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It I, no •• bl. In ,hi. U\Ody I ... bolllfa f.9ud1nq 'hI
Inllulncl of holpltlU .. Uon .... I""Ing chlld,"n If. "". und ... t.ndlbll by .. 10'011<:. to ~.ophle •• ,labl ... _dlul uporrlUc. 0' _lth •• 10"'01 .tUt...:!ln.)
l.fo' ... tI .... of docto... n.ay bo U .... <IOC.O,O· .II~I on .h. I_U of ho.pltoll •• tL ........ _ child ... d.,lvo ho<o
.ctlon In Ingl.nd and 1f.101111 Ithf Oll9h g.oup. IU. th.
IIltlond " .. o.lnlon 10' ,!lot IIOlfo .. 01 CIIIldf.n In Ko.pHd! of ..... IU .... n y.o .... , ..... I"" I.v.to of
Ippfocl.tlon 01 .h ••• .,.'h. I_e, 01 IIOtp""lIutLon .. Ill .. h' In _1 •• 1 el •• I ......... eh •• Idonco ..
outllnO<! IR .. cUo .. I doll o f "DU'" Ih"" .h.t ono oho .. ""' plt.lI .. tton dOli ..... Il00 •• 1""9 • • , ... og .. l .. l_cU on
young child, •• bu, .Il00 ....... ~ ••• hoopltoll •• tlon ••••
do .. glng In 'ho lonq to ••• U 10 In .MI ,o'pe"' .h., Iny
no'pltoll .. Uo. n.o<Il to bo ...... a ",,1 ... lblll ty Ir>dudng foetor ov •• Uno. ". .. ,Iog In ond of 1 ... 1f "od .hot .he d.chl .... '0 ..... pl •• U •• bo toko. vlt~ .hl. nutlon
_ 75 -
Of •• 19nlUunUy col ... d to .~. n_'. 01 c~lld'~n
~o.plt.l! •• d by GPO .R<! '~'Y •• plol" 'M 10<9*ot ~odonc. in GP r.t .. of hoopltoll •• ,IOft "" .. ho, GP fo,'o" 0' GP .nd poti.nt foc'o,. c_lnod oro ,o<>ol<lo,od. ""'0 .0gUlvo •• ".rI.nee ...... 0100 .... OM foe'o, clo .. ly
dHI.,."U.Un9 'h. oI ••• n GPo In'orvlowed who h.~ chlld,·o"
od.lttod to hO'pHoi 10 tb. 'h, .. ""nth otu<ly "..Iod. Th.y boo< .0 .d.H ..... hlp to hooplt01l .. lIo<> ut .. of hOoplUI
• ot .. of •• 10"., ID. " ....... nt.dU. by ho.p'tol doeto .. 10 occ<>w>tod 10' by dHIo,.nc .. In u ...... n In 'nu.I'y .nd I. G' ' .. "orl ...
""tlplo tt~r ... lon ollOlYIII for hOlplt.l dOctor. and G .. ...... ot. , ......... Hy uUu ... of ""'roan.orlth •••• n ,~ .. , .. t .... "c. of ,.10,,01 ... 'oblllty In both 9'OUP" lion, of U •• otho, Ioc,o .. In ,h ... 9' ... , ..... or. 01011 ..
to. ,bo ..... o.to of doc'on. So. 10 • focto. In both ... 1, ... oLthou.<jb 10. Mopltol d...,.o ••• _n ., • ..,<0 IIkel, to too.plt,H .. chlld •• n ( ••. IOS. p .•. llSl • .mIL. 10. Gh left JI.o •• hL9h ... .r.".1 ••••• I. _ -.241. p_ .1001. T ••• p.actlca .. 0 ."'obl ..... Lch pe.Ulno .0 Gp.
