With childhood illnesses like diabetes and asthma on the rise, health care practitioners are preparing to face the growing concerns of a future patient population.

The June 27 issue of the Journal of the American Medical Association (JAMA) is dedicated to the effects of childhood health on the care needed as patients reach adulthood.

In a June 26 teleconference previewing the issue, Catherine D. DeAngelis, M.D., M.P.H., editor in chief of JAMA, described the long-term difficulties for a child with chronic illness.

“A chronic condition in a child will become a chronic condition in an adult—we just know that. And what you’re talking about for an adult is maybe 10, 20 years of suffering,” she said. “But with a child, you’re talking about maybe 50, 60 years of suffering.”

JAMA highlighted a variety of conditions, including obesity, asthma and attention deficit disorder. Overall, it was reported that chronic conditions now affect 15 to 18 percent of children and teens.

Sandra Mott, Ph.D., RNC, associate professor of maternal child health at Boston College and the president of the Society of Pediatric Nurses—who was not involved in the JAMA studies—offered her thoughts on the causes of chronic diseases in children and what nurses can do to provide care and education to young patients and their families.

“Part of what’s contributing is that so many more infants are being born with severe chronic illnesses that even five years ago they didn’t survive. Today they are surviving because of advances in technology, care and support,” Mott explained.

“Some of these are critical cardiac anomalies and neurological anomalies. Premature babies used to not survive; now they are, but with certain deficits, such as cerebral palsy and metabolic anomalies,” she added. “These contribute to the stress of chronic illness and the need for ongoing care, particularly when these children hit the school system.”

For these types of illnesses, Mott explained that a nurse’s role is to raise awareness and help offer the children and their families a quality of life that wasn’t previously available to them.

Mott also addressed the areas highlighted in JAMA, including obesity, diabetes and asthma.

“The area that gets the most attention is childhood obesity and the long-term effects of this disease on health, including type-2 diabetes and cardiac stress ailments due to their increased weight,” she said. “For these children, the biggest thing for nurses is early education as far as the relationship between diet and activity is concerned. That really begins in infancy, and it’s important to introduce foods that are healthy early on. Of course that has to be coupled with activity.”

To this end, Mott added that it’s important for nurses to advocate for better school breakfast and lunch programs, as well as revisiting activity programs, like gym class and recess—things that are often the first to go during school budget cuts—during the school day.

“Nurses and nurse practitioners can both educate and encourage parents—even during the time of pregnancy and right after the baby is born—to build activity time into the day and always ask parents about the child’s activity during routine checkups,” she continued.

Mott added that parent and child education is also important for children managing asthma.

“Asthma is a huge problem and the incidence has been climbing steadily, but just because a child has asthma, it doesn’t mean he or she can’t engage in activities,” she said. “This is where child teaching and parent teaching come in.”

Addressing the concerns about the impact of childhood illnesses on the future of health care, Mott agreed with the JAMA contributors that attention needs to be paid to the health of today’s youth in order to improve the future of health care.

“The current rise in chronic illnesses in children really could have a devastating effect on health care, in part because it sets the stage for adult health care issues that will be even more critical,” she concluded. “It’s really important for nurses to really hit this hard now because otherwise it’s going to be devastating. But this is also where we need a really strong multidisciplinary attack—from the health care industry, the schools, the communities providing safe after-school activities and the government providing better insurance for children to be healthy and safe.”