Paediatric cut-off questioned
An international research team is asking a deep question: when does childhood end?
Experts are charting age cut-offs for paediatric services around the world, after previous studies found that global health systems do not meet adolescents’ needs.
“Paediatricians are well placed to provide age-appropriate care to adolescents – especially if they are trained in adolescent medicine,” says Adolescent Health Professor at the Murdoch Children’s Research Institute and the University of Melbourne, Dr Susan Sawyer.
“The World Health Organization defines adolescents as aged being 10 to 19 years, however there’s been little research into the age of patients that paediatricians actually treat and how this varies across the world.”
The researchers developed an online survey to explore these questions and obtained responses from 1,372 paediatricians in 115 countries.
“There was a striking difference in the upper age by country and disappointingly only a handful of countries had a mean upper age of 19 years,” Dr Sawyer says.
“South Africa had the lowest upper age at 11.5 years, it seems paediatrics is yet to embrace adolescence. The US had the highest upper age, with 19.5 years.”
Despite similar health care systems, Australia’s mean upper age of paediatric care was 17.8 years while New Zealand’s was 15.6 years.
“The world mean is 17.4 years,” says Dr Sawyer.
“This average has increased over the past 20 years, rapidly in some countries.
“The discipline of paediatrics has historically focused on very young children, largely neglecting adolescents, but the pattern of disease across childhood and adolescence is changing. Public health interventions and medical advances have seen the mortality rate of young children fall dramatically.
“This is not mirrored in adolescents, whose more complex disease burden remains relatively unchanged. The World Health Organization estimates that more than one million adolescents die every year.
“Young people face childhood and adult health burdens, including chronic physical conditions like diabetes and asthma, mental health disorders, anaemia, rising levels of obesity, interpersonal violence, diarrheal and bronchial illnesses, drug and alcohol abuse, sexually transmitted disease and road trauma.”