Association of family characteristics with health status and needs among children with congenital heart disease

2021 ◽  
pp. 1-9
Author(s):  
Ashley Peterson ◽  
Elizabeth Cochran ◽  
Dmitry Tumin ◽  
Lauren A. Sarno
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Survey Data ◽  
Congenital Heart ◽  
Economic Status ◽  
Functional Limitations ◽  
Population Based ◽  
Special Equipment ◽  
Socio Economic Status

Abstract Introduction: Low socio-economic status is associated with poorer quality of life among children with congenital heart disease (CHD), but this finding is based on disparities among children remaining under cardiology follow-up. We used a population-based health survey data set to analyse the impact of socio-economic status on health and functional status among children with CHD. Materials and methods: We used 2007–2018 National Health Interview Survey data, selecting children 2–17 years of age who had been diagnosed with CHD. Outcomes included caregiver-rated general health, presence of functional limitations, number of missed school days, need for special education, and need for special equipment related to the child’s health conditions. Socio-economic status measures included maternal educational attainment, food stamp programme participation, poverty status, and insurance coverage. Results: Based on a sample of 233 children with CHD, 10% had fair or poor health, 38% reported having any health-related limitation on their usual activities, 11% needed special equipment, and 27% received special education services. On multivariable analysis, lower maternal educational attainment was correlated with worse caregiver-rated health, and children without insurance were especially likely to experience functional limitations. Black children with CHD had significantly worse caregiver-rated health compared to White children (ordered logit odds ratio: 0.19; 95% confidence interval: 0.08, 0.45; p < 0.001). Conclusions: In a population-based survey of children with CHD, race and several measures of socio-economic status disadvantage were associated with worse health outcomes. Further evaluation of social determinants of health during cardiology follow-up may help improve outcomes for children with CHD in socio-economically disadvantaged families.

scholarly journals THE ROLE OF DEVELOPMENTAL TOXICANTS AND SOCIO-ECONOMIC STATUS ON CONGENITAL HEART DISEASE IN URBAN AND RURAL ALBERTA

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e37-e38
Author(s):  
Deliwe Ngwezi ◽  
Lisa Hornberger ◽  
Jesus Serrano-Lomelin ◽  
Charlene Nielsen ◽  
Deborah Fruitman ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Economic Status ◽  
Environmental Pollutants ◽  
Rural Regions ◽  
Environmental Injustice ◽  
Socio Economic Status ◽  
Increased Risk ◽  
Group 1

Abstract BACKGROUND Evidence is emerging suggesting associations between environmental pollutants, socio-economic status (SES) and congenital heart disease (CHD); however, it is still inconclusive. Furthermore, it has been documented in environmental injustice studies that people with low socio-economic status are disproportionately vulnerable to environmental hazards and therefore are victims of a double jeopardy. OBJECTIVES We sought to explore the effect of exposure to groups of developmental toxicants (DTs) and SES on CHD development in urban and rural Alberta. DESIGN/METHODS We identified 2,413 CHD cases and postal codes (PC) from echocardiographic databases (2003–2010). We used previously defined groups of DTs comprised of: 1- organics and gases, 2-organics and 3-heavy metals. Exposure was assigned to each PC as the sum of the product of multiplying amounts of DTs (tonnes) emitted from any industrial facility within 10 km radius during the whole study period, by the inverse distance from the facility to the centroid of the PC. Exposures were categorized into deciles from 1(lowest) to 10 (highest) for group 1 DTs and tertiles (1=lowest to 3 =highest), for groups 2 and 3 DTs and the SES index. Poisson regression models were used to calculate risk ratios and 95% CI, adjusted for SES index or DTs and traffic-related surrogates (NO2, PM2.5). RESULTS Adjusted Effect of DT Exposure: Group 1 DT showed increased risk in urban and rural regions in the 10th decile of exposure, aRR=1.85(1.5, 2.3) and 2.67(1.04, 6.8, respectively). Group 2 DT risk was increased only in urban 3rd tertile, RR=1.45(1.3, 1.6). Group 3 DTs were associated with an increased risk in urban and rural regions in the 3rd tertile of exposure [aRR=1.16(1.04, 1.3), and 2.8(1.14, 7.1, respectively)]. Adjusted Effect of SES: SES was independently associated with an increased risk of CHD in urban lowest tertile, [aRR=1.13(1.0, 1.3)] and rural lowest and middle SES tertile, [aRR=2.9(1.9, 4.8) and 1.6(1.1, 2.6), respectively]. CONCLUSION High exposures to groups of DTs and SES were independently associated with an increased risk of CHD in urban and rural Alberta. This suggests that neighborhood SES in Alberta does not impose a disproportional exposure to DTs. Furthermore, SES had a greater impact in rural compared to urban regions. We would like to explore for interactions between the SES and DT exposures and to determine if there is environmental injustice in Alberta.

