Shortsighted parents
SHORT STATURE is not by itself a disease; it may not even be a social liability. So parents need to be cautious about subjecting children who are growing slowly to an arduous regimen of hormone therapy to make them taller.
Parents did not face this temptation until July of last year, when the Food and Drug Administration declared the synthetic growth hormone Humatrope safe for any child at the lowest height range for their age. Previously the drug had been reserved only for youngsters with a proven hormone deficiency.
Children afflicted with this deficiency had been treated successfully and without significant adverse effects for 20 years. The synthetic hormone appears safe, though it is impossible to know the consequences far into adulthood.
If safety isn't the issue, efficacy surely is. According to Dr. Laurie Cohen, an endocrinologist at Children's Hospital in Boston, young people without a hormone deficiency who take the synthetic drug gain only a couple of inches in height after a lengthy course of injections.
The treatment costs $10,000 to $40,000 a year, sometimes defrayed by insurance companies. It is an unsound use of premiums to pay for a regimen that has no medical rationale. Blue Cross-Blue Shield, Harvard Pilgrim, Tufts, and Fallon -- the largest health plans in Eastern Massachusetts -- are wise to limit reimbursement to cases where there is a clear medical condition.
In a recent Globe article, reporter Patricia Wen found that some parents are nonetheless determined to get their children the shots. "Even a couple of inches makes a world of difference," one said.
Studies on the impact of height vary. One by Dr. David E. Sandberg of the University of Buffalo concluded that short children are as well adjusted as their taller classmates. Another, by Nicola Persico and Andrew Postlewaite of the University of Pennsylvania, found an economic advantage attached to greater height, at least for people who were taller as teenagers. "Those who were relatively short when young are less likely to participate in social activities that may facilitate the accumulation of productive human capital like social adaptability," they wrote.
It's true that most US presidents are taller than average, and many people consider height an advantage thoughout life. But parents who believe that "a couple of inches" matter would be better off encouraging their children to have productive and happy high-school years rather than insisting on hormone treatment, which only emphasizes the child's comparative shortness. A highly motivated youngster at peace with his or her appearance will probably do well no matter the height. Just ask Michael J. Fox or Paul Simon.
