Socioeconomic inequities in the health and nutrition of children in low/middle income countries
Socioeconomic inequities in the health and nutrition of children in low/middle income countries
复制标题
DOI：
10.1590/s0034-89102010000100001
复制
发表时间：
2010-02-01
期刊：
影响因子：
--
通讯作者：
Gwatkin, Davidson
中科院分区：
文献类型：
--
作者：
Barros, Fernando C;Victora, Cesar G;Gwatkin, Davidson
目的：描述社会不平等对低收入和中等收入国家儿童健康和营养的影响。方法：我们回顾了现有的关于国家内社会经济差异的数据，这些差异与服务的使用、营养状况、发病率和死亡率有关。通过了一个概念框架，其中包括影响不平等的五个主要等级类别：社会经济背景和地位、不同的暴露程度、不同的脆弱性、不同的健康结果和不同的后果。自1990年以来，PubMed数据库的检索确定了244篇与该主题相关的文章。结果还分析了近100个最近的国家调查，包括人口健康调查和儿童基金会的多指标类集Surveys.RESULTS：来自贫困家庭的儿童更有可能，相对于那些来自富裕家庭，接触病原体，一旦他们被暴露，他们更有可能生病，因为他们的抵抗力较低，覆盖率较低的预防干预措施。一旦他们生病，他们就不太可能获得保健服务，这些服务的质量可能会降低，获得挽救生命的治疗的机会也会减少。因此，从贫困家庭的儿童有较高的死亡率，更有可能营养不良.CONCLUSIONS：除了儿童肥胖和母乳喂养的做法不足，所有其他的不利条件的分析是更普遍的儿童从不太富裕的家庭。仔细记录儿童健康方面社会经济不平等的多层次决定，对于理解这一问题的性质和制定可以减少这些差异的干预措施至关重要。
OBJECTIVE: To describe the effects of social inequities on the health and nutrition of children in low and middle income countries.METHODS: We reviewed existing data on socioeconomic disparities within-countries relative to the use of services, nutritional status, morbidity, and mortality. A conceptual framework including five major hierarchical categories affecting inequities was adopted: socioeconomic context and position, differential exposure, differential vulnerability, differential health outcomes, and differential consequences. The search of the PubMed database since 1990 identified 244 articles related to the theme. Results were also analyzed from almost 100 recent national surveys, including Demographic Health Surveys and the UNICEF Multiple Indicator Cluster Surveys.RESULTS: Children from poor families are more likely, relative to those from better-off families, to be exposed to pathogenic agents; once they are exposed, they are more likely to become ill because of their lower resistance and lower coverage with preventive interventions. Once they become ill, they are less likely to have access to health services and the quality of these services is likely to be lower, with less access to life-saving treatments. As a consequence, children from poor family have higher mortality rates and are more likely to be undernourished.CONCLUSIONS: Except for child obesity and inadequate breastfeeding practices, all the other adverse conditions analyzed were more prevalent in children from less well-off families. Careful documentation of the multiple levels of determination of socioeconomic inequities in child health is essential for understanding the nature of this problem and for establishing interventions that can reduce these differences.