Reducing inequalities in child health: understanding pathways, interventions and policies

减少儿童健康方面的不平等：了解途径、干预措施和政策

• 批准号: MR/P008577/1
• 负责人: David Taylor-Robinson
• 金额: $ 118.55万
• 依托单位: University of Liverpool
• 依托单位国家: 英国
• 项目类别: Fellowship
• 财政年份: 2017
• 资助国家: 英国
• 起止时间: 2017 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FP008577%2F1
• 关键词: Reducing; inequalities; child; health; understanding

RELEVANCE OF THE PROBLEMREDUCING HEALTH INEQUALITIES AND IMPROVING CHILD HEALTH ARE UK and INTERNATIONAL POLICY GOALS. Poverty and social inequality harm children's health. The poor health associated with poverty limits children's potential and development, leading to poor health and life chances in adulthood. The costs to society as a whole of the resulting inequalities, which have their origins in childhood, amount to around £60 billion per year in the UK. Tackling the poorer health of poorer children is a major challenge for public health in the UK. For this to happen, however, we need to identify how to break the link between adverse socio-economic conditions (SECs) with worse child health. One major challenge is that, while the association of poverty and children's health is clear, we lack understanding of the complex pathways linking adverse social conditions to worse child health. Another challenge for research is that it is rarely possible to study the sorts of population-wide interventions that might make a difference using conventional methods, such as randomized controlled trials.AIMS and OBJECTIVESTHIS RESEARCH AIMS TO IDENTIFY THE KEY MECHANISMS THAT LEAD TO POORER HEALTH IN POORER CHILDREN AND TO EVALUATE THE EFFECTS OF INTERVENTIONS AND POLICIES THAT HAVE THE POTENTIAL TO IMPROVE THE SITUATION. I will do this using some of the largest contemporary datasets in the world that follow-up children over the course of their lives in the UK and Denmark. These include the UK Millennium Cohort Study, the Welsh Electronic Cohort of Children, and the Danish National Birth Cohort. I will quantify the main causes and consequences of inequalities in child health and evaluate the impacts of public health, welfare and education interventions with the potential to break the link between poverty and poorer health.Taking childhood asthma, one of the most common longterm conditions in childhood, as an example, I have shown that children living in poorer socioeconomic conditions are more likely to have wheezing in childhood. Examining possible reasons, I found that the poorer children with asthma were more likely to have mothers who smoked during pregnancy and who were less likely to breast-feed. These two reasons accounted for most of the differences in asthma between disadvantaged and advantaged children that we observed. In my proposed research, I will apply statistical methods to see what would happen to inequalities in childhood asthma in the UK population if, for example, effective interventions to increase breast-feeding (such as baby friendly support policies in maternity hospitals) were fully implemented nationwide. The research will also show what effect longterm conditions like asthma have on attendance at school and exam results. Poor child health leading to poor educational performance is likely to be an important way in which health inequalities are generated, but this is not well understood currently. APPLICATIONS and BENEFITSThis research will directly inform policymakers and practitioners grappling with how best to break the link between child poverty and poorer health, and thereby improve health and reduce health inequalities across the life course. By applying new methods to important child health conditions I will develop a better understanding of HOW TO REDUCE INEQUALITIES IN CHILD HEALTH. I will work with policy makers and practitioners to make sure that the findings make a difference to the health and wellbeing of children, families and whole populations. Though I'll undertake most of the work in Liverpool, I have brought together an international collaboration of researchers from a range of disciplines to address this critical public health issue, which will provide superb research training. The information generated in my research programme has great potential for having a population-wide impact, a reduction in health inequalities and clear overall economic benefits.

