Did you know the beginning of April marked national public health week? Probably not. The observance which began officially in 1995 doesn’t garner much in the way of public attention. Still, it serves to highlight public health achievements as well as talk about ongoing public health issues.
Many of the numerous accomplishments of public health are now considered basic services not recognized for the benefit they have given us all in health improvement. The newborn screening program was one of the accomplishments highlighted this year. This program has in particular greatly impacted my specialty of pediatric endocrinology, and I think it is important to acknowledge its important place in public health history.
Every year, newborn screening efforts test nearly every baby born in the U.S. for serious health conditions. Early detection of these conditions allows prompt medical treatment and potentially prevents disability, suffering, and death. In particular, testing the 4 million infants born every year for congenital hypothyroidism costs $5 per newborn and is estimated to prevent 160 cases of intellectual disability associated with untreated hypothyroidism.
I’ve written in the past about congenital hypothyroidism. The condition refers to a specific type of hypothyroidism diagnosed in newborn babies. This serious condition occurs in roughly 1 in every 4,000 newborns and can have devastating effects if not detected and promptly treated. Eighteenth century medical literature described the mental retardation and physical effects of untreated congenital hypothyroidism, cretinism. But only in the last 30 years have doctors been able to detect these issues prior to birth, allowing for parents to be prepared and physicians and family members to lay out a plan for the child’s future.
The Texas state newborn screening for congenital hypothyroidism has been active since 1980. It is estimated that 120-150 newborns in Texas with hypothyroidism are identified annually by screening. The program is a cornerstone in Texas public health and continues to grow. Today, the program tests newborns for 30 life-threatening issues including sickle cell disease and cystic fibrosis. Congenital adrenal hyperplasia screening represents another important life-threatening condition with pediatric endocrine ties that are screened by the state.
There are many other accomplishments in public health largely unrecognized by us. Thankfully, the U.S Centers for Disease Control & Prevention has compiled a list of the 10 great public health achievements in the 20th century.
Many other Cook Children’s specialties besides endocrinology rely on newborn screening to identify at risk babies early. Many of the conditions tested by newborn screening are rare metabolic conditions. The metabolic genetics program offers evaluation and treatment of these inherited metabolic conditions to help families understand and cope with their child’s diagnosis. A visit to that program can help with a more accurate diagnosis and appropriate treatment, while also helping families determine the best short- and long-term care.
As a self-described ‘techie,’ Joel Steelman, M.D., has a keen interest in the wise use of technology to improve medical care. Since 2001, he has helped implement electronic medical recordkeeping in two endocrine practices. He still loves to write, and he is a regular contributor to the Physician Perspective page on the Cook Children’s Web site.
- Cook Children’s Endocrinology and Diabetes Program
- Cook Children’s metabolic genetics program
- Newborn screening tests
- Prenatal tests