10.6 Million Children Globally Suffer from Serious Health-Related Suffering, Palliative Care Severely Lacking
A new study published in The Lancet Child & Adolescent Health reveals a staggering 10.6 million children aged 0 to 19 were living with serious health-related suffering (SHS) in 2023, with a disproportionate 96% residing in low- and middle-income countries. The findings underscore a critical gap in global healthcare, as access to essential palliative care remains severely limited for this vulnerable population.
The research, building on methodology from the 2018 Lancet Commission on palliative care and pain relief, provides the most rigorous analysis to date of SHS in children, utilizing data from the Global Burden of Disease Study 2023. Previous estimates of children needing palliative care ranged dramatically, from 1.2 million to 21 million, highlighting the need for a more precise understanding of the issue.
Serious Health-Related Suffering (SHS) encompasses physical, psychological, social, and spiritual pain and distress linked to life-threatening or life-limiting conditions. As one of the study’s co-first authors explained, SHS can be understood as a “proxy for palliative care need.” The study’s authors emphasize that this is “the first study to rigorously analyse children’s SHS, based on the Lancet Commission methodology, using child-specific criteria over time.”
The data reveals a concerning trend: while the number of children not succumbing to their conditions has increased, the overall burden of SHS has not significantly decreased since 1990. In 2023, 81% of SHS was experienced by children who survived beyond the year, compared to 59% in 1990. This suggests a growing number of children are living with chronic conditions requiring ongoing palliative support.
The most prevalent conditions contributing to SHS in 2023 were endocrine, metabolic, blood, and immune disorders, accounting for 51% of all cases. The study provides detailed insights into 21 different health conditions impacting children globally. .
Despite international commitments to improve palliative care, the study authors lament that the number of children experiencing SHS – and, crucially, those lacking access to care – has remained stubbornly stagnant. This unmet need, they argue, “epitomises the worst failings of global health, particularly because it is neither costly nor complicated to address.”
Addressing this crisis requires a multi-faceted approach. The authors call for empowered communities, robust policies supporting palliative care research and training, improved access to essential medicines, and the seamless integration of palliative care services within existing healthcare systems. A critical component is also addressing the “pervasive misconception that children do not experience pain to the same extent as adults.”
The research highlights a significant gap in paediatric palliative care research, with one expert noting that this area has been “perilously ignored” even in comprehensive overviews of child and adolescent health. While acknowledging the challenges in data collection and inclusion, the authors caution that the true global burden of SHS among children may be even greater than reported.
Ultimately, the study serves as a powerful call to action, urging increased investment in paediatric palliative care, particularly in regions where the need is most acute. As one appraisal of the study’s contribution to the field succinctly stated, “As complicated as the numbers and methodologies might be, one child suffering needlessly is one child too many.”
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