Health

Weighing the Risks of Childhood Play

By Ryan McGreal
Published July 19, 2007

Today's Hamilton Spectator carries an alarming story about the dangers of children's playgrounds.

Noting that playground injuries were responsible for 940 emergency room visits in Hamilton-Niagara in a single year (2004-2005), the article quotes Margaret Keresteci from the Canadian Institute for Health Information saying, "People think of playgrounds as safe but they can be dangerous places."

The story is alarming not because of the revelation that children sometimes injure themselve in playgrounds, but because it inadvertently adds a voice to the chorus of paranoid parents who are reacting to the normal risks of active living by ensconcing their children inside sterile indoor bubbles.

As parents and as a society, we need to draw a careful distinction between legitimate and easily preventable risks of disaster and risks of minor, character-building injuries; and acknowledge that attempts to avoid danger can carry their own insidious dangers as well.

Emotionally Crippled

Children who never get any time and space to themselves to explore, make their own discoveries, push themselves to new challenges, draw inferences and test them, solve their own problems, take on initiatives, and all the related aspects of independence can grow up emotionally crippled: beholden to extrinsic signals, afraid to take chances, even susceptible to learned helplessness.

In last Saturday's Spec, Dianne Rinehart argued passionately in defence of the risk of childhood injury, citing not only the danger of obesity and related chronic diseases, but also of psychological illness and missed chances to develop confidence and independence as adults.

In the "olden days," before school boards removed playground equipment for fear of law suits, kids climbed monkey bars - or, better yet, swung from trees and ran through forests and fields. Now they need fitness club memberships, "play" is a "work" out, and it has to be scheduled into mum or dad's day, so they can drive them there.

The result? Kids aren't just getting fatter and going slightly stir-crazy, they aren't learning the creative thinking skills they used to acquire through "unorganized" play - as opposed to soccer practice - to become confident, independent, problem-solving adults.

Kids need to fall from trees and, yes, live a little dangerously, research proves, to be prepared to meet life's challenges.

Weighing Relative Risks

Even as the actual rates of assaults, kidnappings and so on continue to decrease, consciousness of such dangers continues to increase through a combination of public education and what we might call "sensational" news reporting.

Ditto for serious injuries and devastating illnesses, as medicine and the possibility of preventative intervention become more comprehensive through vaccinations, mandatory helmet laws, and so on.

Unfortunately, people are notoriously incapable of accurately weighing relative risks. We're predisposed toward easily visible risks with direct, observable cause/effect relationships, and tend to downplay slower, more insidious connections like that between inactivity and heart disease.

Parents who move to sanitized suburbs and drive their children to the park (if they go at all) to keep them "safe" think nothing of obesity, type II diabetes, heart disease etc. as a direct result of sedentary lifestyles and too much prepared food.

Risk of Injury Death

Parents also think nothing of the drastically elevated risk of injury through car accidents when they suddenly have to drive everywhere.

Let's look at the risks. According to the US Centres for Disease Control, of the ten leading causes of injury death in 2001 by age, the number one cause of death for children between 1 and 14 was unintentional motor vehicle collisions, responsible for 2,102 deaths, or 43.9 percent of the total injury deaths listed.

Unintentional drowning was the number two killer, with 791 deaths or 16.5 percent, and unintentional fire/burning was number three, with 482 deaths or 10.1 percent.

Pedestrian deaths and falls combined amounted to 178 deaths, just 3.7 percent.

Top 10 Causes of Injury Death, Age 1-14
Deaths Percent of Total
Vehicle 2102 43.9%
Drowning 791 16.5%
Fire 482 10.1%
Pedestrian / Fall 178 3.7%
All Other 1239 25.9%
Total 4792 100.0%

Source: 10 Leading Causes of Injury Death by Age Group - 2001, Centres for Disease Control [PDF]

Risk Management

Living in a modern society involves a lot of risk management. In the case of childhood, we need to compare the risk of injury in a playground with the risk of injury from not playing in a playground.