o~IJ •• hue bad "P"'''nu. 01'(10" to be the "'dlu} foetor c_ to both """p' .... Ich •• phlRe v .. ,.blLlty tor GPo
only. Ind.ed It h the _tt ''''''''hn. "p\ono.o,y •• rl.bl. fo. Gp •. 110'''''''11. o~ .PP •• clotl .... ot th. Influence ot
both .'''''!>O 'fblch upl.lno .... !ablll.y 10' hooplt.l doe.o .. .... 1,. '1110 '_ct of bod .. perlonc .. on dOCton' roh"ol .. to ... I_pend.n. of lOa .. "Yeol,y .. tln~. 01
"'''","nt.<lU ••• ".n In ,ha """plo '.9 .... I"n •• nd In , ........ cO".latl ...... n. •• JI.o"'n9 "".a .~9 ... v.
a,pert.no .. 01 "'''oon'otIU. ~""o "0' ' .. ul, In u~ln~ It ....... Inu. P,oblu ..... loh M. alqh. h •• ~ .h""9hl to
bo .... 1",,1<01 .. pl.n .. l .... 10. '"~, •••• ~ h~'r""1i •• tlon
""k - ...... 9otl ... ··PO'Io"c .. 01 """oon ... ,, 1o hy G',. In.t •• d It _Id '1'(10" .b .. aony GP. h'.'n, n~9"lv.
- 7a _
g .... o.nurlU. expulenc .. !n ,h. p .. t ~.t oO<jnhcan< ~f
t~. alld "o,uro of gutroo"todU. tond .... of ton to uf ..
c .... th.y oo~"""I""go o • • Ild. e..d O'porlOM .. thon ... .. ns!U .. d"ct",o to 'ofe .... « "f'en 'j,,1I 'n co .. ' .o.! .. • hon .. no\thlng .ho. U ove,utl .............. Hy of th.
p .... nUng probl ... One G1 In the .U.dy qulto ol .. ,ly _nog.d ,utroonto,I,1s In .hio ... y. Ho o.plolnOd hi.
roforrol roU of U/18 ~i9"o'h' end ~S, of hto geMc.' 9 .. tro.n~ .. Lth .... rkload by ,.I.dng 0 fnalhy In M. pue.leo .. hi ch , .. "nod f< ... hh ,.v.tOlng • dodolon to
hOBpltolln on roq,,'" f,o. 'ho cbUd', .oth .. , Thl£
uporlonol chonged hi. g ... ,oo ••• <I" ••• n.g .... n' to oM of h".pltoll.lng ...... chlldron ,oga,dl." of thol, .. die.' ~r
hoot ,\tuotlc .. bee""'. of tllo potontla. for dlo .... ' In ,ha .!.".tlon ud bee.u .. of hh hellng. "f uItIN'O
"opondblll.y fo, tluoL a. dId no • • 0' qu .. _ntodth n .,.lnq g .... r.lly o.~uo but fdt tM' Ulo uc.ptlono
p~t1ont .... ,tobl .. oocountod fo. ""n (U'I 01 ,h. up .. ln'" vulonoo In ho.plt.1 ,of« .. 1 , .... by GP •• '"'" r.y ....
~ .. ,bo co .. for hOlpltOI do"'o" .. Ith only )61 01 UlI
uplolnod varlone • .-1o.log to 'dooU" 'octo<o. This
dlffuon". i. uplo'"ad In .h ... 'a"". hoaog.noHy oC ho.plUI doetou on doetor_,olov.nt o,It.,)" ,.oh •• yo.,,' uporlon". whloh would InO.te the !.ponone. of P"t1 .. t_ulov.n t orl.orlo. Tho foot t""t n. of tho total
v.due. In potlont ,efucol '"t~o lu ho.p"O' d •• ,o" Is
"plalned by .ho doctor and boUy loctorl •• \ocud In •• h
All _"Uooo<l .. rH .. tbo """klood of t~o G' 10 • Ilttlo
M~b" Ln .bio 0_10 .han In lrolat>d 9""","lIy. It 10 .100 cl .. , r,_ lho roo~l ....... It I. ,n. buoy doc.o, rothor Ut.oc lho "'" <!octor por ", .... 0 .. nd. _ ..
