5 children's health groups. Physical health and development. The concept of “health group”

Health groups.
Very often, when parents study their child’s chart, they find an entry in it - health group one (or second, third...). But not all parents know what kind of group this is and on what basis it is nominated. Although in fact, this is just a record for a doctor or teacher. Reporting on the characteristics of the baby’s health, allowing you to rationally draw up an action plan for his improvement or education.

What are health groups?
Health groups are a specific scale that takes into account the health and development of the child, it also includes all the risk factors that influenced or are influencing him, and a forecast for the future is made. The health group is set by a local pediatrician or a medical worker at a preschool institution; this is based on 6 established criteria.

The first criterion evaluates heredity. At the same time, it is necessary to note whether there are diseases in the family that are passed on from generation to generation, and to determine the baby’s predisposition to them. After questioning the parents in detail, the doctor will make a conclusion and determine whether the child is at risk of getting sick or not. In addition, it is important to evaluate the course of pregnancy, the birth itself and, of course, the first month of the child’s life. Complications of pregnancy, childbirth and the baby’s first illnesses are very important for the correct determination of the health group.

The second criterion is, this includes height, weight, head circumference, chest circumference and other parameters. In addition, the child’s neuropsychic development is assessed - this is the third criterion. The child’s skills, speech development, and communication are assessed. To help the doctor, there are tables that reflect the baby’s skills by month and year, but deviations in one direction or another are not considered a pathology; in order to determine whether it is a pathology or not, it is necessary to evaluate the entire range of skills. Afterwards, the child’s behavior is assessed, taking into account the child’s communication with others, how he eats, his emotionality, and bad habits. The last, but very important criterion is the child’s chronic diseases or developmental defects and anomalies. Particular attention is paid to those vices that affect the life and existence of the baby. A health group is not a static indicator. It can change throughout the child’s life, but, alas, most often in the direction of worsening - from the first to the second, and more often from the second to the third.

Children's health status.
Having collected all the data and assessed it, the doctor determines the health group at a given time. The health of the children's population is characterized by both the presence or absence of diseases, and harmonious and age-appropriate physical and mental development, a normal level of all body functions, and the absence of a tendency to diseases. Health assessment criteria have been developed:

The presence of any diseases at the time of examination (that is, they came to the appointment sick or healthy);
- level of functional state of all body systems (how correctly all organs and systems work);
- correspondence of physical and mental development to age (how the child grows and what he can do);
- the degree of resistance of the body to adverse effects (how often and for how long it gets sick).
Based on the results of a medical examination, children are divided into five groups.

Group I- healthy children, physically and mentally developing normally, without functional deviations. Children in this group may rarely get sick during the observation period, but at the time of the examination they should be healthy, and the body’s resistance should be high. In fact, the first health group includes absolutely healthy children, but children with this health group are very rare, literally a few. Over my years of practice, I have only exhibited this health group a couple of times.

Group II- healthy children, but with functional and some morphological abnormalities, with reduced resistance to diseases. Such children should not have chronic diseases, but can suffer acute diseases more than 4 times a year.

The second group has several subgroups, and the entire group includes healthy children, but with some nuances. Group “A” includes healthy babies, but either there is a family history, or the mother’s pregnancy and childbirth were complicated. Group “B” includes children who are often ill, with some functional abnormalities with a possible risk of developing chronic diseases.

The remaining groups include sick children with diseases of varying severity. Such children must undergo medical examination by specific specialists. Special health and treatment programs are being developed for them. So, the third group includes children with developmental defects in the compensation stage; if the defects are in the subcompensation stage, then such children already belong to the fourth health group, and the decompensation stage is the fifth health group.

III group- children with chronic diseases in a state of compensation (that is, in a state without exacerbation, not manifesting themselves in any way). This group unites children with congenital pathology or chronic diseases, in which there may be rare and mild exacerbations of the underlying disease. The body's resistance in such children is somewhat reduced. Such diseases for which group 3 will be assigned include chronic gastritis or duodenitis, diarrhea, chronic bronchitis, pyelonephritis, anemia, obesity, stuttering, flat feet and adenoids.

