IN THIS ISSUE
Fun months can carry big risks
Easing road risks for mobile youngsters
Keeping kids safe around water
A primer on sun, heat and biting bugs
Some constructive responses when kids say ‘I’m bored’
Put food hygiene on menu for a healthier summer
To avoid medical bill shock, plan and prepare, just in case
BY THE NUMBERS
15%
May 30-Sept. 1 increase in deadly teen driver crashes, compared to other seasons
2.4 million
Emergency room visits by children 14 and younger in a typical summer
3 per day
Children who die from drowning, a leading cause of of injury death for Americans younger than 14.
15 minutes
Shortest time in which youngsters, even in shade, can suffer sunburn that also can heighten their later risks for skin cancer.
Here’s how adults can summer-proof kids from “Trauma Season”
Dear Reader,
It’s dubbed the Trauma Season by some, the “100 Deadliest Days” by others.
We like to think of summer as a carefree time when youngsters and their parents relax in long, warm days filled with outdoor fun. But there are hazards too, worth thinking about and planning to avoid. Bicycles, cars, bodies of water, the sun — all pose special risks, not all of them obvious. Not to mention excess exposure to electronic devices and drugs.
Moms and dads needn’t fret excessively, nor become scolds. But awareness, moderation, and common sense can prevent costly drama, and even tragedy — and help young people return safe and well to school this fall. How?
Fun months can carry big risks
Let’s face it: Even model youths get into mischief and do foolish things. Grownups can hope and try to minimize the health harms that may occur. But the period between Memorial Day and Labor Day, the traditional summer and school vacation time, poses challenges. With young folks getting break time and splashing around, biking, hiking, and, yes, driving, their injury toll spikes:
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Unintentional injuries to youngsters 14 and under resulted in more than 2.4 million emergency room visits in the summer of 2004, the latest summer for which data are available, U.S. News and World report says, adding that “those injuries resulted in 2,143 deaths.”
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The AAA Foundation for Safety says that from May 30 until Sept. 1, “the average number of deadly teen driver crashes climbs 15 percent compared to the rest of the year,” and from 2012 to 2017, “more than 1,600 people were killed in crashes involving inexperienced teen drivers during this deadly period.”
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The federal Consumer Product Safety Commission, based on media reports compiled by a partner group, found that in summer 2017, “at least 163 children younger than age 15 fatally drowned in swimming pools or spas. …. Of the 163 reports, 112 of the victims ── nearly 70 percent ── were children younger than age five.”
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Specialists at Children’s Hospital of Pittsburgh of UPMC, one of the nation’s leading pediatric facilities, say they might see 100 kids a month for traumatic injuries during the school year. But from May to September that number can double. Many are routine but some severe and a result of youngsters’ seasonal activities, including lawn mowing, swimming, falling, and moving around on bikes, motorcycles, ATVs, and amusement park rides.
Statistically speaking, it’s good to know that the chances are low of youngsters becoming part of a summer tragedy. But kid carelessness or juvenile hijinks gone astray can put a big hole in a household budget, with an emergency dash to the pediatrician’s office, urgent care center, or even a hospital emergency room racking up sizable insurance claims and medical bills. This is a huge concern in too many families, with half or so of working-age Americans telling pollsters in a recent survey that they could not pay an unexpected medical bill of $1,000 in 30 days.
Meantime, unintentional injuries and deaths of children, from babies to age 14, cost society $58 billion in medical bills, in lost wages of the children’s caregivers, and in the future productivity of the children who died prematurely in 2000 alone, a child safety group has estimated.
Now many a parent has spent a sleepless night, worrying about the vast array of harms and injuries that can afflict their offspring. Experts, such as those at the federal Centers for Disease Control and Prevention, have found that taking extra precautions in some key summer activities can be beneficial to youngsters’ health and well-being. These include helping the young to better deal with how they safely: Get around; enjoy the water; and frolic outdoors.
Grownups can start the summer-proofing for young folks now ….
Easing the road risks for mobile youngsters
With more free time in the summer, how are kids supposed to get from place to place — safely?
After years of decline, deaths and injuries due to cars, trucks, and motorcycles have spiked recently, and vehicular safety experts have expressed rising alarm. Our vehicles are killing us, and we need to take major steps to stop this by ensuring no driver gets behind the wheel when drunk, drugged, sleepy, or distracted ── impairments that young drivers clearly ignore, as their lethal wrecks rise sharply in the summer.
