RECENT research has confirmed what we have long suspected — children whose parents died while they were still young or adolescents have an increased risk of death, from all causes, as they grow into early adulthood.

This increased risk may reflect both genetic and other factors, according to researchers at the Epidemiology Section, Department of Public Health at the Aarhus University in Denmark. Social and environmental factors contribute greatly to the increased risk of death among these children.

From 1968 to 2008, 2.7 million people born in Denmark, 3.3 million people born in Sweden between 1973 and 2006, and a random sample of 89 per cent of all those born in Finland from 1987 to 2007 (1.1 million) were studied. Of the combined cohort, 2.6 per cent of these children experienced the death of a parent, which occurred between the ages of six months and 18 years.

50 PER CENT GREATER RISK OF DEATH

There was a 50 per cent greater risk of death for the children, from all causes, if the death of a parent occurred. Regardless of the age of the child when the parent died, this increased risk for mortality persisted into adulthood. Compared with the death of a parent from natural causes, death from unnatural causes resulted in an even greater mortality rate ratio, with parental suicide carrying the highest mortality rate ratio for children.

These findings carry implications for clinical responses as well as public health measures or strategies. The research, however, was unable to go into detail regarding the parent-child relationship that existed before the parent died, or the lifestyles or the physical environment that prevailed.

So, research in these countries revealed that if the parents die prematurely, their children had a long-lasting increased risk of dying from both external causes and diseases, regardless of the age or sex of the children or the age or sex of the deceased parent. It didn’t matter the cause of the parent’s death, nor the socio-economic background in which it occurred.

These findings reveal the need for health and social support to be provided specifically to bereaved children and that such support may need to cover an extended period of time.

ARE THESE FINDINGS APPLICABLE TO CHILDREN IN JAMAICA?

The high rate of crime and violence with the prevalent loss of life of parents in Jamaica, coupled with the loss of life of parents from other causes, result in a high rate of adult mortality which our society often considers in isolation without recognising or discussing the possible harmful effects it may have on the children left behind.

Many of our children already receive inadequate adult supervision. Some are rebellious, some are devious and smoke cigarettes, ganja, as well as drink alcohol, while others simply need guidance and emotional support as they traverse the challenging periods from early childhood to adolescence, to young adulthood. Some are uncertain about the various feelings within their body, are unsure how to address the direction in which their sexual drive appears to be leading them, some push the envelope to see how much they can get away with, and others simply do not mature as quickly, physically or mentally, as their peers.

THE LOSS OF GUIDANCE, DISCIPLINE, AND SUPPORT

Without firm guidance from a caring adult or parent figure to love and simultaneously firmly guide the child or teenager through coping with these various challenges, setting appropriate rules and supporting them even when they slip, fall or fail, the outcome for these children and, by extension, for our society is bleak. Praise and approval are constantly needed by children and teenagers to encourage good behaviour and growth into a more mature human being. Insufficient appropriate parenting, or the loss of a parent or parent-substitute through death or migration, can therefore be quite devastating, both in the short, medium and long term.

We should be concerned, therefore, not only with the high rate of violent, accidental or premature adult death in Jamaica, but also with the subsequent effect such deaths have on children. The loss of adequate guidance, discipline and physical and emotional support caused by the loss of a parent or parent-substitute has now been shown to result in increased mortality for children going into adulthood. Our society needs to plot its way forward on this very crucial matter.

Derrick Aarons MD, PhD is a consultant bioethicist/family physician, a specialist in ethical issues in medicine, the life sciences and research, and is a member of the Executive Council of RedBioetica UNESCO.