scholarly journals Mortality Risk in People with Type 2 Diabetes: A Large Prospective PopulationBased Cohort Study (The Ayrshire Diabetes Follow-Up Cohort (ADOC) Study)

2021 ◽  
Vol 6 (3) ◽  
Author(s):  
Collier A ◽  
Hair M ◽  
Cameron L ◽  
Ghosh S ◽  
Boyle J ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Mass Index ◽  
Cohort Study ◽  
Heart Disease ◽  
Smoking Status ◽  
Economic Status ◽  
Population Based ◽  
Socio Economic Status

Background: This study investigated the effects of age, gender, socio-economic status, smoking status, hypertension, ischaemic heart disease, Body Mass Index (BMI), Glycaemic control (HbA1c) and dyslipidaemia in type 2 diabetes in a population-based analysis.

scholarly journals Neighbourhood maternal socioeconomic status indicators and risk of congenital heart disease

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qun Miao ◽  
Sandra Dunn ◽  
Shi Wu Wen ◽  
Jane Lougheed ◽  
Jessica Reszel ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Household Income ◽  
Congenital Heart ◽  
Population Based ◽  
Income Poverty ◽  
Lower Odds ◽  
Logistic Regression Models ◽  
Chd Risk

Abstract Background This study aimed to examine the relationships between various maternal socioeconomic status (SES) indicators and the risk of congenital heart disease (CHD). Methods This was a population-based retrospective cohort study, including all singleton stillbirths and live births in Ontario hospitals from April 1, 2012 to March 31, 2018. Multivariable logistic regression models were performed to examine the relationships between maternal neighbourhood household income, poverty, education level, employment and unemployment status, immigration and minority status, and population density and the risk of CHD. All SES variables were estimated at a dissemination area level and categorized into quintiles. Adjustments were made for maternal age at birth, assisted reproductive technology, obesity, pre-existing maternal health conditions, substance use during pregnancy, rural or urban residence, and infant’s sex. Results Of 804,292 singletons, 9731 (1.21%) infants with CHD were identified. Compared to infants whose mothers lived in the highest income neighbourhoods, infants whose mothers lived in the lowest income neighbourhoods had higher likelihood of developing CHD (adjusted OR: 1.29, 95% CI: 1.20–1.38). Compared to infants whose mothers lived in the neighbourhoods with the highest percentage of people with a university or higher degree, infants whose mothers lived in the neighbourhoods with the lowest percentage of people with university or higher degree had higher chance of CHD (adjusted OR: 1.34, 95% CI: 1.24–1.44). Compared to infants whose mothers lived in the neighbourhoods with the highest employment rate, the odds of infants whose mothers resided in areas with the lowest employment having CHD was 18% higher (adjusted OR: 1.18, 95% CI: 1.10–1.26). Compared to infants whose mothers lived in the neighbourhoods with the lowest proportion of immigrants or minorities, infants whose mothers resided in areas with the highest proportions of immigrants or minorities had 18% lower odds (adjusted OR: 0.82, 95% CI: 0.77–0.88) and 16% lower odds (adjusted OR: 0.84, 95% CI: 0.78–0.91) of CHD, respectively. Conclusion Lower maternal neighbourhood household income, poverty, lower educational level and unemployment status had positive associations with CHD, highlighting a significant social inequity in Ontario. The findings of lower CHD risk in immigrant and minority neighbourhoods require further investigation.

OP29 The prevalence of congenital heart disease in the UK: a population-based register study

2014 ◽  
Vol 68 (Suppl 1) ◽  
pp. A17.1-A17
Author(s):  
KE Best ◽  
E Draper ◽  
J Kurinczuk ◽  
S Stoianova ◽  
D Tucker ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Population Based ◽  
Register Study ◽  
The Uk
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