IV group- children with chronic diseases in a state of subcompensation. This group includes children with congenital pathology or chronic diseases, in which, after an exacerbation of the underlying disease, the general condition and well-being are impaired for a long time. The body's resistance in children is sharply reduced. These are epilepsy, hypertension, thyrotoxicosis, progressive scoliosis.

Group V- children with chronic diseases in a state of decompensation. These are children with severe disabilities who cannot walk, cancer patients and other serious conditions. Children in this group have severe developmental defects or chronic diseases with significantly reduced functional capabilities. Such children usually do not attend general child and adolescent institutions and often have disabilities.

Depending on the diagnosis itself, children with the third and fourth health groups may be recommended to reduce their loads or even home schooling.

How can you tell if the group is the right one?
When determining a health group, it is necessary to take into account all criteria characterizing the health of a given child. A comprehensive health assessment is carried out at the time of the medical examination. The functional state of body systems is determined by clinical methods, using functional tests. The correspondence of the physical and mental development of the child’s body according to biological age is carried out. The body's resistance is judged by the number of acute diseases and exacerbations of chronic diseases over the previous year. When examining children and adolescents, we must not forget about functional deviations in health, which can occur at a certain age and are not a true pathology, but reflect age-related physiological changes occurring in the body.

So there is a pattern of occurrence of functional deviations in the health of children:
- in infancy, abnormalities in the composition of the blood (anemia), allergic manifestations appear,
- digestive disorders appear at an early age (especially if the child is not fed correctly);
- in preschool age, dysfunctions of the nervous, respiratory and urinary systems, musculoskeletal system and ENT organs appear;
- at school age, disorders of cardiovascular activity and functions of the visual organs appear.

The most frequently asked questions.
If a child belongs not to the first health group, but to the second, is this dangerous?
Not really, but this child requires attention from both the doctor and the parents, even more from the parents. The fact is that this health group indicates that the baby’s body is working at the limit of its strength. To maintain your health, or that it is affected by too many harmful factors, the negative effects of which may not be immediately apparent - for example, severe hypoxia during childbirth can make itself felt only at 2-3 years of age, when development has cooled down. The second group is a signal for observation and active activities with the child through hardening, massage, gymnastics - but this is not a sick child. Previously, there was an opinion that children with the second health group should be limited in physical activity in kindergarten and school as a kind of “blow away specks of dust,” but this is an unjustified recommendation. You just need to monitor the tolerance and gradualness of the loads, but not limit them.

The third health group is children with chronic pathology and is this forever?
No, the third health group, if there have been no exacerbations of the disease for a long time, and the terms of its clinical observation have passed, are transferred to the second group, that is, the child is considered healthy, with the reservation that he was once sick. This happens with allergy sufferers, children under three years old - as they say, they “outgrow”, with children with pyelonephritis, children with anemia who have been cured and hemoglobin is at stable levels.

Children with the third health group do not go to physical education?
No, they go - but usually they go to a preparatory or special group, it all depends on the disease. They are shown courses in physical therapy and gymnastics.

According to the Constitution of the Russian Federation, the state is obliged to promote in every possible way the preservation of the health of its citizens. For this purpose, there is state medicine, social insurance, and regular medical examinations of the population are carried out. Correctly assessing the condition of the human body and providing him with an optimal package of medical services allows adult health groups and children. Official medicine identifies three main health groups for the elderly middle-aged people and citizens.

Health groups in adults. Group No. 1

The first health group includes people who do not have any chronic diseases. Their health is quite good; they rarely get colds. Blood pressure is normal or has slight deviations that are not significant for normal social life and the performance of work and family responsibilities.

Typically, people with the first health group actively engage in sports and try to lead a healthy lifestyle. They do not have bad habits, drug or alcohol addiction. They are very attentive to the condition of their own body: they eat rationally, strictly observe all hygiene standards, and do not forget about exercise. When the first signs of the disease appear, immediately consult a doctor.

