Dynamic model for preventing mental retardation in the population: the importance of poverty and deprivation.
A dynamic simulation model is used to answer the question, "What is the most effective child health policy initiative for the prevention of mental retardation (MR)?" The impact of medical strategies is contrasted with social interventions to see how they affect the prevalence of MR in the general population. The model is based on data from four U.S. Census and California Vital Statistics reports (1960, 1970, 1980, 1990). An interstate comparison (California and South Carolina) uses 1990 data. The results of the simulations reveal that medical interventions to improve the developmental outcome of low birth weight (LBW) infants did not cause a reduction in the rate of MR in the population after a 24-year trial period. In contrast, reducing the proportion of children living in poverty who are exposed to environmental deprivation significantly decreased (10%) MR at the end of the model's time period. This analysis supports the view that long-term reduction in MR prevalence is attainable by modifying public policies that influence children's development. Effective MR prevention calls for public policy committed to multifaceted health and educational services for both affected parents and their young children.
McDermott
S W
SW
Department of Family & Preventive Medicine, School of Medicine, University of South Carolina, Columbia 29208.
Altekruse
J M
JM
D000293:Adolescent; D000328:Adult; D001925:Brain Damage, Chronic / Q000453:epidemiology / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008607:Intellectual Disability / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D011203:Poverty / Q000523:psychology*; D011610:Psychosocial Deprivation; D012307:Risk Factors; D014481:United States / Q000453:epidemiology