A little more than a third of young drivers’ car, truck, and motorcycle crashes occur between 9 in the morning and 5 in the afternoon, but studies have shown a 22 percent increase in recent times in teens’ nighttime wrecks. One in 10 evening vehicular fatalities involves a young driver.
Although many states have imposed graduated privilege systems with vehicle licenses, for example, prohibiting youthful novices from late-night driving, requiring supervision, or limiting the number of teens in a car or truck, parents may want to add their own wise protections, too.
Besides talking fully and often with young drivers about buckling into safety restraint systems and not getting behind the wheel when intoxicated ── with alcohol, or drugs, including marijuana and prescription medications ── parents may want to put in place “house rules.” They can set volume levels for family vehicle radios and insist on limits to eating, applying makeup, or other activities while driving.
They also can bar young people’s use of cell phones or electronic tablets in the family car or truck. Some parents tell teens their vehicle can’t move unless the devices are turned off and parked ── maybe in the locked glove compartment or in a designated box or container with a seal. If mom and dad can’t get all the young folks in a vehicle to end device distraction, they most certainly can insist that young drivers cannot text, search, chat, or perform other functions on their electronics while on the move.
Yes, many nifty apps offer helpful navigation through crowded roads and to distant spots. But adults can counsel youngsters to use these, too, with extra care. And they should take note that many of the app makers themselves now have guards on their products, so motorists are limited in how they can be used when vehicle motion is detected.
Parents, please don’t consider these steps only for the young: Set an example and follow these constraints yourself.
All motorists may need to step up their vigilance because pedestrian and bicyclist wrecks are on a worrisome upswing, too. It’s bad because this also is occurring as increased incidence of hit-and-run cases. (These carry stiff penalties and drivers should know the legal consequences of fleeing the site of a vehicle wreck.)
It’s not easy to persuade impatient youngsters about the dangers of dashing, on foot or on bikes, across streets, which too often may not be well monitored, marked, or accommodating of walkers or riders. But it’s incumbent on adults to impress on kids that they’ll never come out ahead in the contest between them and several tons of speeding steel.
Protective gear may be helpful: Youngsters, if they’re out and about early or late, may benefit by wearing some items with reflective elements. As pedestrians and bikers, they may be better seen if they’re using lights attached to their heads, arms, or the steering wheels of their bikes.
Older teens may think these measures uncool. But adults may want to insist, and laws may require, that bicyclists and motorcycle riders don helmets and, even in the heat, wear sufficient clothing that they’ll get some protection if they and their riders skid into the road.
Motorcycle safety is its own special concern, and parents sweat it a lot, as they should. This also applies to all-terrain vehicles, or ATVs, which continue to be popular though they come with high risks and should not be ridden by those younger than 16.
By the way, as the heat soars, it should go without saying, but still: Please don’t leave unattended children, the disabled, seniors, or pets in a hot vehicle with the windows rolled up. More states, spurred not primarily by concern for humans but by animal lovers, permit Good Samaritans under extreme circumstance to act to save the vulnerable.
Keeping kids safe around water
Bodies of water ── whether swimming pools, lakes, rivers, bays, or the ocean ── can provide a wonderful balm to the summer swelter. Don’t let them injure or kill young people on vacation.
The CDC offers these quick guidelines on water safety:
“Drownings are the leading cause of injury death for young children ages 1 to 4, and three children die every day as a result of drowning. Always supervise children when in or around water. A responsible adult should constantly watch young children. Teach kids to swim. Formal swimming lessons can protect young children from drowning. Learn cardiopulmonary resuscitation (CPR). Your CPR skills could save someone’s life. Install a four-sided fence around home pools.”
The agency also advises:
“From 2005-2014, there were an average of 3,536 fatal unintentional drownings (non-boating related) annually in the United States — about ten deaths per day. An additional 332 people died each year from drowning in boating-related incidents. About one in five people who die from drowning are children 14 and younger. For every child who dies from drowning, another five receive emergency department care for nonfatal submersion injuries. More than 50 percent of drowning victims treated in emergency departments require hospitalization or transfer for further care (compared with a hospitalization rate of about 6 percent for all unintentional injuries). These nonfatal drowning injuries can cause severe brain damage that may result in long-term disabilities such as memory problems, learning disabilities, and permanent loss of basic functioning (e.g., permanent vegetative state).”
Federal officials have chased makers and designers for some time to ensure that pools get built with drains and water intakes that don’t draw with enough force to trap youngsters and pull them under.
