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NIH Neglect revealed

 

In September, the prestigious journal JAMA Pediatrics published and editorialized about a comprehensive study reviewing NIH funding for pediatric diseases: "Correlation Between National Institutes of Health Funding for Pediatric Research and Pediatric Disease Burden in the US," by  Rees, et al. (doi:10.1001/jamapediatrics.2021.3360.) Its goal was to determine the correlation between NIH funding and disease burden for pediatric conditions.The study analyzed 14 060 disease-specific pediatric grants awarded by the NIH
from 2015 to 2018 in the US. Funding for pediatric research was correlated with pediatric disability-adjusted life-years (DALYs), deaths, years lived with disability, and years of life lost. They analyzed 157 disease conditions, including some mental illness diagnoses. They noted "There was substantial overfunding and underfunding of certain conditions."

However, no where in the article or in their classification of disease states was any mention made of child abuse or neglect trauma. In fact, for the past 50 years NIH has continuously and repeatedly underfunded research into child maltreatment and associated harms. This prompted our protest to the Editor which was published December 28:


National Institutes of Health Funding Priorities
To the Editor

The analysis by Rees et al1 and the accompanying Editorial provide a valuable and insightful evaluation of crucial current pediatric research priorities and policies. While the
lists of diseases (Figures 1, 2, and 3) included some mental health morbidities (eg, bipolar disorder, self-harm, and anxiety and depressive disorders), and the Editorial noted omission of the challenge of β€œfactoring in determinants of cognitive,behavioral, and physical health outcomes for children that are not captured in disorder categories,”neither publication explicitly mentioned existing or needed research into the pediatric
pandemic of child maltreatment or the importance of childhood trauma and adversity in the development of mental and physical disease and behavioral morbidities (eg, domestic
violence, homelessness, criminality, mass shootings, and unemployment) across the life course. Existing research has documented changes in genetic, epigenetic, neuroanatomic,
neuroendocrine, immunologic, and inflammatory systems associated with child maltreatment, discovering possible pathophysiologic mechanisms, but much more research is necessary to prove that these changes directly cause or mediate specific disease states. The NIH's deemphasis on funding for child maltreatment research
for several decades has hindered an entire generation of career scientists who might have contributed some important knowledge on child maltreatment, identification, treatment, prevention, etc. While increasing attention ($51 million in NIH grants to child maltreatment in 2021, (in addition to some National Institute of Mental Health funding) is being
given to the pathological effects of adverse childhood experiences, trauma, and stresses, and increasing associations are being made with a panoply of childhood and adult pathologies, research into pathophysiological mechanisms warrant more investigation. As advocates for research into a pathology that does not yet have patient or family media advocacy organizations, we recognize it is very difficult to take resources away from well-funded problems with well developed constituencies or to garner new resources. In addition to the disparities documented in these publications, it is urgent to recognize the need for research into this pediatric pandemic, as the morbidity and mortality associated with child maltreatment are on par with those associated with pediatric cancer and heart disease.
Jeoffry B. Gordon,MD,MPH; David Corwin, MD

The letter speaks for itself. PACEsConnection is in a position to advocate in the public square like the March of Dimes, or the Jimmy Fund, St Jude's or ACTUP for redress in this matter. The original articles are attached.

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Since so much of our lifelong health comes from our childhood experiences, childhood mental health-care should generate as much societal concern and government funding as does physical health, even though psychological illness/dysfunction typically is not immediately visually observable. Also, if society is to avoid the most dreaded, invasive and reactive means of intervention β€” that of governmental forced removal of children from dysfunctional/abusive home environments β€” maybe we then should be willing to try an unconventional proactive means of preventing some future dysfunctional/abusive family situations.

Being free nations, society cannot prevent anyone from bearing children; society can, however, educate all young people for the most important job ever, even those high-schoolers who plan to always remain childless. One can imagine that greater factual knowledge of what exactly entails raising and nurturing a fully sentient child/consciousness in this messed-up world β€” therefore the immense importance and often overwhelming responsibility of proper rearing β€” would probably make a student less likely to willfully procreate as adults.

But due to the Only If It’s In My Own Back Yard mindset, the prevailing collective attitude, however implicit or subconscious, basically follows: β€˜Why should I care β€” my kids are alright?’ or β€˜What is in it for me, the taxpayer, if I support programs for other people’s troubled families?’ While some may justify it as a normal thus moral human evolutionary function, the self-serving OIIIMOBY can debilitate social progress, even when social progress is most needed; and it seems that distinct form of societal penny wisdom but pound foolishness is a very unfortunate human characteristic that’s likely with us to stay.

The following quoted text was taken from the findings of a study: β€œThe future of any society depends on its ability to foster the health and well-being of the next generation. Stated simply, today’s children will become tomorrow’s citizens, workers, and parents. When we invest wisely in children and families, the next generation will pay that back through a lifetime of productivity and responsible citizenship. When we fail to provide children with what they need to build a strong foundation for healthy and productive lives, we put our future prosperity and security at risk …

All aspects of adult human capital, from work force skills to cooperative and lawful behavior, build on capacities that are developed during childhood, beginning at birth … The basic principles of neuroscience and the process of human skill formation indicate that early intervention for the most vulnerable children will generate the greatest payback” [The Science of Early Childhood Development].