Standard monitoring is carried out among people belonging to the first health group, no more than once a year. This is quite enough to prevent the development of chronic diseases.

Health groups in adults. Group No. 2

The second group includes people who are fully able to work, but have any chronic diseases. Most often, these diseases occur without any exacerbations or sudden deterioration of the condition.

People with the second health group maintain a moderate level of physical activity and do not always eat rationally. They do not have drug addictions, but may have bad habits (for example, smoking). Monitoring of the body's condition is carried out among the second group more often, about twice a year. If necessary, treatment is prescribed.

Health groups in adults. Group No. 3

The most typical purpose of the third health groups for pensioners and people who have been disabled since childhood. The ability to work can be lost completely or partially; exacerbations of chronic diseases regularly occur, which significantly prevent a person from maintaining a normal level of social and physical activity.

Preventive examinations of people belonging to the third health group are carried out especially often, about 3–4 times a year. If necessary, hospitalization is prescribed. A person with a third health group has the right to treatment in dispensaries and sanatoriums.

When a child undergoes medical examination, in his medical record a mark is put down about assigning him a certain health group. Usually it is determined as soon as the baby is born, but over time, under the influence of various factors, the child’s health status may change, and accordingly, the health group also changes.

In general, “health group” is a concept rather conventional and is used to assess the health of children under seventeen years of age as a result of a comprehensive examination, without taking into account previous diseases that did not leave significant traces in the child’s body or did not become chronic.

Among the factors that are taken into account when making such an assessment are the main ones:

• are there any chronic diseases;
• how various organs and systems of the body function;
• how the body resists diseases, how often does a child suffer from seasonal diseases;
• general level of development, both neuropsychic and physiological.

Many parents, seeing such a mark, cannot understand its meaning and begin to panic. After all, there are five health groups, and it is necessary to understand what each one means.

Group I is characterized by normal development child and absence of chronic diseases. In principle, these are healthy children.

III group. This children-chronicles in a state of remission, or with disabilities resulting from injuries and operations, they may have weight problems. But these children have no restrictions in life. Neuropsychically they are normal.

IV group. Happens often exacerbation of chronic disease, such children need constant health maintenance with the help of medication. They may have learning disabilities and find it difficult to adapt to society.

Group V is characterized by presence of serious illnesses, dysfunctions of organs and organ systems. These are disabled people.

We will talk about group II in more detail and try to figure out why the child is assigned to it. It's worth knowing that almost 60% of children belong to health group II. In general, such children are healthy, but there is a possibility of acquiring chronic diseases. Usually, in order to ensure ease of medical observation and rapid response, they are divided into two subgroups.

2-a – there is a hereditary factor, or the conditions in which the baby lives can contribute to the development of illness, both physical and mental. Such children are mobile, active and physically develop without deviations.

And the presence of allergic reactions and minor disturbances in the functioning of organs do not interfere with their full life. These children can engage in physical education without restrictions, in accordance with age programs, they are recommended to attend additional sports sections.

2-b – Children have some deviations from the norm, for example, they are susceptible to respiratory diseases, they have a weakened immune system, or there are minor developmental abnormalities. It happens that there is a slight lag behind peers in development.

They are recommended special classes that facilitate physical training, taking into account all risk factors, that is, according to special programs. It is undesirable to overwork and undergo serious physical activity.

Thus, we can distinguish a number of factors allowing the child to be classified into group II:

• if he was born prematurely, or, on the contrary, later;
• if the mother was pregnant with several babies;
• the central nervous system was affected during pregnancy;
• immediately after birth the child suffered from an infectious disease;
• the baby weighed little at birth;
• rickets or its consequences are present;
• excess body weight;
• diathesis is present;
• there is cardiac arrhythmia or a heart murmur is heard;
• often suffers from acute respiratory infections and acute respiratory viral infections (more than 4 times annually);
• low level of hemoglobin in the blood;
• there is abdominal pain, lack of appetite;
• the Mantoux reaction fluctuates between positive and negative;
• the child has suffered from Botkin’s disease or pneumonia;
• surgical procedures were postponed.

