Download National Children`s Study (NCS)

National Children’s Study (NCS)Answering Tough Questions About Child Health
Frances J. Dunston MD, MPH
The A J McClung Chair of Pediatrics
Professor and Chair, Department of Pediatrics
Morehouse School of Medicine
Study Center Director, Community Engagement
Presentation Overview
• Describe the National Children’s Study
(NCS)
• What is the importance of the NCS?
• What will we learn from the NCS?
• How will the NCS benefit children?; society?
• How will it answer tough questions, i.e.
Autism?
What is
The National Children’s Study ?
• The National Children’s Study is a long-term
research project that will examine the
environmental influences on children’s
health and development
• The largest long-term study of children’s health
and development ever to be conducted
in the United States
• The scope and magnitude of the study provides
the ability to answer tough, yet unanswered
questions about the health and well-being
of children.
The National Children’s StudyScope of the Study
• The NCS will examine the effects of the
environment on the health and development
of more than 100,000 children across the US,
form pre-birth to age 21 years.
• The study defines environment in the broadest
terms: natural, man-made, biological,
chemical, social, behavioral, genetic, cultural
and geographic.
The National Children’s StudyWhat is its Purpose? Why now?
• The environment to which children are born
and in which they must grow and develop
has changed
• Now we recognize the powerful influences
of the environment on children’s health
• New health problems have emerged that
need new answers to tough questions
• New knowledge can shape health polices
and practices that can improve health
The National Children’s StudyPriority Themes
• A study of children’s physical, social, cultural,
behavioral, and chemical environments
• Involving children from diverse ethnicities and
backgrounds
• The first nationwide study to benefit from
human genome mapping
• Focused on understanding the causes of
obesity, injury, asthma, pregnancy related
outcomes, and developmental disorders such
as autism
Elements that Influence
Health Outcomes
Sources of
Exposure
Examples
Physical Environment
Housing quality,
neighborhood
Chemical Exposures
Pesticides, phthalates,
heavy metals
Biologic Environment
Infectious agents,
endotoxins, diet
Genetics
Interaction between
genes and
environment
Psychosocial milieu
Family structure,
socio-economic status,
parenting style, social
networks, exposure to
media and violence
Important
Health Outcomes
Examples
Pregnancy Outcomes
Preterm, Birth defects
Neurodevelopment &
Behavior
Autism, learning
disabilities,
schizophrenia,
conduct and behavior
problems
Injury
Head trauma, Injuries
requiring
hospitalizations
Asthma
Asthma incidence and
exacerbation
Obesity & Physical
Development
Obesity, diabetes,
altered puberty
Converging Factors
• Numerous environmental exposures can
converge to impact children’s health and
development
• Which environmental exposures are most
important in the occurrence or prevention of
health problems in children
• What factors in a child’s environment are most
protective?
The breadth and scope of the NCS
has the power to answer these questions
How will the National Children’s
Study be conducted?
National Children’s Study
Locations
National Children’s Study
Sample
All Births
in the Nation
~4 million births
in 3,141 counties
Sample of Study
Locations
105 Locations
Sample of Study
Segments
Selection of
neighborhoods
Study
Households
All or a sample of
households within
neighborhoods
Study Women
All eligible women
in the household
National Children’s Study
MAP OF GEORGIA
DeKalb County
Fayette County
Partners in Our Children’s Health
Communities of
The National Children’s Study
National Children’s Study (NCS)
and Autism
-Answers to tough questions
Autism
Autism in the Media
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Autism in the Media
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Autism in the Media
©2008 Media General Communications Holdings, LLC.
Autism in the Media
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Autism in the Media
Copyright ©2008 TWEAN News Channel of Syracuse, LLC, d/b/a News 10 Now
Autism in the Media
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Autism in the Media
©2008 About.com, a part of The New York Times Company.
What we know about Autism
• Autism and the autism spectrum disorders
(Rett syndrome, Asperger syndrome, childhood
integrative disorder) are now the most
common set of developmental disorders
in children, occurring in 1 in 150 children
• The incidence of reported cases of autism
has increased dramatically- from 1 in 10,000
in 1978 to 1 in 300 in 2006
• Autism is a complex, life-long biological
disorder of developmental
What we know about Autism
• Autism may be confused with other neurodeveopmental conditions such as mental
illness, hearing problems
• Autism may co-exist with other distinct
conditions
• Universal screening of all children is now
recommended for early identification and
better treatment, education and lifetime
outcomes.
What we don’t know about
Autism –tough, unanswered
questions
• What are the causes of autism?
• Why is the incidence of autism increasing?
• Is there an association between vaccines
and autism?
• How do environmental factors influence
autism?
• What are the best treatments for autism?
• What are the best predictors of good
outcomes?
What tough questions will the
NCS answer about autism?
• The role of genes in autism: Is autism caused
by a specific gene defect?
• The role of infections during pregnancy and autism:
Is there a link?
• Multiple research studies have not been able to
show a link between autism and MMR vaccine,
the administration of multiple vaccines, or
thimerosal as a preservative in vaccines.
Is there more we can learn?
• The interaction of environmental toxins and gene
expression and autism: Retinoids and the HOX
gene
So, the NCS will Provide…
• The answer to concerns about known
exposures during childhood to potential
toxicants
• The power to determine absence of effects
or benefit of exposures to various products
important for our society
• Causal factors for a number of diseases
and conditions of children with suspected
environmental causes
• How multiple causes interact to result
in multiple outcomes
So, the NCS will Provide…
• Large sample size required to apply
knowledge of the human genome to
understand multi-factorial genetic conditions
• Identification of early life factors that
contribute to many adult conditions
• A national resource to answer future
questions by using stored biological and
environmental samples and the extensive
data for decades to come
So, the NCS will Provide…
• An evidence base for decisions about
health changes in health policy and
practice
• Economic benefits -cost avoidance
• Improvements in health for all
children
Wednesday, April 30, 2008
1 p.m. – 5 p.m.
Auditorium,
Louis W. Sullivan
National Center
for Primary Care
Morehouse
School of Medicine
720 Westview Drive SW,
Atlanta, Georgia 30310
Admission is free –
Please RSVP:
[email protected]
Reception to follow