问题的相关性减少健康不平等和改善儿童健康是英国和国际的政策目标。贫困和社会不平等损害儿童的健康。与贫困相关的健康状况不佳限制了儿童的潜力和发展，导致成年后的健康状况和生活机会不佳。由此产生的不平等现象（根源于童年）在英国每年给整个社会造成的损失约为 600 亿英镑。解决贫困儿童健康状况较差的问题是英国公共卫生面临的重大挑战。然而，要实现这一目标，我们需要确定如何打破不利的社会经济条件 (SEC) 与儿童健康状况恶化之间的联系。一项重大挑战是，虽然贫困与儿童健康之间的联系是显而易见的，但我们对将不利的社会条件与儿童健康状况恶化联系起来的复杂途径缺乏了解。研究面临的另一个挑战是，使用传统方法（例如随机对照试验）研究可能产生影响的各种人群干预措施几乎是不可能的。 目的和目的本研究旨在确定导致贫困儿童健康状况较差的关键机制，并评估具有潜力的干预措施和政策的效果。改善状况。我将使用世界上一些最大的当代数据集来跟踪英国和丹麦儿童的一生。其中包括英国千禧队列研究、威尔士电子儿童队列和丹麦国家出生队列。我将量化儿童健康不平等的主要原因和后果，并评估公共卫生、福利和教育干预措施的影响，这些干预措施有可能打破贫困与健康状况不佳之间的联系。以儿童哮喘（儿童时期最常见的长期疾病之一）为例，我已经表明，生活在较差社会经济条件下的儿童​​更有可能在童年时期出现喘息。通过检查可能的原因，我发现患有哮喘的贫困儿童的母亲更有可能在怀孕期间吸烟并且母乳喂养的可能性较小。这两个原因解释了我们观察到的弱势儿童和优势儿童之间哮喘差异的大部分原因。在我提出的研究中，我将应用统计方法来了解如果在全国范围内全面实施增加母乳喂养的有效干预措施（例如妇产医院的婴儿友好支持政策），英国人口中儿童哮喘的不平等会发生什么。该研究还将显示哮喘等长期疾病对上学和考试成绩的影响。儿童健康状况不佳导致教育成绩不佳可能是产生健康不平等的一个重要方式，但目前这一点还没有得到很好的理解。应用和益处这项研究将直接为政策制定者和从业者提供信息，帮助他们解决如何最好地打破儿童贫困和健康状况不佳之间的联系，从而改善健康状况并减少整个生命过程中的健康不平等。通过将新方法应用于重要的儿童健康状况，我将更好地了解如何减少儿童健康方面的不平等。我将与政策制定者和从业者合作，确保研究结果对儿童、家庭和全体人民的健康和福祉产生影响。虽然我将在利物浦承担大部分工作，但我已经召集了来自多个学科的研究人员的国际合作来解决这一关键的公共卫生问题，这将提供一流的研究培训。我的研究项目产生的信息具有巨大的潜力，可以对全民产生影响，减少健康不平等并产生明显的总体经济效益。

项目成果

Relationship between socioeconomic status and gastrointestinal infections in developed countries: A systematic review and meta-analysis.

发达国家的社会经济地位与胃肠道感染之间的关系：系统评价和荟萃分析。

• DOI: 10.1371/journal.pone.0191633
• 发表时间: 2018
• 期刊: PloS one
• 影响因子: 3.7
• 作者: Adams NL;Rose TC;Hawker J;Violato M;O'Brien SJ;Barr B;Howard VJK;Whitehead M;Harris R;Taylor-Robinson DC
• 通讯作者: Taylor-Robinson DC

Impact of poverty and adversity on perceived family support in adolescence: findings from the UK Millennium Cohort Study.

贫困和逆境对青春期家庭支持的影响：英国千年队列研究的结果。

• DOI: 10.1007/s00787-024-02389-8
• 发表时间: 2024
• 期刊: European child & adolescent psychiatry
• 影响因子: 6.4
• 作者: Adjei NK

Impact of child poverty and adversity on perceived family support in adolescence

• DOI: 10.1093/eurpub/ckad160.067
• 发表时间: 2023-10-24
• 期刊: The European Journal of Public Health

Impact of Parental Mental Health and Poverty on the Health of the Next Generation: A Multi-Trajectory Analysis Using the UK Millennium Cohort Study.

父母心理健康和贫困对下一代健康的影响：利用英国千年队列研究进行的多轨迹分析。

• DOI: 10.1016/j.jadohealth.2023.07.029
• 发表时间: 2024
• 期刊: official publication of the Society for Adolescent Medicine
• 作者: Adjei NK

Impact of poverty and family adversity on adolescent health: a multi-trajectory analysis using the UK Millennium Cohort Study.

• DOI: 10.1016/j.lanepe.2021.100279
• 发表时间: 2022-03
• 期刊: The Lancet regional health. Europe
• 作者: Adjei NK;Schlüter DK;Straatmann VS;Melis G;Fleming KM;McGovern R;Howard LM;Kaner E;Wolfe I;Taylor-Robinson DC;ORACLE consortium
• 通讯作者: ORACLE consortium