In the study's report’s 13-page entirety, the term β€œinvestment(s)” was used 22 times, β€œreturn” appeared eight times, β€œcost(s)” five times, β€œcapital” appeared on four occasions, and either β€œpay”/β€œpayback”/β€œpay that back” was used five times. While some may justify it as a normal thus moral human evolutionary function, the self-serving OIIIMOBY can debilitate social progress, even when social progress is most needed; and it seems that distinct form of societal penny wisdom but pound foolishness is a very unfortunate human characteristic that’s likely with us to stay.

Due to the OIIIMOBY mindset, the prevailing collective attitude, however implicit or subconscious, basically follows, β€œWhy should I careβ€”I’m soundly raising my kid?” or β€œWhat’s in it for me, the taxpayer, if I support child development education and health programs for the sake of other people’s troubled families and bad parenting?” Meantime, too many people procreate regardless of their (in)capacity to raise children in a psychologically sound manner, according to child-development science; and consequential dysfunctional parenting occurs considerably more often than what is officially known thus acknowledged.

Thanks for the comment. Well said, a good contribution to the discussion. My intuition is that family life is better in Canada (I know a bit about the issue as a good friend had a career in BC as a social worker,) No society is perfect. My discussion about the NIH makes explicit the fact that common culture, values, and beliefs get magnified and institutionalized with the distortion of public policy.

Aside from the issues raised in my post it is becoming more and more explicit that social policy and family support in the United States is greatly  impaired by our original sin of slavery and the political racism which continues to withhold the societal foundations for family security from all impoverished citizens. Personally I think our "rugged individualism" is a meme fostered by mercantile corporations to deter attention to their natural exploitative behavior. Such factors are present but much less toxic in Canada. Meanwhile, we must continue the struggle to save a few souls, to garner more resources and to sway the body  politic.

Since so much of our lifelong health comes from our childhood experiences, childhood mental health-care should generate as much societal concern and government funding as does physical health, even though psychological illness/dysfunction typically is not immediately visually observable. Also, if society is to avoid the most dreaded, invasive and reactive means of intervention β€” that of governmental forced removal of children from dysfunctional/abusive home environments β€” maybe we then should be willing to try an unconventional proactive means of preventing some future dysfunctional/abusive family situations.

Being free nations, society cannot prevent anyone from bearing children; society can, however, educate all young people for the most important job ever, even those high-schoolers who plan to always remain childless. One can imagine that greater factual knowledge of what exactly entails raising and nurturing a fully sentient child/consciousness in this messed-up world β€” therefore the immense importance and often overwhelming responsibility of proper rearing β€” would probably make a student less likely to willfully procreate as adults.

But due to the Only If It’s In My Own Back Yard mindset, the prevailing collective attitude, however implicit or subconscious, basically follows: β€˜Why should I care β€” my kids are alright?’ or β€˜What is in it for me, the taxpayer, if I support programs for other people’s troubled families?’ While some may justify it as a normal thus moral human evolutionary function, the self-serving OIIIMOBY can debilitate social progress, even when social progress is most needed; and it seems that distinct form of societal penny wisdom but pound foolishness is a very unfortunate human characteristic that’s likely with us to stay.

The following quoted text was taken from the findings of a study: β€œThe future of any society depends on its ability to foster the health and well-being of the next generation. Stated simply, today’s children will become tomorrow’s citizens, workers, and parents. When we invest wisely in children and families, the next generation will pay that back through a lifetime of productivity and responsible citizenship. When we fail to provide children with what they need to build a strong foundation for healthy and productive lives, we put our future prosperity and security at risk …

All aspects of adult human capital, from work force skills to cooperative and lawful behavior, build on capacities that are developed during childhood, beginning at birth … The basic principles of neuroscience and the process of human skill formation indicate that early intervention for the most vulnerable children will generate the greatest payback” [The Science of Early Childhood Development].

In the study's report’s 13-page entirety, the term β€œinvestment(s)” was used 22 times, β€œreturn” appeared eight times, β€œcost(s)” five times, β€œcapital” appeared on four occasions, and either β€œpay”/β€œpayback”/β€œpay that back” was used five times. While some may justify it as a normal thus moral human evolutionary function, the self-serving OIIIMOBY can debilitate social progress, even when social progress is most needed; and it seems that distinct form of societal penny wisdom but pound foolishness is a very unfortunate human characteristic that’s likely with us to stay.

Due to the OIIIMOBY mindset, the prevailing collective attitude, however implicit or subconscious, basically follows, β€œWhy should I careβ€”I’m soundly raising my kid?” or β€œWhat’s in it for me, the taxpayer, if I support child development education and health programs for the sake of other people’s troubled families and bad parenting?” Meantime, too many people procreate regardless of their (in)capacity to raise children in a psychologically sound manner, according to child-development science; and consequential dysfunctional parenting occurs considerably more often than what is officially known thus acknowledged.

Thank you for posting this, Dr. Gordon. It is a stunning revelation yet not a surprise.

Others, too, can use the PACEs Connection social media platform (use the icons below this post to share the article to LinkedIn, Facebook, Twitter, Pinterest, Reddit, or to copy and paste the link into emails) to share it widely.

Thank you for making the information available to an audience that cares, and for sharing supporting materials.

Please keep us posted on any response you receive, or other actions taken? This looks to me as though it merits congressional oversight. I am wishing the late Elijah Cummings were here to delve into this.  

Thank you again,

Carey Sipp

SE Regional Community Facilitator

PACEs Connection

csipp@pacesconnection.com

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