Exploring cross-sectional associations between common childhood illness, housing and social conditions in remote Australian Aboriginal communities
Exploring cross-sectional associations between common childhood illness, housing and social conditions in remote Australian Aboriginal communities
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DOI：
10.1186/1471-2458-10-147
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发表时间：
2010-03-20
影响因子：
4.5
通讯作者：
Guthridge, Steve
中科院分区：
文献类型：
--
作者：
Bailie, Ross;Stevens, Matthew;Guthridge, Steve
背景：有限的流行病学研究提供了对住房条件与各种不良健康结果之间的因果和调节因素的复杂网络的见解。本研究探讨了澳大利亚偏远土著社区住房条件（主要关注基础设施的功能状况）与常见儿童疾病之间的关系，目的是为住房干预措施的发展提供信息，以改善儿童健康。方法：利用一项住房干预研究的基线调查数据，对儿童常见病照护者报告与住房基础设施的功能和卫生状况、社会经济、心理社会和健康相关行为之间的关系进行分层、多层次分析。结果：多因素分析显示，呼吸道感染报告与房屋整体功能状况之间存在很强的独立关联(优势比（OR） 3.00；95% CI 1.36-6.63)，但其他疾病的报告与整体功能状况或特定健康生活习惯所需的基础设施功能状况之间没有显著关联。儿童疾病报告与显示OR为2或2以上的次要解释变量之间的关联包括：皮肤感染-房屋温度控制不良的证据（OR 3.25; 95% CI 1.06-9.94），房屋害虫和害虫的证据（OR 2.88; 95% CI 1.25-6.60）；对于呼吸道感染——婴儿期母乳喂养（OR 0.27; 95% CI 0.14-0.49）；腹泻/呕吐——食物制备和储存区域的卫生状况（OR 2.10； 95%可信区间1.10-4.00）；对于耳部感染-儿童护理出勤（OR 2.25; 95% CI 1.26-3.99）。结论：这些发现增加了其他证据，表明建设项目需要得到一系列其他社会和行为干预的支持，才能更充分地实现潜在的健康收益。
Background: There is limited epidemiological research that provides insight into the complex web of causative and moderating factors that links housing conditions to a variety of poor health outcomes. This study explores the relationship between housing conditions (with a primary focus on the functional state of infrastructure) and common childhood illness in remote Australian Aboriginal communities for the purpose of informing development of housing interventions to improve child health.Methods: Hierarchical multi-level analysis of association between carer report of common childhood illnesses and functional and hygienic state of housing infrastructure, socio-economic, psychosocial and health related behaviours using baseline survey data from a housing intervention study.Results: Multivariate analysis showed a strong independent association between report of respiratory infection and overall functional condition of the house (Odds Ratio (OR) 3.00; 95% CI 1.36-6.63), but no significant association between report of other illnesses and the overall functional condition or the functional condition of infrastructure required for specific healthy living practices. Associations between report of child illness and secondary explanatory variables which showed an OR of 2 or more included: for skin infection - evidence of poor temperature control in the house (OR 3.25; 95% CI 1.06-9.94), evidence of pests and vermin in the house (OR 2.88; 95% CI 1.25-6.60); for respiratory infection - breastfeeding in infancy (OR 0.27; 95% CI 0.14-0.49); for diarrhoea/vomiting - hygienic state of food preparation and storage areas (OR 2.10; 95% CI 1.10-4.00); for ear infection - child care attendance (OR 2.25; 95% CI 1.26-3.99).Conclusion: These findings add to other evidence that building programs need to be supported by a range of other social and behavioural interventions for potential health gains to be more fully realised.