This paper provides a comprehensive review of the medical literature around the childhood determinants of adult diabetes and cardiovascular disease.
The study was undertaken by Dr Nicola Nelson, as part of her advanced training in paediatrics, during her six-month attachment to the Ministry of Health. The context for the research is that it is a building block for the Ministry's ‘Leading for Outcomes’ workstream of the Clinical Services Directorate. This paper does not necessarily define formal Ministry of Health policy in this area, but is intended to inform policy decisions and programme implementation in the health sector.
It is an important background document for health researchers, funders and planners and clinicians who are attempting to stem the growth of chronic disease in adulthood. It clearly identifies the precursors of the major chronic conditions that have the potential to cripple not only individuals, but also the health system.
In addressing root causes, the paper also picks up the first ‘Future direction’ of the New Zealand Child Health Strategy 1998, which supports ‘a greater focus on health promotion, prevention and early intervention’.
Purpose
The objective of this review is to draw together current evidence relating to the factors in childhood that influence the development of cardiovascular disease and type 2 diabetes in adulthood, with the intention of identifying the most important points of intervention.
Methodology
The information for this review was obtained from multiple sources. Much of it comes from relevant Ministry of Health publications, along with research reports published in academic and scientific journals and books. Several strategies were used to find documents, with a focus on information relevant to New Zealand. This included repeated Medline searches using key words, surfing Internet websites, searching bibliographies from key texts and use of a bibliographic database search carried out by the Ministry’s information services staff. Further studies were identified from citations from retrieved articles and discussion with experts.