Maternal and Child Health Library

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September 9, 2005

1. REPORT PROVIDES ADVICE FOR PEDIATRICIANS TO HELP FAMILIES IN THE AFTERMATH OF NATURAL AND OTHER DISASTERS

Psychosocial implications of disaster or terrorism on children: A guide for the pediatrician delineates specific responses, discusses risk factors for adverse reactions, and gives advice for pediatricians to ameliorate the effects of disaster on children and adolescents. The clinical report was produced by the American Academy of Pediatrics (AAP) and published in the September 2005 issue of Pediatrics. Selected topics include the nature of disasters; effects of parental reaction; stages of response to disaster; developmental effects on response to trauma; gender, ethnicity, and other influences on response to trauma; and living with fear. Resources for additional study, dealing with the behavioral needs of children, and community preparedness are presented. The report is intended for use by pediatricians in assisting parents and community leaders in accommodating the unique needs of children during disasters and in being cognizant of the psychological responses of children to reduce the possibility of long-term psychological morbidity and to help children feel safe in their daily lives. Free online access to the full report is available at http://pediatrics.aappublications.org/cgi/content/full/116/3/787. Additional resources to help cope with natural and other disasters are available on the AAP Web site at http://www.aap.org/new/disasterresources.htm.

• Functional health literacy -- Some students reported that the language on the Internet was difficult for them to understand, and many students were not familiar with the spellings of medical terms.
• Critical health literacy -- The concept of online "trusted brands" emerged as a strong theme to describe the way the students identified credible information; however, the nature of these brands differed. Students also reported that managing the volume of information that a search engine might retrieve for a common term was a challenge.
• Interactive health literacy -- Some students reported instances where information from the Internet had helped them adopt healthy behaviors or avoid unhealthy behaviors. There was also a perception that online information could act as a useful starting point to stimulate their consultation with a provider. However, few of the students cited any guidance by parents or teachers in their Internet quests.

• The median distance from any school to the nearest fast-food restaurant was 0.5 km, indicating that students in half the city's schools need to walk little more than 5 minutes to reach a fast-food restaurant.
• Nearly 80% of schools had at least one fast-food restaurant within 800 m (approximately a 10-minute walk).
• There were three to four times as many fast-food restaurants within 1.5 km from schools than would be expected if the restaurants were located around the city in a configuration unrelated to school locations.
• There was statistically significant clustering of fast-food restaurants within 1.5 km of schools located within areas of the city outside downtown.
• Fast-food restaurants were found to cluster significantly around schools in both the high- and moderate-commercialization regions of the city.
• Fast-food restaurants were found to cluster significantly around schools in regions of the city in the highest income tertile, where median annual household incomes were $43,700 or greater.