Impact of Specific Medical Interventions on Reducing the Prevalence of Mental Retardation

Brosco, Jeffrey P.; Mattingly, Michael; Sanders, Lee

doi:10.1001/archpedi.160.3.302

Cited by 57 publications

(34 citation statements)

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“…Even today clinicians perform extensive diagnostic testing on people with cognitive disabilities in hopes of finding a simple medical cure, despite the relatively small impact of PKU and similar conditions on the prevalence of intellectual disability in the late 20th century. 3 In the 1970s and 1980s, PKU took on new roles as an exemplar in the naturenurture debates and as a resource for advocates of genetic testing. 2 PKU is a genetic condition that is highly treatable if infants receive a diagnosis at birth and are placed on a diet low in phenylalanine, an essential amino acid found in all dietary proteins.…”

mentioning

confidence: 99%

The Political History of PKU: Reflections on 50 Years of Newborn Screening

Brosco

Paul

2013

Pediatrics

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confidence: 99%

The Political History of PKU: Reflections on 50 Years of Newborn Screening

Brosco

Paul

2013

Pediatrics

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“…Nonetheless, our study revealed that, among the medical technologies introduced between 1950 and 2000, NICU treatment of LBW infants is the most significant contributor to the increased prevalence of ID. In the first third of the 20th century, the predominant causes of ID were infections and metabolic conditions, 12 and infant mortality was greater than 100 deaths per 1000 live births. 26 By 1960, overall infant mortality dropped to 23.3 per 1000, yet remained high for LBW infants, ranging from 899.1 for birth weights of 500 to 999 g to 61.0 for 2000 to 2499 g. 20 Since 1960, infant mortality rates have declined for all groups, most dramatically for the smallest infants, while the number of LBW infants has increased.…”

Section: Discussionmentioning

confidence: 99%

Impact of Specific Medical Interventions in Early Childhood on Increasing the Prevalence of Later Intellectual Disability

Brosco

Sanders

Dowling³

et al. 2013

JAMA Pediatr

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Importance: For the past 100 years, medicine in industrialized nations has become increasingly focused on specific medical interventions designed to improve the health of individual patients. Substantial evidence suggests that broader improvements in public health, nutrition, and economic well-being are more salient than medical or surgical interventions for the remarkable decrease in infant and child deaths since 1900. Less is known about the impact of specific medical interventions on morbidity such as intellectual disability (ID).Objective: To explore the impact of medical interventions in early childhood on increasing the prevalence of later ID, as reported in the literature from 1950 through 2000. Design:We reviewed the medical literature and other data from 1950 through 2000 to construct estimates of the condition-specific prevalence of ID over time. We further explored the existing literature to document historically relevant influences on condition-specific prevalence, including the introduction of effective interventions, the timing of these introductions, and the likelihood of their widespread use.Setting: Twentieth century United States and Western Europe.Participants: Populations of children who received a life-saving intervention within the first 5 years of life and were evaluated for ID after 5 years of age.

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“…Such programs likely had less effect on the prevalence of intellectual disability than did more general children's and maternal health programs, however. 54 This is because most cases of intellectual disability are related to a combination of risk factors, such as family income, technology available, within the funding and priorities set by Congress and the president. Federal children's health programs are but one factor in determining children's health in the United States, of course, but all efforts to improve children's health over the past century have faced the same enduring set of historical circumstances.…”

Section: Discussionmentioning

confidence: 99%

NAVIGATING the Future Through the Past The Enduring Historical Legacy of Federal Children's Health Programs in the United States

Brosco

2012

Am J Public Health

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The United States excels at treating the most complex medical conditions, but our low-ranking health statistics (relative to other countries) do not match our high-end health care spending. One way to understand this paradox is to examine the history of federal children's health programs. In the 1800s, children's health advocates confronted social determinants of health to reduce infant mortality. Over the past 100 years, however, physicians have increasingly focused on individual doctor–patient encounters; public health professionals, meanwhile, have maintained a population health perspective but struggled with the politics of addressing root causes of disease. Political history and historical demography help explain some salient differences with European nations that date to the founding of federal children's health programs in the early 20th century. More recently, federal programs for children with intellectual disability illustrate technical advances in medicine, shifting children's health epidemiology, and the politics of public health policy.

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Impact of Specific Medical Interventions on Reducing the Prevalence of Mental Retardation

Abstract: Although specific medical interventions have prevented thousands of cases of MR, their contribution to the overall prevalence of MR is relatively small.

Cited by 57 publications

References 62 publications

The Political History of PKU: Reflections on 50 Years of Newborn Screening

The Political History of PKU: Reflections on 50 Years of Newborn Screening

Impact of Specific Medical Interventions in Early Childhood on Increasing the Prevalence of Later Intellectual Disability

NAVIGATING the Future Through the Past The Enduring Historical Legacy of Federal Children's Health Programs in the United States

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