As for outdoor bodies of water, including ponds, lakes, bays, and the ocean, young people should be encouraged to swim there only if the areas are proven safe and have monitors and lifeguards. They should be taught to follow authorities’ direction when swimming outdoors, including avoiding rough chop, rip tides, and other risky ocean conditions.
Enthusiasts for sports involving the water ── including boating, water skiing, wake boarding, and the like ── know that keeping younger participants safe and well means training them, ensuring they have the right gear, and counseling them about behaving wisely and within smart practices and guidelines for a given activity.
A primer on sun, heat and biting bugs
Mother Nature can have some rude surprises for those who don’t take precautions against the sun, heat, and critters.
The CDC has some good thoughts on solar and thermal stresses, especially for the young:
“Heat-related illness happens when the body’s temperature control system is overloaded. Infants and children up to 4 years of age are at greatest risk. Even young and healthy people can get sick from the heat if they participate in strenuous physical activities during hot weather. For heat-related illness, the best defense is prevention. … Dress infants and children in loose, lightweight, light-colored clothing. Schedule outdoor activities carefully, for morning and evening hours. Stay cool with cool showers or baths. Seek medical care immediate if your child has symptoms of heat-related illness. Just a few serious sunburns can increase you and your child’s risk of skin cancer later in life. Their skin needs protection from the sun’s harmful ultraviolet (UV) rays whenever they’re outdoors. Cover up. Clothing that covers your and your child’s skin helps protect against UV rays. Use sunscreen with at least SPF (sun protection factor) 15 and UVA (ultraviolet A) and UVB (ultraviolet B) protection every time you and your child go outside.”
For those who try to live green, it may be worth keeping up with developments on sunscreens and their potential environmental damage, specifically to already struggling coral reefs.
Many youngsters take advantage of summer’s added free time by training for various sports. Great caution should be exercised, though, by coaches, trainers, and athletes working out in the heat. Not only is heat stroke a risk, so, too is sudden cardiac arrest ── the No. 1 killer of young athletes, often tied to an undetected preexisting condition.
The young and older alike need to stay hydrated as the temperatures rise. Don’t be gulled by extravagant and unfounded claims for replenishment, though, with sugary “sports drinks.” Drink lots of plain, old-fashioned water. Take frequent breaks from vigorous activity to do so.
Depending on where you take your pause, if you’re outdoors, you may suddenly get swarmed by pesky bugs, some of which can cause health problems with their bites or stings. Public health officials ── with growing concern about climate change’s effects ── have fought with newly prevalent tropical infections in sultrier parts of the United States, including diseases like Zika, West Nile, dengue, and chikungunya. A key way that people can protect themselves from infection is preventing mosquito bites and curbing skeeter populations.
When possible in the summer heat, and especially in areas where the bugs thrive, long sleeves and long pants may be advisable garb. Or it may be good to stay indoors with the AC running and the windows shut. Be sure your screens are in good repair. You may want to apply repellents with these ingredients: DEET, picaridin, IR3535, oil of lemon eucalyptus, or para-menthane-diol. Use caution with young children and all chemical repellents. We all can do our part to help public health officials reduce mosquito populations, especially by eliminating breeding areas where standing water collects.
Outdoor enthusiasts also need to be wary of Lyme disease, which has increased as an insect-borne affliction. Federal authorities say they receive 30,000 formal reports of Lyme infections, a fraction of the likely total number of cases, which is probably nearer 300,000.
Those with the disease ── caused by a bacterium that enters the body via tick bites ── suffer fever, headache, fatigue, and a distinctive skin rash, erythema migrans. Lyme responds early and well to antibiotics, including oral doxycycline, amoxicillin, and cefuroxime axetil. Some patients with neurological or cardiac forms of illness may require intravenous ceftriaxone or penicillin. If left untreated, Lyme infection can spread to joints, the heart, and the nervous system, causing serious harm. Some patients see the disease linger, and prolonged care and antibiotic treatment may be required. Diagnoses are made by symptoms, increasingly improved lab tests, and information about tick exposure and possible infection.
Although the black-legged tick, blamed for carrying Lyme, is steadily increasing its range, 96% of the reported disease cases occur in 14 northeastern and Midwestern states, including Virginia and Maryland.
Those who enjoy the outdoors, especially with pets, need to take precautions against ticks. They can wear appropriate, protective clothing (long sleeves and long pants), use repellents with DEET and permethrin, and inspect themselves closely and regularly for the clinging insects. Dogs should be checked regularly by their owners and vets for ticks; owners may wish to consider applying repellents for their animals.
