Looking beyond the medical sphere when speaking of children’s health

To avoid individualising the causes of negative health outcomes, it is important to question what narratives dominate in public health.

Friday the 9th of September was an exciting day for charities working to promote children’s health and wellbeing in Scotland: the My Health, My Rights Conference, (this link will take you away from our website) organised by Children’s Health Scotland (this link will take you away from our website), was held as an all-day event in Edinburgh. It was a great opportunity to meet known colleagues in person for the first time since the start of the COVID-19 pandemic, as well as to make new connections. The conference was not only attended by professionals working in healthcare and the third and statutory sectors, but also by children and young people who participated, and also led, some of the activities throughout the day.  

Needless to say, there were countless thought-provoking moments over the duration of the conference. Some of the key themes that emerged were around the value of fostering social connection to nurture wellbeing within communities, and ensuring that children and young people feel valued and listened to. These topics were predominantly discussed from a medical standpoint. Conference participants heard about the positive effects that feeling connected has on the brain; compelling evidence was shared about the adverse consequences that isolation and chronic stress can have on us, particularly how these affect our ability to build resilience, and also contribute to higher obesity rates or the onset of type 2 diabetes. Being listened to, we also learnt, has important implications for human development, from shaping our linguistic abilities to our social skills. The benefits of social prescribing and nature-based health interventions were also discussed, particularly the positive outcomes these have on mental health, as well as physical health. 

Whilst it is undeniable that focusing on “the science of connection”, to borrow the words of one of the keynote speakers, is important, the way in which the key themes of the conference were explored were a reminder of the narratives that still tend to hold the most power in public health policy. It is thus important to ask what the consequences of focusing on some narratives, but not others, can be.  

The biomedical model, and particularly ‘brain claims’ in policy (this link will take you away from our website), still hold strong. This risk of ‘looking inward’, into what happens to our bodies when we experience adverse life circumstances, is that we divorce these health outcomes from the structural factors that cause them in the first place, as has also been noted, for example, in critiques about the way ‘adverse childhood experiences’, or ACEs (this link will take you away from our website), are often thought about at policy level. Chronic stress, for example, does not happen in isolation: financial instability, inadequate housing conditions, difficulties accessing health and social care services, all contribute to a rise in the poor health outcomes that worry experts across sectors. With the cost of living crisis already having grave impact on the lives of millions across the UK, now more than ever we should avoid individualising determinants of health, which focusing on the science (particularly neuroscience) often leads to. Social prescribing and nature-based health interventions should continue to be promoted and expanded, however these cannot be considered sufficient solutions to address the impact of not being able to access the professional care and support that people urgently need, as well as basic necessities, such as adequate food or heating. 

It is clear that everyone at the Children’s Health Scotland conference agreed that it is crucial that children and young people always feel safe, valued, and listened to, whether we arrive at this view from a medical standpoint or not. The question now is, how do we come together to advocate and campaign to create the societal structures that are needed for them, and adults, to feel this way, and to support staff across sectors to provide that care and support to people? Looking inwards, at the science, is a start. However, feeling connected and having good life standards should be the norm not just because of the positive impact this has on us on a biological level, but because it is the baseline that any society should aspire to – and we do not need a brain scan to evidence this. Listening to the voice of lived experience is fundamental. As shown in a recently published report by the ALLIANCE, on disabled children’s and young people’s experiences of accessing support during the COVID-19 pandemic, what people want and need the most is to be listened to, so that their needs are adequately addressed. And as outlined in Scotland’s National Action Plan for Human Rights (SNAPHR) (this link will take you away from our website): “Real change for children and young people can only happen when adults listen to them and act on what is heard.” 

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