, .. t'OO~'o<!t\o c ..... o boopi"]. 11010 &Ok .... noo In tor .. of both th roloUvo unl~, .. nc, of ot,~c.uro! f .. lly hetoro by ~. raUn9' ond In t".o o! 'b,
da_nO"ot,d 10000'U"cO 01 &0'''"01 anol .. y In ...... ln
0'9onlooUOftol nnu .. or tho heloion '0 hoopltolho for
'''''OOMorIU •. Doopit .... y d(ff ... ", rU~rr.1 "'" vi .... on the <oI.nnco 01 0 Ii .. 01 non-_dlul rocto," In ,o"''''''to,IU. II oiol1or lor 1 .. lly 60 , I Ch on<! boOpltal
,"l<ouU,ltl, .. , .. "I <Io~I.lon. (' ••. ("P' .nd
e ..... l', Depo, ...... PO<,O<O).
(11) Gaou ... n •• "tl. I. ,ho.....sa, 'v," I, 0
( 1111
eo.ol<lo"I>I ....... _. 01 do.'on· u ........ .v.n~. of ..... c ........ H, 10 ... n by •• ch docto, _ , U", I. dllld .. ,,·. C ..... lt, <>opo .... n .. .
ond 1.1 e .... Of •••• n .... U, by GPO. """ .... .. rap ... ont l.n 01 GPo .... Ur .0 •• "tt.,10 ••.
LA''1' dlft ... " ... 10 .,. ........ ' .. IU. Mnog ... n • • nd h .. f .... 1 ..... odot bo." .. " dO"O'" In
both on u~fI"'I.1 .I< .. doll lpopa'
patlon"",I""""1 aod In .bolt """ ,."","d p, •• ,lu poUq.
(Iv) lIOot chlld/><K>Ol ........ " ••• 1". I ........ '1 • ., It 100_
.. lth 0,,1 lObl"l'otlon .,.. •• py (oon ond potl.".
, ... 11. ft .. PO' ..... (10" of o<:.uol 011<1 21\ 01 vI9no'" u" .... "/0,,," '0 hoOpl,,1 ."" 161 01
ud &hepln9 .... n t .. el9ht hours dolly. Be show.d thtt • ~G-70 y .. r old heviR9 011 .. "en hoblU had ° phyolcol
hul'h cO" .. pondln9 to on indlvld"ol thirty yee,o youn9"' hovln9 f ..... thon thue bob\t.. 1n oth •• "o<d. 0 fOTty
fi". yu, old Individual followed fly. and. holl yur •
• ner the original 5t.udy wh" follow.d fouT to fly. of the
.fo,nontlonod heolth behavlOUT$ hod 0 lilo ~~I"'ctoncy of
'."onty thr.1 "hil. "ith .i~ t<> uvon hobito the 11£0
.. peotancy ..... u ... onty eight. Health boho ... lou,o of "n.
Indlyldual .. lthln the fully .ay 0110 100 ... 0 .n I .. p.~' on
othor .... boor. of tho .. fullY. ..01<In9 by .other ••• 0
lpecl!lc unhoolthy b .. h.vl">1' Iou b •• n ohown to Influence
Intant oli •• ntary and ,espl'HO'Y Illneso 11".1. oven abo ... e
the elf •• u of .. jor foeto<o such as social clue (0<]0<00.
FI.,un end ".lker. 19811. Buld .. Influencing health
dl,ectly, huHh bohavlou'. hIve on Indl,.ct eff.~t on
children'. hullh In thel' oodell.I"'J copocHy fo' In$tonce.
On ..... pie h so<>Hn" vhl~h 10 .0<_ co_only t.~en up by
the c~lld<on of eooke .. 1IIO,,,.n and GcuM. 19B,I. UHt
119761 outllnu the rol~ of the f .. ii~ 9~no<~lly u
educat"," of chlld,en In a ,.n". of h.oHh ~~h" ... lour5.
