Status of injuries as a public health burden among children and adolescents in China: A systematic review and meta-analysis

The Pediatrician Workforce in the United States and China

From 2019 to 2022, the For Our Children project gathered a team of Chinese and American pediatricians to explore the readiness of the pediatric workforce in each country to address pressing child health concerns. The teams compared existing data on child health outcomes, the pediatric workforce, and education and combined qualitative and quantitative comparisons centered on themes of effective health care delivery outlined in the World Health Organization Workforce 2030 Report. This article describes key findings about pediatric workload, career satisfaction, and systems to assure competency. We discuss pediatrician accessibility, including geographic distribution, practice locations, trends in pediatric hospitalizations, and payment mechanisms. Pediatric roles differed in the context of each country's child health systems and varied teams. We identified strengths we could learn from one another, such as the US Medical Home Model with continuity of care and robust numbers of skilled clinicians working alongside pediatricians, as well as China's Maternal Child Health system with broad community accessibility and health workers who provide preventive care.In both countries, notable inequities in child health outcomes, evolving epidemiology, and increasing complexity of care require new approaches to the pediatric workforce and education. Although child health systems in the United States and China have significant differences, in both countries, a way forward is to develop a more inclusive and broad view of the child health team to provide truly integrated care that reaches every child. Training competencies must evolve with changing epidemiology as well as changing health system structures and pediatrician roles.

Association Between Violent Discipline at Home and Risk of Illness and Injury in Children: Findings From a Cross-sectional Study in Rural Western China

To estimate the prevalence of violent discipline at home against young children, and to explore the potential association between violent discipline at home and multifaceted health risks in children. A community-based cross-sectional survey was conducted in twenty rural counties of weight provinces in western China. The information about child neglect and socio-demographic factors, exposure to different forms of violent discipline at home and four health outcomes was collected by face-to-face interview. Before analysis, the included interviews were weighted by the double-weighted comprehensive weighting. The proportion of children reported by primary caregivers to have experienced different forms of violent discipline by gender were calculated. To adjust the clustering effect of the survey design, two-level univariate and multivariate logistic regression models were constructed to evaluate the potential association between a child's exposure to violent discipline at home and risk of suffering from diarrhea, fever, cough and injury. A total of 3,682 weighted interviews were finally included in the analysis. The prevalence of any violent discipline, psychological aggression, any physical punishment and severe physical punishment were 76.4%, 57.5%, 68.3% and 14.1%, respectively. In multivariate analysis, after adjusting for clustering, there was still a positive association between a child's exposure to psychological aggression and risk of diarrhea (adjusted OR: 1.47, 95%CI: 1.14-1.90) and injury (adjusted OR: 1.95, 95%CI: 1.36-2.80); a child's exposure to any physical punishment and risk of diarrhea (adjusted OR: 1.36, 95%CI: 1.04-1.77), cough (adjusted OR: 1.37, 95%CI: 1.14-1.66), and injury (adjusted OR: 2.05, 95%CI: 1.37-3.06); and a child's exposure to severe physical punishment and risk of injury (adjusted OR: 2.07, 95%CI: 1.41-3.05). Considering that using violent discipline at home is prevalent in rural western China, and it could threaten young children's health, effective measures to prevent young children from violent discipline are urgently needed.