These kids need in the attention of the medical staff, It is very important to monitor their condition on a regular basis - these should be medical examinations with in-depth examination and, if necessary, the use of drug therapy or periodic spa treatment.

Over time, a child can move from one health group to another, depending on whether his condition gets better or worse.

And in order for him not to move to the next group in terms of severity of illness, but, on the contrary, to rise up the conventional steps higher, it is necessary to constantly monitor his health status, carry out preventive measures and adhere to the recommendations of the attending physicians in everything.

P indicators of the health status of children and adolescents are:

• general morbidity,
• infectious morbidity,
• health index,
• percentage of long-term and frequent sick people,
• prevalence and structure,
• percentage of people with normal physical development;
• percentage of people with disabilities in mental and physical development.

Monitoring the health status of class students is carried out by the class teacher together with a medical worker.

In the cool magazine The last page summarizes information about student health during the school year in the form of the following indicators:

• Health index - the percentage of children who did not get sick during the school year (normally 70 - 80%, in fact - 17-30%).
• Number of frequently ill children (more than 3 - 4 times per year).
• The number of children with chronic diseases and the list of these diseases (a feature of recent years is an increase in the number of “adult diseases”: chronic gastritis, gastric ulcer, hypertension, etc.).

Information about the health status of students in the class and school is discussed at the pedagogical council and, together with a medical worker and the State Sanitary and Epidemiological Surveillance Center, a comprehensive plan for protecting the health of schoolchildren is drawn up.

Every year, millions of children and adolescents undergo medical examinations. The purpose of these examinations is to identify persons in need of medical and recreational measures. In addition, they make it possible to determine the need for medical personnel and a network of treatment and preventive institutions (HCI). Taken together, their results characterize the health status of the entire younger generation.

A comprehensive assessment of the health status of each child or adolescent with assignment to one of the “health groups” is given with mandatory consideration of all the listed criteria. This grouping allows for a comparative assessment of the health status of various populations, both at the time of examination and during dynamic monitoring, to check the effectiveness of preventive and therapeutic measures.

The main 5 groups of children's health.

There are five health groups of the children's population. Depending on their membership in a particular health group, children and adolescents need a differentiated approach when developing a set of treatment and preventive measures.

The first group - healthy children, with normal development and a normal level of function - children who do not have chronic diseases; those who were not ill or rarely ill during the observation period; having normal, age-appropriate physical and neuropsychic development (healthy children, without deviations).

For persons included in the first health group, educational, work and sports activities are organized without any restrictions. The pediatrician carries out preventive examinations as scheduled, and medical prescriptions usually consist of general health measures that have a training effect on the body.

The second group - healthy children, but having functional and some morphological abnormalities, as well as reduced resistance to acute and chronic diseases - children who do not suffer from chronic diseases; having some functional and morphological deviations; often (4 times a year or more) or for a long time (more than 25 days for one disease) sick (healthy, with morphological abnormalities and reduced resistance).

Children and adolescents included in the second health group (the so-called risk group) require closer attention from doctors. This contingent needs a complex of health-improving measures aimed at increasing the body’s resistance by non-specific means:

• 2) hardening by natural factors;
• 4) additional fortification of food products, etc.

The timing of repeated medical examinations is set by the doctor individually, taking into account the direction of deviations in the state of health and the degree of resistance of the body.

The third group - children with chronic diseases in a state of compensation, with preserved functional capabilities of the body - children with chronic diseases or with congenital pathology in the stage of compensation, with rare and not severe exacerbations of a chronic disease, without a pronounced violation of the general condition and well-being (patients in a state of compensation).

