Health Equity: 09/02/09

Wednesday, September 2, 2009

[EQ] Child development in a birth cohort: effect of child stimulation is stronger in less educated mothers

Child development in a birth cohort: effect of child stimulation is stronger in less educated mothers

Aluísio JD Barros1,*, Alícia Matijasevich1, Iná S Santos1 and Ricardo Halpern2

1 Centro de Pesquisas Epidemiológicas, Universidade Federal de Pelotas, Pelotas, Brazil.

2 Departamento de Pediatria e Puericultura, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil.

IJE Advance Access published online on August 28, 2009

International Journal of Epidemiology, doi:10.1093/ije/dyp272 - 2009

Available online at: http://ije.oxfordjournals.org/cgi/content/abstract/dyp272?ijkey=x2KBZ5SzE3eVWNm&keytype=ref

“……Child health has improved in many developing countries, bringing new challenges, including realization of the children's full physical and intellectual potential. This study explored child development within a birth cohort, its psychosocial determinants and interactions with maternal schooling and economic position.

Methods
All children born in Pelotas, Brazil, in 2004, were recruited to a birth cohort study. These children were assessed at birth and at 3, 12 and 24 months of age. In this last assessment involving 3869 children, detailed information on socio-economic and health characteristics was collected. Child development was assessed using the screening version of Battelle's Development Inventory. Five markers of cognitive stimulation and social interaction were recorded and summed to form a score ranging from 0–5. The outcomes studied were mean development score and low performance (less than 10th percentile of the sample).

Results
Child development was strongly associated with socio-economic position, maternal schooling and stimulation. Having been told a story and owning a book were the least frequent markers among children with score 1. These children were 8.3 times more likely to present low performance than those who scored 5. The effect of stimulation was much stronger among children from mothers with a low level of schooling—one additional point added 1.7 on the child's development for children of low-schooling mothers, whereas only 0.6 was added for children of high-schooling mothers.

Conclusions
Our stimulation markers cannot be directly translated into intervention strategies, but strongly suggest that suitably designed cognitive stimulation can have an important effect on children, especially those from mothers with low schooling….”

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[EQ] Cardiovascular disease, diabetes and established risk factors among populations of sub-Saharan African descent in Europe

Cardiovascular disease, diabetes and established risk factors among populations of sub-Saharan African descent in Europe:
a literature review

Charles Agyemang 1 , Juliet Addo 2 , Raj Bhopal 3 , Ama de Graft Aikins 4 and Karien Stronks 1

1 Department of Social Medicine, Academic Medical Centre, University of Amsterdam, The Netherlands
2 Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
3 Division of Community Health Sciences, Public Health Sciences Section, University of Edinburgh, UK
4 Department of Social and Developmental Psychology, Faculty of Social and Political Sciences, University of Cambridge, UK

Globalization and Health 2009, 5:7doi:10.1186/1744-8603-5-7

Available online at: http://www.globalizationandhealth.com/content/5/1/7

“……Most European countries are ethnically and culturally diverse. Globally, cardiovascular disease (CVD) is the leading cause of death. The major risk factors for CVD have been well established. This picture holds true for all regions of the world and in different ethnic groups. However, the prevalence of CVD and related risk factors vary among ethnic groups.

Methods

This article provides a review of current understanding of the epidemiology of vascular disease, principally coronary heart disease (CHD), stroke and related risk factors among populations of Sub-Sahara African descent (henceforth, African descent) in comparison with the European populations in Europe.

Results

Compared with European populations, populations of African descent have an increased risk of stroke, whereas CHD is less common. They also have higher rates of hypertension and diabetes than European populations. Obesity is highly prevalent, but smoking rate is lower among African descent women. Older people of African descent have more favourable lipid profile and dietary habits than their European counterparts. Alcohol consumption is less common among populations of African descent. The rate of physical activity differs between European countries. Dutch African-Suriname men and women are less physically active than the White-Dutch whereas British African women are more physically active than women in the general population. Literature on psychosocial stress shows inconsistent results.

Conclusion

Hypertension and diabetes are highly prevalent among African populations, which may explain their high rate of stroke in Europe. The relatively low rate of CHD may be explained by the low rates of other risk factors including a more favourable lipid profile and the low prevalence of smoking. The risk factors are changing, and on the whole, getting worse especially among African women. Cohort studies and clinical trials are therefore needed among these groups to determine the relative contribution of vascular risk factors, and to help guide the prevention efforts. There is a clear need for intervention studies among these populations in Europe…”