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- Mangrio, Elisabeth
(författare)
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Epidemiological studies of sociodemographic factors, early life factors, health, and medical care consumption among small children
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- By international standards, children in Sweden experience good health. Sweden has low infant mortality rates, low accident mortality rates, a high number of breastfed children and a high proportion of vaccinated children. However, during the past twenty years the prevalence of overweight children has doubled in Sweden, while that of obese children has increased 4-5 times. Furthermore, there has been an increase in self-reported problems such as anxiety and sleeping disturbances among adolescents. Asthma and other types of allergic diseases are the most common chronic diseases during childhood, while infectious diseases are the most common causes of short-term morbidity. It is well-known that the social position of the family, living conditions, and parental health-related behaviors are closely connected with health in childhood. The socioeconomic position (SEP) of the family affects the child’s health from the very beginning of life through the mother’s health-related behaviors during pregnancy. Even though the prevailing etiological model for adult chronic disease emphasizes adult risk factors, the importance of earlier life circumstances has recently attracted considerable attention. A life course perspective seems to increase our understanding of health in childhood as well as later on, in adulthood. In this thesis, the associations between sociodemographic factors and early life factors (e.g., maternal smoking during pregnancy, exposure to secondhand tobacco smoke, breastfeeding, and high birth weight) on the one hand and health and medical care consumption on the other hand, were investigated among small children in Malmö. The studies in the thesis were population-based and cross-sectional, and the study populations comprised children who visited the Child health care (CHC) centers for their 8-month or 4-year check-up during 2003-2008 and whose parents answered a self-administered questionnaire. The self-administered questionnaire was handed out to the parents of 8-month-old and 4-year-old children in conjunction with their check-up at the CHC centers aiming to reach all children in Malmö in these two age groups. The questionnaire was distributed by the pediatric nurses at the centers. The results showed that antibiotic consumption at an early age was influenced by several factors including parental sociodemographic factors, lifestyle factors, psychosocial support, as well as child-related factors. The results further showed associations between exposure to unfavorable early life factors and the development of childhood allergy and overweight or obesity. Such effects were enhanced when there were presence of parental allergy or parental overweight, respectively. Children with less educated mothers were exposed to more health risks, fewer health promoting factors, worse social support and had a higher medical care consumption than children with mothers with higher levels of education.In conclusion, the results show that children’s health seems to be highly influenced by the characteristics of the families into which they are born. The results also put focus on the importance of early targeted interventions.
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| 2. |
- Mangrio, Elisabeth, et al.
(författare)
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Maternal educational level, parental preventive behavior, risk behavior, social support and medical care consumption in 8-month-old children in Malmo, Sweden
- 2011
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 11:891
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Tidskriftsartikel (refereegranskat)abstract
- Background: The social environment in which children grow up is closely associated with their health. The aim of this study was to investigate the relationship between maternal educational level, parental preventive behavior, parental risk behavior, social support, and use of medical care in small children in Malmo, Sweden. We also wanted to investigate whether potential differences in child medical care consumption could be explained by differences in parental behavior and social support. Methods: This study was population-based and cross-sectional. The study population was 8 month-old children in Malmo, visiting the Child Health Care centers during 2003-2007 for their 8-months check-up, and whose parents answered a self-administered questionnaire (n = 9,289 children). Results: Exclusive breast feeding >= 4 months was more common among mothers with higher educational level. Smoking during pregnancy was five times more common among less-educated mothers. Presence of secondhand tobacco smoke during the first four weeks of life was also much more common among children with less-educated mothers. Less-educated mothers more often experienced low emotional support and low practical support than mothers with higher levels of education (>12 years of education). Increased exposure to unfavorable parental behavioral factors (maternal smoking during pregnancy, secondhand tobacco smoke and exclusive breastfeeding <4 months) was associated with increased odds of in-hospital care and having sought care from a doctor during the last 8 months. The odds were doubled when exposed to all three risk factors. Furthermore, children of less-educated mothers had increased odds of in-hospital care (OR = 1.34 (95% CI: 1.08, 1.66)) and having sought care from a doctor during the last 8 months (OR = 1.28 (95% CI: 1.09, 1.50)), which were reduced and turned statistically non-significant after adjustment for unfavorable parental behavioral factors. Conclusion: Children of less-educated mothers were exposed to more health risks, fewer health-promoting factors, worse social support, and had higher medical care consumption than children with higher educated mothers. After adjustment for parental behavioral factors the excess odds of doctor's visits and in-hospital care among children with less-educated mothers were reduced. Improving children's health calls for policies targeting parents' health-related behaviors and social support.
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