112 _
~hlldren. Th •• uus of SdOll ~hildr.n on .~. _ntol
h •• lth of .oth ... h oh" @~ldMt In .. own 01><1 Hurl.'.
ot181 .. udy of dopr@".lon In ...... n' in .ltu.tLons "Itl>out o.her probh ••. 7l of ...,the" vith youn9 chlldun .... re
d.pr .... d "hlle n of those .. !thou. chlldron _re
d.pr .... d. whe .. oth.,r str .... on .. ere in nln.nce. 17' of
_n .. ltho"t children. and U, with chlld«n. wu.
d.pr .... d. IIhH@ e~ldene~ cn the hveh of depr ... lon ot
"".n ... "lth YO""9 children In Inlond I. not available. ,he on. year pHlod prevalence of dOpr ... lon In ,h. 1~_6, .g. group of "rbon Wollen I. 17 9' (Clury, 19861.
Wo.en In 'he role of coring for ch!!dron ore U""ly .0 (ed
.lgnllle.nUy 110". ,un dovn and Uud thon .on (GOYS ond
Hugh .. , 1979\ but .ou oUen ull-•• dleo.ed fer phyolc~1
hulth proble .. slnee th~y continue to be ulled upCn In
tho hou .. hold .. lien sld (LH ... n, 19711. TII ..... Oftn are
11'0 1 .. & lIbly to 5eek .edl".l "elD for poyeholeqlcd proble .. (Goldberg, ~ .. ye and -rno.p.on. U16\.
Tho health probl ... of .. o ... rn take thol, toll o~ children
'00. "-pr .... d vo.on ore lou IIhly to Inltlel. or
oncouro9. conv .... tlon In young children !hckerlng. ~jll •. Co. u<l Pound, 1905). Acddont. to children or. ""r.
CO"'on In fo.llI .. wh .. re the ..,ther hu p"vcMloglcol probluo, the ratio. being ~.~,j for lo ... r clu. nnd $:
for .Iddl" clA .. hlllllu (8'OWnO ond D •• ld."n. I~"O).
Lower ch .. f •• illes hove ~.6 UOIU u .. ny oecld.nt. &0
,h.ir .iddl. cl ... coun,@rput. geneully. refl.etlng the
high .. hvolo of •• ruo In I""", d ... 1 •• 111 ..... n
without .. urna! poychol<><;l!cal proble... Th. ~utnor. here
poln. to the uonuct!onal "ot" .. of 01 .. ,
P.ychopothol .... y/.cdd .. n. rohti""ohlp ''''19utlng .hat
Incr ... "d ocddo .. t •• ~e no. just due '0 lod 01 .uptlryloion
but duo aho to cha"ge. in the behnlour 01 .110 child In
rupon .. to a dloturb .. d .other. In •• dlc.1 toru .other.
en P.vchotroplc dru95 aloo ha ... children wIth IOOre
reoplratory Illne .. consultationo '0 th~ G~ 1~0"1~ and
51~9, 1980). S ..... in th~ f .. lly gen.rally ~~. ~I.o b~~n
oho"n tc give rh. to streptococcal ,.<oat In(nctleno in
~rl"
_ H7 •
"<JU'. 1,1 hU...,. "" _pHd doctor. 01 I ... __ ,H)' DC
, .. UoUI .. ltll .~~t .. 109J' 01 .. ooy c .. lld •• n
"
2 3 • S 6
••• ·.HQIQIUI """,
...... -"" .. _rlt, of Sl'lOl>"_tolO9Y
011 lnltld Iywptoa u.llnoU"". <io<:tou rHlnq ,"" ... 4lrol .y.pt_t01O<JY of cM Id .. " c~n .. d _ thl hi,,, IndO of
rlpOrtod w,,"'Un, I" chIU •• " Ind .. p ..... d th oplnl"" th.' luch roportin9 I. c_ but no .... lly U o .... utl ... lo .. ot thl __ un' 0 1 !IuLd 10lt by children. " "",VI' to. p .... n<
dl.chl.,I" ... Iy Icco.dl09 to ""'101 ut '""o,d.. ",11 .... ,o .. l.olly Oft the .. ""ut 01 PII •• nu to be 111_ to contl"ue uhf<lutlotl It 1'1_. 'In chLldrn ..... dUII_ lon,o •• u"
.... nee .... " ("'. t ... cl .... n~. of q .. t< ... "U<lth .... Ieh
.nullO;! 1ft ""."l .. " .. t<. hO'plUl _ .s.,. (". the .. live
~hlld •• ". Clt.Il<l<ell .... ,. detelMd bee.u •• or nd"", dLtu .... ltl .. III tile "- Ilt .. U .....
