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WMJ Vol. 118 No. 1: In This Issue

Children and Risk

 
Sarina Schrager, MD, MS, WMJ Associate Editor
 

 

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Taking a risk implies being exposed to some type of danger. A parent’s instinctive reaction is to protect their children from risk. From birth—when they are at risk of choking, to toddlerhood—when they are at risk of falling or running away, to adolescence—when they are at risk of making bad decisions or being bullied, parents want to help their children be safe. By protecting them, we feel like we are doing our duty as parents. We don’t want our children to suffer any pain or emotional hardship. However, the protection can become detrimental to a child’s development. The pejorative term “helicopter parent” describes a parent who is omnipresent and overbearing. These parents are overprotective and do not allow their child to experience any risk, which may backfire as the child grows up and does not have the skills to deal with adversity.

The backlash against overprotective parents is a movement among childhood development experts (many in Europe) of creating situations that expose children to limited risks for “an experience essential to childhood development, useful in building resilience.”¹ Playground designers in the United Kingdom have created play areas for children with “limited risks” that the children are allowed to experience, while at the same time not exposing them to any serious danger. These playgrounds have piles of bricks, wood boards that children can climb on, and some even have fire pits so that kids can experience burning things in a controlled environment. However, the idea that we can expose children to risks in a controlled environment seems to be a contradiction. Real risk implies real danger, not a scripted experience designed to give children the illusion of taking a chance.

Unfortunately, thousands of children in Wisconsin do not have the opportunity to be exposed to “limited risks,” as they are exposed to real risks. Almost 17% of children in Wisconsin live in poverty.² Children who live in poverty are exposed to real risks including gun violence, homelessness, and food insecurity.

Several papers in this issue discuss risks for children in Wisconsin. Christensen, et al describe prevalence of childhood lead poisoning.³ Exposure to high levels of lead can impair brain development and learning in small children. In 2016, over 4,000 children in Wisconsin were identified as having high lead levels. Lead has been in the news lately with the story of pervasively elevated lead in the water in Flint, Michigan, and significantly elevated levels in children who live in the area.⁴ This story was triggered by a local physician who noticed that lead levels in her patients were very high. She worked with the public health department to identify the source of the lead and to take measures to decrease exposure.

In another paper, Christensen, et al describe incidence of carbon monoxide exposure and poisoning between 2006 and 2016. During that time, over 3,700 people were exposed to carbon monoxide and over 2,100 were treated for carbon monoxide poisoning.⁵ High levels of carbon monoxide can occur in malfunctioning or old heating systems.

In addition to the environmental exposures that endanger children in Wisconsin, there are dangers that stem from adult behavior. A paper in this issue by Creswell, et al describes exposures to opioids among children in Wisconsin between 2002 and 2016.⁶ During this time period, there were over 3,300 calls to the poison control hotline and over 2,700 hospital encounters due to children or adolescents being exposed to opioids.⁶ The majority of these exposures were to prescription opioids, demonstrating a different kind of risk to children.

All of these papers demonstrate risks that Wisconsin children face. They also suggest opportunities for physicians to intervene and advocate for environmental safety. Physicians should engage in public debate regarding safe housing, water supply, and disposal of potentially harmful medications. Roald Dahl was talking about allowing children to take risks in their exploration of the world around them in order to help them navigate complicated situations as they age. However, there is a range of acceptable risks. Above and beyond that, society should attempt to protect its children.

References

1. Barry E. In Britain’s playgrounds, ‘bringing in risk’ to build resilience. New York Times. March 10, 2018.
2. Smeeding TM, Thornton KA. Wisconsin poverty report: progress against poverty stalls in 2016. Institute for research on poverty, University of Wisconsin-Madison. Published June 2018. Accessed April 9, 2019.
3. Christensen K, Coons MJ, Walsh RO, et al. Childhood lead poisoning in Wisconsin. WMJ. 118(1):252-256.
4. Ingraham C. This is how toxic Flint’s water really is. Washington Post. January 15, 2016.
5. Christensen GM, Creswell PD, Meiman JG. Carbon Monoxide Exposure and Poisoning Cases in Wisconsin, 2006–2016. WMJ. 118(1):257-262.
6. Creswell PD, Gibson C, Theobald J, Meiman JG. Exposures to opioids among Wisconsin children and adolescents, 2002–2016. WMJ. 118(1):245-251.