Personally, I'm all for skinned knees, grubby faces, and regular exposure to the risk of minor injury through active living - what Calvin's dad drily called "building character" in Bill Waterson's Calvin and Hobbes comics.

As the father of two children, I'm secretly delighted when they bonk their heads on metal slides, fly off the ends of merry-go-rounds in old parks that still have them, slash their arms on branches while tear-assing through the woods, run around barefoot and get "hobbit feet", build their own toys from plywood and old two-by-fours, and all the wonderful stuff that transforms childhood from a micromanaged ordeal to be endured into a perilous and delightful world to be discovered.

To be sure, I fret and kvetch like most parents. I'm certainly more protective in some ways than my own parents were, especially with letting my children play outside unsupervised. Sometimes, I just can't bear to look (as when my older son hurtles himself off a swing right at its apex and sails through the air).

For parents, it's an ongoing struggle to find the right balance between concern for children's safety and understanding that the biggest danger today's children face comes from timidity and inactivity.

Ryan McGreal, the editor of Raise the Hammer, lives in Hamilton with his family and works as a programmer, writer and consultant. Ryan volunteers with Hamilton Light Rail, a citizen group dedicated to bringing light rail transit to Hamilton. Ryan writes a city affairs column in Hamilton Magazine, and several of his articles have been published in the Hamilton Spectator. He also maintains a personal website and has been known to post passing thoughts on Twitter @RyanMcGreal. Recently, he took the plunge and finally joined Facebook.

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By Ryan (registered) - website | Posted July 19, 2007 at 14:50:27

A bit more context on this statistic:

"playground injuries were responsible for 940 emergency room visits in Hamilton-Niagara in a single year"

There are about 500,000 people in Hamilton, 131,000 in St. Kits, 80,000 in Niagara Falls, 23,000 in Grimsby, and 15,000 in NOTL [1], for an approximate total of around 750,000 for the region.

StatsCan tells us [2] that Ontario children between 0 and 14 years of age make up about 20 percent of the population, so we can estimate that there are about 150,000 children in Hamilton-Niagara.

So, 150,000 children playing for an entire year produced 940 hospital visits (of which it's possible, bear in mind, that a single child went to the hospital more than once).

Let's be generous and assume that doctors office / walk-in clinic visits were the same: that gives us a total of 1,880 treated injuries.

That makes a 1.25 percent injury rate per year, or a 0.0034 percent injury rate per day.

Notes

[1] http://www.citypopulation.de/Canada-Onta... [2] http://www12.statcan.ca/english/census01...

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By Rusty (registered) - website | Posted July 19, 2007 at 15:03:47

Vehicle accidents are at the top of your list - where are the articles on that? When's the last time you read an article decrying the unsafe state of our streets?

Another horrendous accident and pedestrian death in Toronto yesterday:

http://www.thestar.com/News/article/2375...

The local councilor said the street design was not to blame. Have you seen some of these intersections in Markham, N York and Scarborough? I would hate to have to walk around there.

It's time we got outraged about the real safety issues facing our children.

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By kleenex (anonymous) | Posted July 19, 2007 at 15:16:33

Another reason to send your kids out: children who don't get exposed to dirt, pollen, bugs etc at a young age are more likely to get allergies and asthma as they get older.

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By seancb (registered) - website | Posted July 19, 2007 at 15:29:41

I have always said that people, specifically kids, need to give their immune system a regular workout by getting a little dirty once in a while, otherwise they will die from the first cold they catch at age 30.

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By Ted Mitchell (registered) | Posted July 20, 2007 at 13:17:02

Parents who push for these ultra-safe play structures seem stunned beyond imagination.

Perhaps they are the same ones who teach their children to back away in fear from the friendliest of dogs, only to ignore the cars racing by a few feet away.

Unfortunately it is the rare human brain that sees things as they are instead of heavily filtered through what is socially acceptable.

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