Property owners also should consider ways that they can tick-proof yards. Some of these steps, along with others, also may prove useful in some parts of the country in helping to control triatomine or kissing bugs, whose nasty bites and habits spread Chagas disease.
When kids say ‘I’m bored,’ here are some constructive responses
I’m bored: When their children say these two words, parents can develop real summer headaches. It’s a challenge to balance giving young folks a needed break from school stresses, while also ensuring that they don’t fall into the mischief captured in the maxim that “idle hands are the devil’s workshop.”
Many parents try to keep kids busy and active, in part by getting them to take on more household chores. This makes sense. But be sure that teens get training and supervision if they’re using lawn mowers, hedge trimmers, and other such equipment, which results in summer surges of emergency room visits. Youths also need oversight when they climb on ladders to paint or fix up houses. Falls, including those from playground equipment, are another common source of trauma requiring medical care.
A bigger concern for adults these days, however, may be getting the young up, moving, and out of the house. More than 12 million American children, 1 out of every 6, are obese. They have an increased risk of developing health problems, including high blood pressure and high cholesterol, two big risk factors for heart disease. Obesity can also cause sleep apnea, bone and joint problems, and chronic health conditions such as asthma and type 2 diabetes.
Summer can be an ideal time to get kids into neighborhood fitness activities, whether in local recreation centers and programs, youth leagues, or through organizations like scouting or the YMCA or YWCA. Parents need to walk a line here, too, as many of them become so gung-ho for youth sports that they pressure kids into harmful over-exertion and injury.
Getting young people active also may help reduce another contemporary mental and social health nightmare for parents and teachers: over-reliance by the young on electronic devices, including smartphones, electronic tablets, and video games. Hold your ground, moms and dads, and not only set vacation limits on kids’ screen time but even consider putting your youngsters on e-diets. The carrot-and-stick approach, with summer fun activities held over kids’ heads in exchange for staying off-line, may be one way to lessen the chances that youths with too much time on their hands will get into trouble — with disrupted sleep and anti-social activities, including cyber bullying, stalking, and getting mixed up with unsavory online characters and unsuitable content.
It’s no 24/7 picnic for parents, either, if young folks hang out, live and in person, rather than online. Grownups need to offer them close and appropriate guidance and oversight, so kids develop healthy social practices, without negatives like teen drinking, smoking — or now vaping or using e-cigarettes — drug abuse, sexual misbehaviors, and violence. To be sure, studies show positive news and trends about teens’ overall (mis)behaviors: The current generation of young folks are less likely than before to abuse substances, experience unplanned pregnancy, and to smoke cigarettes.
One way that grownups have found to reduce kids’ knuckle-headed summer behaviors is by keeping them in school. Year-round school calendars mean many students get a shorter seasonal break. And many doting parents believe that in the too-prevalent pressure-cooker of competitive academics, their children should attend summer classes or burnish their post-secondary prospects with time in specialized programs, camps, or cultural or educational tours. Students can see cognitive and academic declines if they don’t get a good dose of summer intellectual stimulus, research finds. Alas, poor kids, who aren’t likely to jet to Europe or Asia for classes in art and history, register the steepest drops due to lack of educational opportunities in the summer.
Lest any adults think that there might be a huge missed mention of a key way to keep young folks busy and productive in the summer, a cultural phenomenon is under way: Teen volunteerism has stayed strong and is on an upswing. There’s been a rise in earlier and earlier opportunities for internships, externships, and workplace “shadowing” situations.
But summer jobs for youths are in sharp decline. Economists say the increasing preference by parents for youngsters to emphasize academics over earnings may be partly to blame. It also may be that since the Great Recession, adults have pushed younger folks out of entry-level jobs. As the economy has revived, and as it booms in sectors where kids typically got starter jobs — in fast-food and retail —employers are reporting labor shortages and an inability to coax youths into summer employ. It’s as true with summer work as summer schooling: Poor kids aren’t getting the best shot they really need, and more affluent youths, who already have better employment prospects, still snag good and helpful summer jobs.
That’s not good. But there’s another positive trend that may be prominent this summer: Youthful social activism seems to be trending up significantly, and the nation’s seeing smart, thoughtful, concerned kids willing to tackle America’s tough problems through the democratic system, including with gun violence, racism, economic inequity and injustice, and voter rights and disenfranchisement. With key midterm elections rolling on us this fall, let’s see if a generational surge helps us all address issues that adults seem stuck on. These might include health insurance, social support networks, and the access to and affordability of safe, excellent medical care. Sound too big or complex? I’ll be cheering for the young and their enthusiasms — and hoping you and yours have a healthy, fun, and outstanding summer!
