrial polluters.
Shift our societal mindset that tolerates pollution over health for the sake of “progress”.
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A global pandemic that started in 2019 and is ongoing. To this day, hundreds of millions of people have been infected and millions have died. Many will suffer long-term health problems. The pandemic also has a dramatic effect on children’s everyday lives, in particular, education, and social life, family dynamics, and exacerbating existing structural inequities (source).
Childhood Health Risks
There are three pathways to consider. The first is social, children’s interaction with peers and family have drastically changed due to lockdown and the financial burden of the pandemic. This has contributed to cognitive changes, as well as loneliness, depression, and anxiety. The second pathway is through long covid, which could change mental and physical development. Finally, there is multi-systemic inflammation syndrome, which has been associated with Covid-19. It affects various body parts that can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs (source).
Considerations
Specialised health units for children with long covid and multi-systemic inflammation syndrome (MIS).
Future funding to study how long covid and MIS affects childhood development, adulthood, and geriatric health of this generation.
Financial provisions for children with life long post covid health issues.
We should consider what type of healthcare system is needed to support a generation facing multiple primary and secondary health issues due to Covid.
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Planetary dysregulation is changing climatic systems, which is creating the conditions for more frequent acute weather events. These can range from heat waves, winter storms, to flooding, tsunamis, hurricanes, and earthquakes.
Childhood Health Risks
When acute weather is met with poor housing, little to no economic resources, and discrimination, it creates an ecosystem of multiple stressors and traumas. For example, a heat wave in an urban neighbourhood with little shade can make a home very hot. Additionally, if the home has no insulation, poor ventilation, and no cooling infrastructure, it will remain hot. In turn the extreme heat can cause physiological stress in the body, contribute to cardiovascular and respiratory difficulties, and in some cases it can cause heat stroke which can lead to death and long term damage.
Considerations
We need to reframe housing from asset to health care. The home is a crucial piece of infrastructure that when done well can help keep families together, shelter them from acute weather, and provide a space for safety and healing. This has to be offered to everyone, which is why it cannot be a capital asset.
Healthcare services specialising in the traumas, diseases, and illnesses related to experiencing acute weather events. We need to know more about the health consequences for children and how these childhood experiences will affect their future health.
"It seems redundant to say, but we should prioritise the health of children as they are our future ancestors, who have imaginations and futures to fulfil.”
THE EMOTIONAL & PSYCHOLOGICAL EXPERIENCE
Above, we provided a list of potential threats associated with growing up in a world of crises (e.g., malnutrition, loss of family, and experience of violence), taking a toll on children’s development and health. However, probably one of the most detrimental consequences of growing up in crisis is the experience of emotional and psychological trauma.
The American Psychological Association defines trauma as ‘an emotional response to a terrible event’ (source). Similarly, The International Society for Traumatic Stress Studies defines trauma as ‘negative events that are emotionally painful and that overwhelm a person’s ability to cope’ (source). All the global crises mentioned above (and their associated threats) can be traumatic events (e.g., experiencing violence, losing a family member, or seeing your home destroyed by a hurricane).
Emotional, physical, and cognitive reactions to a traumatic event are varied and include anxiety, sleep problems, sadness, concentration problems, and anger (source, source). Reactions vary between individuals: some are resistant and do not experience any symptoms after a traumatic event, and some are resilient and recover from their symptoms over time. However, some do not recover and experience persistent post-traumatic stress, sometimes to the extent of a post-traumatic stress disorder (PTSD) or complex PTSD (CPTSD). CPTSD describes a combination of PTSD symptoms and other symptoms, such as difficulties in emotion regulation or physical symptoms (source, source, source).
Many factors play a role in children’s resilience to traumatic events, including individual- and family-level factors but also more systemic factors, such as poverty and racism (source). A risk factor for not recovering well and experiencing post-traumatic stress is the experience of multiple and/or continuous traumatic events (source). We can infer from this that the more global crises children experience at the same time – and continuously – the higher their risk of developing post-traumatic stress.
To summarise, growing up in a world of crises means growing up under conditions that impair health and development, not only in the short-term but over the whole life course. Depending on the type of crisis, the associated traumatic event, and individual, family, and contextual factors, children’s health and development will be affected in different ways. However, in any case, their systems will be deprived of something essential (e.g., nutrition) and/or will be affected negatively by environmental stressors (e.g., pollution), meaning that the development of their bodies and their brains will be impaired. This, in turn, is a problem in the short-term but also has long-term consequences for health over the life course. In addition to these more ‘direct’ effects of a crisis or traumatic event, there is the experience of emotional and psychological trauma. Some, but not all, children recover from trauma. Those children who do not recover, will experience prolonged post-traumatic stress, maybe even to the extent of PTSD or CPTSD.
CONSIDERATIONS FOR A SUPPORTIVE & HEALING SYSTEM FOR YOUNG PEOPLE
Children need safe, stimulating, and nourishing environments to develop and grow up healthy. Each child has their own specific needs, but all children share basic needs that are essential for healthy development. There are enough resources to be able to provide the right healthcare for all children, we simply have to prioritise them.
Understanding how planetary dysregulation affects childhood development and health can also help us understand their health needs as they age.
If we want to avoid poor health in geriatrics, we have to start by reducing health risks in childhood.
We need more funding and structure to understand how to better support children that are experiencing complex trauma due to displacement, Indigenous discrimination, and harsh migration journies.
The healthcare ecosystem for children under planetary dysregulation should include;
the dismantling of borders
humane and just immigration policies
proper housing
weather resistant infrastructure
reliable food supply chains
Equitable access to nourishing food
anti-pollution policies
environmental justice.
Support of Indigenous Land Rights and Knowledges
We need specialised research to develop healing strategies and practices for children experiencing multiple and complex traumas.
What happens in childhood can be healed with a specialised and robust healthcare ecosystem.
Indigenous and non-western healing practices should be consulted in healthcare strategies that focus on refugee children.
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