- HI -TIIo •• I. ~o dltt.,.ne. In tbo I.voh 01 occ ... to ""oplul to, the "".pltol ..... _ un ...,tI.l .... -..ld be .. ~,:t"
In thlo ... ben _apl.. It I. _ ...... ""t_.thy .hot In thh ... ben ..... 1., _ IIv ... UIU.o alto •• t u. • .,n 1< .... tho
hOlplUl, JO\ 01 bOth g'''''P' dld,--,Id 11 .... It V'O'y dIHI ... lt to , .. to t/to ""'.plt.l In ....... Itt"". ",",. _ ......... Ip
.110) , .... 'c.t'ng thot ... tho .. ,",,0 did .... v. cMld •• n
hOlpltdhO'd t ........ H "" .. dHllcult to p.oy 10. tunlpo" to
th. hOlpl.ol thU _Id "".ho •• 01 "- CO" chlid ... n. In
'M. ' .. poet _c, 1>0.0 n •• ootlt ... 10,<1 holly cu, thOn did
hO'plt.1 cor ..... tb ... (S. u. lit, p •. O!!.
1..- g.n ... 1 .h"ocu<l,tI •• of the t .... g'o .. p' 01 to_lIln
'" ~"" di>lcr'bod.
146 -
Qu .. tion~6 op~cHleally .bout their relotlon.hlpo "lth their
nel9hbouro 2H ot hOlplUI ta,. and 8\ of hOIl, to<e lIoth~rs
'''pOrhd bol"9 on bad U'II' with, 0' not IIld"9, .. lth their nelqhbouu (p .ODt),
" ... ntlon 10 now focused On upect. of the young child In the
ra .. Uy conte.t.
1.4.d. Gon ... l ...... Ily I:n~ho .... nt Of Oildr.n
Thon ... n no dIH .. onc .. ~ In .h. cltewouoncu Ot 'h~
p,egnoncy and birth for the t~o ,roup. of oo.h .. o. Th.
nu.b.r. Cf proqMndeo .. onto<l. the tloln9 of .ho proqnanoy.
Mtltudu to the pregnanoy .nd birth. ond tho .hdng of
ootho<" fir" conuct with tholr ohlld,on wero doll .. (et
both troupo. Support froa loth«" and 001"rations of ooth~r and child In tho [!r£t IIOnth we .. the .aM fa. the ''fO 9'OUpo. fOr ex •• plo. 250\ and 21\ of hOlpl.ol .nd h .... 00.0 oother. did not "hh to be pregnnt a, the .... t>t concoptlon. 81 and 7U ,upectlvely _r. happy with ,h .. 1t
P"9naney oveuU .. d 81 and 89\ of father. ".r.
IUpport!v"'''try lupportlve n the blnh of lM bIoby.