Put food hygiene on menu for a healthier summer
The CDC estimates that 48 million people get sick, 128,000 are hospitalized, and 3,000 die from foodborne diseases each year in the United States. The U.S. Agriculture Department reports that “foodborne illnesses increase during the summer, and the reason why is twofold: bacteria multiply faster in warmer temperatures, and preparing food outdoors makes safe food handling more difficult.”
A key way to keep your kids, yourself, your friends, and your loved ones healthy and well this summer centers on safer food handling. There are good guides available from the USDA (click here) and the New York Times (click here).
To minimize your risk of foodborne illness, be persnickety about your hygiene and how you keep your meats and produce. Wash your hands thoroughly and often, and encourage others to do so, too. Keep prep areas hygienic and tidy, taking special care to avoid cross-contamination, say, by handling raw chicken, pork, or beef on surfaces that aren’t cleaned thoroughly before produce and other foods get placed on them.
Wash produce thoroughly, and don’t rely on packaging claims about ready-to-eat foods. Think twice about rinsing raw meats, as this may help to spread contaminants on surfaces, splashing them around.
Temperature matters a lot in food safety: Keep uncooked foods cold, and, when preparing them, cook them to levels that kill bacteria. Carry and use a food thermometer when barbecuing or grilling outdoors.
Cover and store food properly, especially outdoors. Don’t let items spoil or get contaminated, by, say, flying and crawling insects or sloppy human eaters.
The reality is that we live now in a global economy, and food crosses borders but high standards aren’t always maintained in growing areas, near and distant. Meats and produce can be tainted at the source, then shipped widely.
As the New York Times reported:
“The year is not yet half over and already there have been seven documented multi-state outbreaks of food poisoning. The latest involved eggs in their shells containing salmonella and packaged chopped romaine lettuce contaminated with the especially dangerous ‘hamburger bug’ E. coli O157:H7. The [CDC] said the romaine outbreak involved 172 people sickened across 32 states, with one death. The other outbreaks so far this year, all involving salmonella, were traced to dried coconut, chicken salad, an herbal supplement called kratom, raw sprouts, and frozen shredded coconut. Last year, there were eight multistate outbreaks, and in 2016, there were 14.”
Food poisoning cases can range from mild to severe, the worst incidents requiring hospitalization. If you get sick, don’t put yourself in harm’s way by letting yourself get dehydrated by diarrhea or vomiting. (Stay out swimming areas, especially pools, if you’ve got diarrhea.) If you know that you weren’t alone, and others also fell ill after eating at an event or business, consider reporting the matter to public health authorities. They struggle to pinpoint causes of and to prevent foodborne illness outbreaks.
To avoid medical bill shock, plan and prepare, just in case
Medical bills can be not only painful to the pocketbook,but also burdensome and bankrupting. Don’t just cross your fingers and hope you’ll be OK. If you’ve got rambunctious kids or those prone to accident or illness, a little preparation and research can save you money, headaches, and heartache.
Talk in advance to your pediatrician, family doctor, and health insurer. You’ll want their guidance on your best approaches, in case you need rapid or emergency medical services this summer for your family. Many doctors take summer vacations, too. You’ll want to have some idea of when yours might be unavailable and what they suggest in their absence.
Too many consumers learn too late that their health coverage these days is spotty. Do you have high-deductible insurance, meaning you’ll need to pay a lot out of your own pocket if your boy suffers a gash or your girl falls off the playground slide? What “in-network” providers also are near to you or where you know your kids will be often his summer? You don’t want to be shocked with big bills if your kid was treated by a much costlier provider, outside your insurer network.
It may be that you also can avoid big financial hits by determining in advance if your insurer, doctors, and hospital may recommend appropriate, in-network medical care offered at neighborhood retail clinics, many attached to pharmacies, some popping up in groceries or in retail shopping malls. Physician assistants and nurse specialists in these facilities can deal with lesser, common summer health problems kids encounter. They can put in a few stitches, suggest treatments for sunburn or poison ivy or swimmer’s ear, and may be able to do so faster and cheaper than a doctor’s office.
HERE’S TO A HEALTHY REST OF 2018!
Sincerely,
Patrick Malone
Patrick Malone & Associates