Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Public health

Public investment in childhood health: worth the cost

A new study of mortality of children on renal replacement therapy in 32 European countries demonstrates that 67% of the variance between countries can be explained by disparities in public health expenditure. Investment in health care is critical and has demonstrable benefits for the most vulnerable populations.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1: Increased public health expenditure improves paediatric renal care.

References

  1. Chesnaye, N. C. et al. Mortality risk disparities in children receiving chronic renal replacement therapy for the treatment of end-stage renal disease across Europe: an ESPN-ERA/EDTA registry analysis. Lancet http://dx.doi.org/10.1016/S0140-6736(17)30063-6 (2017).

  2. UNICEF & World Bank Group. Ending extreme poverty: a focus on children. UNICEF https://www.unicef.org/publications/files/Ending_Extreme_Poverty_A_Focus_on_Children_Oct_2016.pdf (2016).

  3. Global Burden of Disease Child and Adolescent Health Collaboration et al. Child and adolescent health from 1990 to 2015: findings from the Global Burden of Diseases, Injuries, and Risk Factors 2015 Study. JAMA Pediatr. http://dx.doi.org/10.1001/jamapediatrics.2017.0250 (2017).

  4. McGovern, M. E., Krishna, A., Aguayo, V. M. & Subramanian, S. V. A review of the evidence linking child stunting to economic outcomes. Int. J. Epidemiol. http://doi.org/10.1093/ije/dyx017 (2017).

  5. The Low Birth Weight and Nephron Number Working Group. The impact of kidney development on the life course: a consensus document for action. Nephron 136, 3–49 (2017).

  6. Ajarmeh, S., Er, L., Brin, G., Djurdjev, O. & Dionne, J. M. The effect of a multidisciplinary care clinic on the outcomes in pediatric chronic kidney disease. Pediatr. Nephrol. 27, 1921–1927 (2012).

    Article  Google Scholar 

  7. Hidalgo, G. et al. Association of income level with kidney disease severity and progression among children and adolescents with CKD: a report from the Chronic Kidney Disease in Children (CKiD) Study. Am. J. Kidney Dis. 62, 1087–1094 (2013).

    Article  Google Scholar 

  8. McDonald, S. P., Craig, J. C. & Australian and New Zealand Paediatric Nephrology Association. Long-term survival of children with end-stage renal disease. N. Engl. J. Med. 350, 2654–2662 (2004).

    Article  CAS  Google Scholar 

  9. Peltz, A., Davidoff, A. J., Gross, C. P. & Rosenthal, M. S. Low-income children with chronic conditions face increased costs if shifted from CHIP to marketplace plans. Health Aff. (Millwood) 36, 616–625 (2017).

    Article  Google Scholar 

  10. UNICEF Innocenti Research Centre. Child poverty in perspective: an overview of child well-being in rich countries. A comprehensive assessment of the lives and well-being of children and adolescents in the economically advanced nations. UNICEF https://www.unicef.org/media/files/ChildPovertyReport.pdf (2007).

Download references

Acknowledgements

S.A. and S.L.F. are supported by the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases (Amaral: K23DK083529, R03DK099486 and R01DK110749; Furth: K24DK78737, U01DK066174)

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Susan Furth.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Related links

PowerPoint slides

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Amaral, S., Furth, S. Public investment in childhood health: worth the cost. Nat Rev Nephrol 13, 386–388 (2017). https://doi.org/10.1038/nrneph.2017.66

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrneph.2017.66

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing