[Modern approaches to child and adolescent health assessment at population level]

Despite the notion that the future of our society depends on children; their health is neither a key target in national health programmes, nor a key priority for research. Further improvement in child and adolescent health in Poland depends partly on appropriate data and on indicators applicable for planning, monitoring and evaluating purposes. Mortality statistics do not provide adequate description of the burden of disease in this age group and new indicators are required due to on increase in chronic diseases, and mental health problems. The aim of the paper is to discuss the concept of child and adolescent health and to stress the need of reliable data, correctly collected, analysed and interpreted. The paper compares the biomedical and biopsychosocial paradigms concerning children's health and well-being. Main determinants of health as alternative outcome measures, commonly used in health promotion, are also discussed. CHILD (The Child Health Indicators of Life and Development) project indicators are presented and their availability in Poland is described. A short international comparison based on five indicators related to health and health determinants, showed that Poland, a relatively low-income country in EU, is affected by health problems typical for Central and Eastern Europe (physical, such as relatively high mortality, poor oral health, and psychological, such as lower life satisfaction). However, new problems typical for more developed West European countries are expected to increase (like asthma and eating disorders). On the other hand, by comparison to other countries more children in Poland live in full families with supportive parents. In conclusion, there is a great progress in measuring children's health all over the world, although most of the new approaches have not been yet implemented in Poland. There is a special need to develop and implement multidimensional measures with well-established validity and reliability, such as quality of life scales and health profiles.