Trends in inequalities in Children Looked After in England between 2004 and 2019: a local area ecological analysis.
Trends in inequalities in Children Looked After in England between 2004 and 2019: a local area ecological analysis.
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DOI：
10.1136/bmjopen-2020-041774
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发表时间：
2020-11-23
期刊：
影响因子：
2.9
通讯作者：
Taylor-Robinson D
中科院分区：
文献类型：
--
作者：
Bennett DL;Mason KE;Schlüter DK;Wickham S;Lai ET;Alexiou A;Barr B;Taylor-Robinson D
评估2004年至2019年期间英格兰儿童照顾（CLA）不平等的趋势，控制失业后，这是经济衰退的标志和虐待儿童的风险因素。纵向区域生态分析。150个英国上层地方政府。18岁以下的儿童。英国地方当局每年开始接受照顾的儿童年龄标准化率（CLA率），根据收入剥夺程度分为五分之一。不平等的斜率指数是使用纵向分段混合效应模型估算的，其中控制了失业因素。自2008年以来，CLA比率急剧上升，不平等现象明显扩大。失业率与CLA率的上升有关：失业率每增加一个百分点，估计每年每10万人中就有9名儿童（95% CI 6至11）在下一年得到照顾。然而，不平等现象的增加与失业的影响无关。2007年至2019年，在控制失业率后，相对于2004-2006年的趋势，最贫困地区和最贫困地区之间的差距每年每10万人增加15名儿童（95%CI 4至26）。在较贫困地区和受经济衰退影响较深的地区，儿童开始得到照顾的比率急剧增加。但失业趋势并不能解释十年来不平等的加剧，这表明其他社会经济因素，包括儿童贫困加剧和儿童服务支出减少，可能正在加剧不平等。安全降低CLA率的政策应立即解决儿童健康和福祉的社会决定因素。
To assess trends in inequalities in Children Looked After (CLA) in England between 2004 and 2019, after controlling for unemployment, a marker of recession and risk factor for child maltreatment. Longitudinal local area ecological analysis. 150 English upper-tier local authorities. Children under the age of 18 years. The annual age-standardised rate of children starting to be looked after (CLA rate) across English local authorities, grouped into quintiles based on their level of income deprivation. Slope indices of inequality were estimated using longitudinal segmented mixed-effects models, controlling for unemployment. Since 2008, there has been a precipitous rise in CLA rates and a marked widening of inequalities. Unemployment was associated with rising CLA rates: for each percentage point increase in unemployment rate, an estimated additional 9 children per 100 000 per year (95% CI 6 to 11) became looked after the following year. However, inequalities increased independently of the effect of unemployment. Between 2007 and 2019, after controlling for unemployment, the gap between the most and least deprived areas increased by 15 children per 100 000 per year (95% CI 4 to 26) relative to the 2004–2006 trend. The dramatic increase in the rate of children starting to be looked after has been greater in poorer areas and in areas more deeply affected by recession. But trends in unemployment do not explain the decade-long rise in inequalities, suggesting that other socioeconomic factors, including rising child poverty and reduced spending on children’s services, may be fuelling inequalities. Policies to safely reduce the CLA rate should urgently address the social determinants of child health and well-being.
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DOI：
10.1136/bmj.j3310
发表时间：
2017-07-26
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Barr B;Higgerson J;Whitehead M
通讯作者：
Whitehead M
影响因子：
3.3
作者：
Bywaters, Paul;Brady, Geraldine;Scourfield, Jonathan
通讯作者：
Scourfield, Jonathan
影响因子：
2.9
作者：
Emmott, Emily H.;Jay, Matthew A.;Woodman, Jenny
通讯作者：
Woodman, Jenny
影响因子：
2.9
作者：
Chandan, Joht Singh;Gokhale, Krishna Margadhamane;Taylor, Julie
通讯作者：
Taylor, Julie
影响因子：
12.8
作者：
HILLSON, JMC;KUIPER, NA
通讯作者：
KUIPER, NA