Fourth group- children with chronic diseases in a state of subcompensation, with reduced functional capabilities - persons with chronic diseases, congenital malformations in a state of subcompensation, with disturbances in their general condition and well-being after an exacerbation, with a protracted period of convalescence after acute diseases (patients in a state of subcompensation).

The fifth group - children with chronic diseases in a state of decompensation, with significantly reduced functional capabilities of the body - children with severe chronic diseases in the stage of decompensation, with a significant decrease in functional capabilities (patients in a state of decompensation). As a rule, children in this group do not attend child care institutions and are not covered by mass medical examinations.

Children and adolescents of the 3rd, 4th and 5th health groups are under dispensary observation by doctors of various specialties; they receive one or another therapeutic and preventive care, depending on the existing pathology and the degree of compensation. In children's institutions, a gentle daily routine is created for them, an extended duration of rest and night sleep, the volume and intensity of physical activity is limited, etc. If necessary, they are sent to special children's and adolescent institutions, where, taking into account the characteristics of the pathology, treatment and education are targeted.

Examples:

Functional heart murmur, tachycardia, bradycardia, sinus arrhythmia, extrasystole, decreased blood pressure (8-12 years up to 80 - 85 mm Hg, 13-16 years - up to 90 - 95 mm Hg) - 2nd health group. Vegetative-vascular dystonia - 3rd health group. Hypertension - 4th health group. Congenital heart disease - 3rd or 4th health group. Dental caries, malocclusion - 2nd or 3rd health group. Chronic gastritis, colitis - 3rd or 4th health group. Dysmenorrhea - 3rd health group.

Allergic reactions (repeated allergic skin reactions to foods, medications, etc.) - 2nd health group. Eczema, dermatitis - 3rd or 4th health group. Logoneurosis, enuresis, tics - 3rd or 4th health group. Mild myopia, astigmatism - 2nd health group. Moderate and high myopia - 3rd or 4th health group. Poor posture - group 2, scoliosis - group 3 or 4.

In-depth research. During it, the child’s health status is assessed during periods of epicrisis, with subsequent recommendations from specialists for the further full development of the baby.

Detection of various diseases in the early stages and improvement of the child’s health, the goal of which is to prevent the formation of a chronic disease.

The pediatrician determines the health group, taking into account all examinations by specialists.

There are several criteria to assess the child’s health status:

1 criterion - whether deviations are observed in early ontogenesis.

2nd criterion - development in physical terms.

3 criterion - neuropsychic development.

4th criterion - the body's resistance to various painful factors.

5th criterion - the state of organs and systems.

6th criterion - whether there are chronic diseases or congenital diseases.

Thus, the determination of the health group is based on the criteria listed above. So, the child has health group 2. What does this mean?

Characteristics of health group 2

You need to understand that a health group is nothing more than the child’s health state and his predisposition to various diseases, as well as the presence of congenital diseases. Health group 2 includes children who have minor health problems. They tend to get sick more often, for example, acute respiratory infections, they may be overweight or likely to have allergies.

Health group 2 occurs most often in newborns. Because currently, completely healthy children are not born, even if the mother does not suffer from any diseases. A person’s attitude to one or another health group is established not only in but also accompanies him throughout his life.

There are two more subgroups among children who are assigned to group 2

2-A are children who have biological, genetic and social factors for the development of diseases, but they are healthy according to other criteria.

Genetic factors are the presence of relatives with various diseases that can be passed on from generation to generation. For example, diabetes, heart disease, allergies and others.

Biological factors are deviations that arose during pregnancy and childbirth in the mother. These are quick or, on the contrary, long labor, cesarean section, long-term presence of the fetus without amniotic fluid, pathologies of the placenta, malposition of the fetus, and so on.

Social factors include smoking, alcoholism of parents, work of parents in hazardous work, chronic diseases of the mother, too early or late pregnancy. The presence of infections that can be sexually transmitted, the threat of premature birth or miscarriage in the mother. Poor nutrition during pregnancy and violation of the general regime.

