To spank or not to spank, that is the question

Regular readers of this blog will have encountered periodic posts on how adverse childhood experiences can lead to health problems later in life. A recently published study in Pediatrics weighs in on this issue with evidence that corporal punishment of children may increase the risk of cardiovascular disease, obesity, and arthritis in adults.

The study looked at information from over 34,000 adults who participated in the National Epidemiologic Survey on Alcohol and Related Conditions. Among the questions asked was whether people faced harsh physical punishment in childhood. Those who suffered overt physical abuse or neglect, emotional abuse or neglect, or sexual abuse were not included in the study. The authors looked for correlations between adult health problems and significant corporal punishment in childhood. They found the risk of obesity to be 20% higher in adults who had experienced severe punishment, the risk of arthritis to be 25% higher, and the risk of CV disease to be somewhat higher, though the latter did not reach the level of statistical significance.

Clearly this paper does not prove a cause-and-effect relationship, but it adds data to the growing body of information that adverse childhood experiences can lead to medical problems later in life. The link may well be dysregulation of the autonomic nervous system that becomes programmed in at a very young age.

Parents often ask their primary care clinician for advice on how best to discipline their children. While medical research may not provide conclusive answers, there is accumulating evidence suggesting that corporal or severe punishment should be avoided. There are effective non-physical means to discipline children. Use of these methods can lead kids down the right path without risking potential problems later in life.

Parents seeking advice on this issue can be advised to keep in mind that as they themselves age, they may at some point need help from their adult children. Their adult children will be in a better position to help if they are not having to deal with arthritis, obesity, or CV disease themselves. In other words, avoiding corporal punishment can be a win-win situation.

Richard Fleming, MD

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