Saturday 28 March 2015

'Cohabitation Can Be Hazardous to Your Health', says American College of Paediatricians

The American College of Paediatricians is a national medical association of licensed physicians and healthcare professionals who specialize in the care of infants, children, and adolescents. The mission of the College is to enable all children to reach their optimal physical and emotional health and well-being. They issued this press release on 23 March.

With its position statement, Cohabitation, the American College of Paediatricians cautions adolescents and young adults about the negative consequences of cohabitation for both themselves and their children, and urges parents to teach their children about the advantages of waiting until marriage.

Research shows that, rather than serving as a stepping stone to a healthy marriage, living together before marriage (cohabitation) makes couples more likely to break-up and more likely to divorce if they do marry.  Partners who cohabitate are more likely to be unfaithful than married spouses, and are more likely to be violent toward the other partner.  Poverty is more common among cohabitating women because their male partners are less likely to work and more likely to spend their time on personal pleasure than do married men.  Women in a cohabitating relationship are ten times more likely to have an abortion than married women, and therefore suffer from its associated mortality and morbidity.

Children also suffer due to parental cohabitation.  Not only do they have an increased risk of losing a parent to divorce or separation, but this may happen multiple times.  Children whose parents are cohabiting at their birth are over 4 times more likely to suffer separation of their parents by their third birthdays than those whose parents were married when they were born.  Couples often enter into cohabitation with a child from a previous relationship leading to the common scenario of child abuse involving a live-in boy friend or a stepfather.  Children whose parents lived together (before or after their birth) are at increased risk for living in poverty, achieving lower levels of education, experiencing school failure and earning lower incomes as adults. In addition, they face a greater risk of suffering from medical neglect, as well as chronic physical and mental health problems, including suicide, substance, alcohol and tobacco abuse. Finally, there are also higher rates of behaviour problems and incarcerations among these children.

The American College of Paediatricians urges parents and paediatricians to educate adolescents about the risks of cohabitation and the life-long benefits of marriage for the entire family and society.  The institution of marriage is one of the best and most cost effective public health tools society has. Saving sexual relationships for marriage should be promoted by the media, school teachers and policymakers alike. Adolescents and young adults should be encouraged to pursue this path for achieving optimal health for themselves, their children and society at large.

Monday 9 March 2015

How should Christian doctors vote?

On 7 May the UK goes to the polls for the general election. Whoever assumes power as a result will have a profound influence in shaping public policy in matters which affect us, our families, churches, patients and colleagues.

Some claim that politics and religion should not mix but God is intimately involved in politics.

He is sovereign over the rise and fall of nations (Isaiah 40:15-14; Daniel 2:21, 4:17, 5:21). He both establishes governing authorities, and holds them ultimately accountable (Romans 13:1).

As Christians we should both pray for our political leaders (1 Timothy 2:1-3) and be subject to them (Romans 13:1; Titus 3:1). But God has also given us a part to play in who actually exercises civil authority. Each of us, before God and in good conscience, must make our own decisions about voting; but we have a duty before God to ensure that we exercise our votes wisely, thoughtfully and in an informed way.

For some the key question will be about who they would prefer as prime minister for the next five years. But for others it will be a matter of which specific issues they care about most and how the various parties and candidates stand on these.

Whether we choose to vote for, or against, a particular party or candidate, or on a specific issue, there are lots of resources to help us reach our decision.

The Economist/IPSOS Mori Issues Index ranks political issues in order of importance as seen by the British public. In September 2014 Race Relations/Immigration was top with 39% followed by the Economy (30%) and the NHS (25%). The next seven were defence (23%), unemployment (21%), education (16%), housing (15%), crime (14%), poverty (13%) and inflation (11%).   

The BBC’s ‘Manifesto Watch’ helpfully outlines where the seven main parties stand on each of these ten top issues.

With the economy and the NHS ranking two and three respectively, it is also worth remembering how the two are closely interrelated.

Most of us are employed by the NHS and almost all of us, along with our patients, rely on it for our healthcare.

In June 2014 the NHS was declared the best healthcare system in the world by an international panel of experts who rated its care superior to countries which spend far more on health.  The Commonwealth Fund, a highly respected Washington-based foundation, examined an array of evidence about performance in eleven countries, including detailed data from patients, doctors and the World Health Organisation.

In the Commonwealth Fund study the UK came first out of the eleven countries in eight of the eleven measures of care the authors looked at. It got top place on measures including providing effective care, safe care, co-ordinated care and patient-centred care. The fund also rated the NHS as the best for giving access to care and for efficient use of resources.

The 30 page report titled ‘Mirror, Mirror on the Wall’, concluded, ‘The United Kingdom ranks first overall, scoring highest on quality, access and efficiency’.

But financial pressures are now squeezing the ability of the NHS to deliver.

The Nuffield Trust has shown that because of population growth, ageing and cost increases, by 2020-21 the NHS will require some £30bn (25%) more than it is getting now just to maintain services at their present level.

But whilst real average NHS spending has increased by at least 3% per year since 1951, this has fallen to 0.75% per year since 2010.

The major driver of this fall has been the UK’s national debt which is now at its highest peace-time level.

When the coalition government took office in 2010 our total government debt was £811bn. But by December 2014 it had reached £1,483.3 billion (80.9% of GDP), an over 80% rise in just five years, with much more to come.

This rise is the result of accumulating annual deficits. Although the gap between annual government income and expenditure is gradually falling the total debt is actually rising.

This national debt matters. It must be serviced with regular interest payments, diverting money from front-line public services.

Even at rock-bottom interest rates, the Government will spend almost half as much on debt interest in 2014/2015 as it will spend on the NHS (£52bn cf £113bn).

As the national debt escalates, courtesy of £100bn-plus annual deficits, and as interest rates inevitably rise, we may yet end up spending more on government debt service than on health.

This situation clearly cannot continue and a key question must be what kind of government is best placed to put our balance of payments in order. Debt is a moral issue with serious consequences for families, communities and countries. 

We also face other moral threats in the health service, not least the legalisation of assisted suicide. On this and other issues of conscience we will want to know where our own MP stands. Recent parliamentary votes on same-sex marriage, sex-selective abortion and three parent embryos, for example, have been deeply disturbing.

The Public Whip website tells you exactly how your own MP has voted on a range of crucial issues and the Christian Institute and CARE have also compiled very valuable online databases on past voting records.

Let’s make use of all this valuable information in making an informed vote that really counts this May. 

But let’s also pray for the future of our country, and health service.