Th. n_r of und.r .... lqht I>ohl .. no .... 1I and " .. oiothr in
both ,roup' I~ _ 1 for ho.plUI 9'OUP. olld N • 5 f a . "_ ,rOUp) "hU. thor" wu a .Uqht tendency In tha <llrecllon of
..... 1 .. I ..... nh.tlon I. 'oc_""ed .. ..,.. Bloww" _.h .. CllII.I<.n ..... nOt e_tod .. l.ul"9 oh •• d 'h,1< _001 ••
1010c\lon .. ntil ,bor ... "Md .,. ol,M .... _th.. "'10 vU to 011_ to, ._ tiN l.tlt",o t •• "bo ......... f .....
In"""ln, to p,owlde ,,," oppfopflo" ,_loo" ... I .. Chlld .. o. lI,nlll"oot dlll ..... c .. In 1-."loo,l<,n 1.~.I. cl<>
""" nlo, in ,bo !In. d. _thl of OM IIvu nl I'" 1_ "OUIII of chlldf'" but diU .. ,"" .. 11«1 ...... I\h 1._ .... _.n
the t .... """po .tt .. thlo ..... Th, "pu.~ .. 1 oe .•• \. ~ l_nlu.IO" In the _ co .... ",,10 I~J'I .>&.,".,.. ......... "h
uti ..... or tbo ,o"oul ,,_Itr UVU~. "I '.G' Iftol",..'.
1911). fony.wo PO f cont of "".plt.1 M<1 11\ nf h·· .. ·• .'.,. I!Oth, .. ,y," cl>lldhood Illn ..... I ....... ,In , •• ~, " ..... ~~.
_ ISO -
av.1I1 .. , of I_nl •• Uon ,uudly 0' • po<lhuh,
l_hotlOll. "vlO'o.n P'" c@nt 117\1 of h,,_ ra, ...........
"o~ uollla, of t_ntuU"" ,oport.<I f ..... thllr tu_ 0,
<11<1 H ot "".pIUI eo .. _thro. U.v." por ".M III',.r ..... pIUI Co" .. th ... ,,,,".oto<l II.corr.~lIr) tll .. , .... c.u •
.... too r-<>, for the I_ohotlo" _,10<1. """1 .... t ... .. _Ye< did IIOt atUc"l.t .......... for not ayalll"".r 1_"lutl""o. n_._nt In t .... of t~. 9"'<" .. 01 boh.vlou. Ind ".peu .. "t 01 ,·hlL~, ...
th ...... f. no ,roup dlft ... ne .. In e'1109. 'u'"n~ M" .I"pl", ".obh •• "",.n th ... child .. " .. ,. yo"n~ l~n.I .. , .10 .... "th.oldl ...... IY ••• " af 16\ of tho to_Ill .. had 1'",1>1_ ot c'yin, I" th ... child .. ", Il' b.d hodlnq pr~M~ .. _ It, had .1"1'1", 1'<01>10 •.
- .. of ... Iou. '~CI_" .aCOUot",od by child .. " ,"d _
dUf., •• ,0 .. ,rou"". TI>e .. we ••• h' .... '"ch •• doto-.... 10< ""'pltol ......... u. far _ eo .. child.... ""'1'110) .... chll<l.u _re oI,nU •• "Uy .., ... ctln tll.., I"''' 11_ CO"
or In chlld,,"'o boh ... I"""I/blol09'<:al ,,~~I~t\ly. '" ... th··.·"" ... 1I ...... _nt of "_pUG_nt ,h ... W.," • "e ....
h .... OY., I. ,lie direction of ho,pltl' co, •• n'h~,o ,.,1""
tb.1r child" ...... 1., to ... no~. Iho" did h" .. e .. ~ ... th ... , HI of hO'pIUI "0" ond lU 01 h_ c~ .. .at,... •• found th.l, cbltd of OUllr tho .. n .. oql ........... "t to -",,0 (I' •. 0661.
"1.U"""'I~ All but H of ""'plt.1 co ..... tbor. utod tb.I< .. ,lotl_",I" .. lth thlit child .. bot ... than ..... t .. 1 M ...... v •• Ih ... _ •
... "" I .. th. dl .. ~tL"" of "- c ... .... t"' .. h.vl"~ , ... n.'