The National Health Observatory (ObSanté) has dedicated its first annual thematic report to children's health and the health system's response to children's needs. Good health during childhood is a major component of proper physical and mental development. A healthy upbringing does not just affect a child's life during their younger years; it is also the foundation for a healthy life as they grow older. The present report has been developed using a validated framework for this type of systemic assessment, based on available, reliable and comparable indicators of child health from conception up to the age of 12 years. This set of indicators, based on data available from various sources in Luxembourg, allows to look at the past and present of child health, health behaviours and the health system for children in Luxembourg, and to provide a baseline for future assessments.
Key findings on health status and behaviours
One in five children aged 11-12 will be overweight or obese in 2022, and this figure has been rising steadily in recent years, from 15% to 22% for boys and from 11% to 16% for girls between 2014 and 2022. With the exception of fruit and vegetable consumption, indicators of healthy behaviours have not improved and even declined: only 57% of boys and 36% of girls reported doing regular physical activity at least 4 times a week in 2022.
A significant proportion of health problems affecting children are preventable: almost one in three schoolchildren aged 5 to 7 had untreated tooth decay in 2022-2023, and around one in seven children were treated for trauma in an emergency department each year between 2013 and 2020.
Measuring children's perceived state of health reveals that less than half of children aged 11 to 12 felt that their health was excellent in 2022, and the proportion of children with psychosomatic complaints has increased: in 2022, 43% of girls and 29% of boys experienced multiple health problems several times a week or even daily over the past six months. These proportions are similar to those in neighbouring countries, but in Luxembourg economic inequalities are evident and increase between 2014 and 2022.
The response of the health system to children's needs
In Luxembourg, paediatricians play a leading role in primary care for children under the age of 10: in 2022, paediatricians provided 97% of consultations for children under the age of 1, 86% of consultations for children aged 1-3 years and 63% of consultations for children aged 4-9 years, while general practitioners provided 3%, 14% and 37% respectively.
More than 40% of paediatricians are over the age of 50. Nevertheless, the number of paediatricians is increasing, and at 0.19 paediatricians per 1.000 inhabitants, it is higher in Luxembourg than in Belgium, France and the Netherlands, and similar to that in Germany.
Participation in recommended check-ups, screenings and vaccinations is over 90% for children under two years of age. However, these participation rates decrease after the second birthday: 40% of children attend the language screening with hearing test at 30 months after birth (Bilan 30), 21% attend the two medical visits and only 5% attend the two preventive dental visits between 2 and 4 years of age.
However, the very low levels of unmet medical and dental care needs among children in Luxembourg indicate an equitable access to health services.
Specialized hospital care for children is centralized at the Kannerklinik of the Centre hospitalier de Luxembourg. The national density of hospital beds for paediatric care decreased between 2017 and 2021, to reach 3.9 beds per 10,000 children in 2021.
Socioeconomic differences
The report highlights significant socioeconomic differences in health behaviours and the health of children. Children from poorer families have worse health outcomes and engage in less healthy behaviours than children from richer families. The available data also suggests that this gap has increased over the last decade (2014 to 2022).
Recommendations
The report also includes a number of proposals aimed at improving children's health and facilitating the measurement and evaluation of the impact of health systems, programmes and policies on children's health.
The full report is available at the following link: https://sante.public.lu/fr/espace-obsante/rapport-thematique-sante-enfant.html.
Press release by the National Health Observatory