"Stunted growth" - an American cultural concept.As an editorial in the August 21 Journal of the American Medical Association JAMA: The Journal of the American Medical Association is an international peer-reviewed general medical journal, published 48 times per year by the American Medical Association. JAMA is the most widely circulated medical journal in the world. points out. "Parental pressure to mitigate short stature in their children is driven by a cultural `heightism' that permeates American society. Taller college graduates make more money, and 80 percent of U.S. presidents have been the taller candidate. Also revealing these prejudices are expressions such as `short-sighted' and `short end of the stick'." (So as not to offend short people, one humorist recently suggested the "politically correct" term height-challenged person as a substitute for "dwarf" in the story of Snow White.)
Regrettably, many American parents (and, even more regrettably, their children) view small stature as a handicap, leading to sense of inferiority, teasing by other children, or being treated a younger than their chronological age. Such cultural concepts are responsible for the increasing us (and subsequent controversy) of growth hormone to treat short-statured American children not shown to be deficient in growth hormone.
True growth-hormone deficiency in a child is a clear indication for the use of growth hormone-but the criteria for its diagnosis have not been clearly established. Many pediatric pediatric /pe·di·at·ric/ (pe?de-at´rik) pertaining to the health of children.
Of or relating to pediatrics. endocrinologists, under pressure from concerned parents, are thus using growth hormone without clear-cut medical indications for its use.
The potential side effects are many, including allergy, impaired glucose tolerance Impaired Glucose Tolerance (IGT) is a pre-diabetic state of dysglycemia, that is associated with insulin resistance and increased risk of cardiovascular pathology. IGT may precede type 2 diabetes mellitus by many years. IGT is also a risk factor for mortality. , hyperlipemia hyperlipemia /hy·per·li·pe·mia/ (-li-pe´me-ah) hyperlipidemia.
carbohydrate-induced hyperlipemia , slipped capital femoral epiphysis Slipped capital femoral epiphysis (SCFE) is a medical term referring to a fracture through the epiphyseal growth plate.
The capital (head of the femur) should sit squarely on the femoral neck. Abnormal movement along the growth plate results in the slip. , transient peripheral edema, scoliosis Scoliosis Definition
Scoliosis is a side-to-side curvature of the spine.
When viewed from the rear, the spine usually appears perfectly straight. , and leukemia. Although its enormous cost (as much as $15,000 to $30,000 a year) is sometimes met wholly or in part by the pharmaceutical companies when parents have no insurance to cover it, the cost to our healthcare system must be taken into account. As the JAMA JAMA
Journal of the American Medical Association editorial notes, one must ask whether a mere average one to two inches in height (and some children do not attain even this level) is worth the cost and the risk. Perhaps the money could be better spent for further education, job training, or professional counseling.