2-B are children who have morphological and functional changes. Newborns who belong to this subgroup suffered from some illness in the first days or hours of life and after discharge from the maternity hospital they still have some abnormalities. Such babies often get sick, have constitutional anomalies and other health abnormalities.

Upon discharge from the maternity hospital, the risk group is indicated, and, judging by it, the pediatrician must draw up a plan for observations, examinations, and carry out preventive measures (hardening, vaccinations). If necessary, drug treatment is prescribed.

Children who belong to subgroup 2-B must be monitored at home for up to three months.

So, what is health group 2, and how can young children and preschoolers be classified as part of it?

There are a number of deviations that can be used to judge the child’s health status:

Multiple pregnancy.

Immaturity is post-term, prematurity.

Damage to the central nervous system.

Hypotrophy 1st degree.

Infection in the womb.

Low birth weight.

Excess weight at birth (4 kg or more).

The initial period of rickets, 1st degree of rickets and its residual effects.

Presence of anomalies in the constitution.

Changes that relate to the cardiovascular system, changes in blood pressure, pulse.

Frequent diseases, including respiratory ones.

Gastrointestinal dysfunction - lack of appetite, abdominal pain, etc.

Group 2 health in a child is not yet an indicator that all deviations should be present in the medical record. Just one or a few is enough. The health group is determined based on the most severe deviation.

All parents can easily find out which health group their child belongs to. Every local doctor has this information, and even a nurse will be able to provide explanations. After all, a child’s health group is not a medical secret.

Monitoring the health of children in child care institutions

Information about children from 2 gr. health care must be provided by a nurse at a child care facility. If a child belongs to this group, then in physical education lessons he is offered a set of exercises specially designed for such children. The loads for them should be lower. But this does not mean giving up sports at all. If a child has health group 2, then such children are often prescribed physical therapy classes.

In addition, medical supervision of children who belong to this group is necessary. Since they may have a high risk of developing various pathologies. The main method that allows you to assess the health status of children is a preventive examination, which is carried out by doctors.

There is also an algorithm for determining health groups in children aged 3 to 17 years. Children are examined:

At 3 years old (before entering kindergarten);

At 5 and a half or 6 years old (one year before primary school);

At the age of 8, when the child finishes 1st grade of school;

At age 10, when the child enters secondary school;

At 14-15 years old.

If, as a result of the examination, the child’s health indicators are related to the classes and groups of diseases identified by the Ministry of Health of the Russian Federation, then he is assigned to a certain health group.

Physical education classes for children of health group 2

In order for physical education lessons to be carried out effectively and without risk to the health of schoolchildren, the latter are classified into one of three groups (basic, preparatory and special). The division is made by a pediatrician or therapist at the end of the school year, but the specialist makes a final verdict only after a re-examination before the start of the next school year.

If a child has health group 2 in physical education, then he belongs to the preparatory medical group. These are practically healthy children, but they have certain deviations and are poorly prepared physically. Schoolchildren can study but with the condition of gradual acquisition of the necessary motor skills and abilities. The dosage of physical activity is observed, contraindicated movements are excluded.

If a child has health group 2, then he is prohibited from completing test tasks in class and participating in sports events. But experts strongly recommend conducting additional physical education classes at home or at school.

Tasks for schoolchildren with health group 2:

Strengthening and improving health;

Improving physical development;

Mastering important motor skills, qualities and abilities;

Improving the body's adaptation to physical activity;

Hardening and increasing the body's resistance to disease;

Formation of interest in constant physical education, development of volitional qualities;

Fostering a positive attitude towards healthy lifestyle;

Mastering a set of exercises that have a beneficial effect on the condition of the child’s body, taking into account the existing disease;

Maintaining proper rest and work schedule, hygiene, and proper nutrition.

Conclusion

Thus, health group 2 in a child is not a death sentence. He should not be considered inferior or terminally ill. The child’s belonging to this group means that he needs sensitive care, and his health must be constantly monitored in order to avoid unpleasant consequences.

Children with this health group lead a normal life and develop well; they are no different from other children.