Medicine And Books

Community Child Health and Paediatrics

BMJ 1995; 311 doi: (Published 25 November 1995) Cite this as: BMJ 1995;311:1445
  1. Stephen Jarvis, Donald Court professor of community child health,
  2. Mark Bagott, senior registrar in community child health
  1. University of Newcastle
  2. Gateshead

    David Harvey, Marion Miles, Diane Smyth Butterworth-Heinemann, £125, pp 705 ISBN 0 7506 1323 8

    Community Child Health and Paediatrics deals with a neglected topic: the specialised health needs of children that are the core elements of community child health practice. This does not include hospital treatment--the editors deliberately omit those “items which relate to the care of acutely ill children”--or the treatment of children in general practice.

    These core elements are the epidemiological techniques to describe and investigate population health; the delivery and monitoring of primary and secondary prevention; surveillance of growth and development and screening for preclinical conditions; the provision of health services for children in need of protection; and the clinical management of children with long term physical and psychological health problems. Lastly, there is an admirable summary of the contributions of various agencies concerned in child health care in the community.

    The quality of the contributions, though high, is occasionally variable: the chapter on screening is a model of clarity and insight, but the contribution on growth and puberty is too strongly hospital biased, and that on the environment and child health takes a slightly narrow view, choosing to ignore the important threat to children's health from road traffic; nowhere in the book is there any concerted attempt to draw together the evidence and hypotheses concerning the effects of social deprivation on future and current child health. This is surely a serious omission. Furthermore, there is no account of the implications of redrawing the hospital-community boundary as suggested by the proponents of ambulatory care.

    At a time both of considerable destructive disruption and of opportunities for development in community child health services, the book is a timely and readable attempt to define the breadth of health needs, the relatively undeveloped scientific base, and the various services that characterise current community child health. No other single publication encompasses all this, and we certainly intend to keep a copy to hand.

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