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Fitz-Simon N, Fallon U, O’Mahony D, Bury G, Kelleher C, Murphy AW for the Lifeways Steering Group.
Society for Social Medicine 50th Annual Scientific Meeting
Predictors of asthma in children in Ireland: a multivariate analysis of deprivation and social support.
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Objective: To examine the impact of sociodemographic characteristics, including social support received by mothers, on the development of asthma in children. Design: Multivariate logistic analysis of the Lifeways cross generational cohort study of families. Setting: Three year follow up through general practice of children born in maternity hospitals in two Irish cities: Galway in the west and Dublin in the east of the Republic of Ireland. Babies’ and mothers’ hospital medical records were available and mothers were asked also to answer a standardised previously validated questionnaire at recruitment, containing health status and social and demographic information. Social support was calculated as the sum of seven possible sources providing a good deal of support and categorised as high (>2) or low. Participants: 1016 babies recruited in the antenatal period born between October 2001 and February 2003. General practice follow up clinical record data by summer 2006 were available for 691 children (68%). Main outcome measure: Diagnosis of asthma by 3 years of age. Results: 10.2% of children had a diagnosis of asthma. Children in the middle of the birth weight range (mean = 3502 g, SD = 581 g) were at lower risk of asthma than those of low and high birth weights. Boys were more likely to have asthma than girls (odds ratio (OR) = 2.2 (95% confidence interval, 1.3 to 3.8)). Children born in Galway were less likely to have asthma (OR = 0.49 (0.26 to 0.93)) and children eligible for means tested General Medical Services cards were more likely to have asthma (OR = 2.3 (1.2 to 4.5)). A high level of social support from several sources (partners, parents, other relations, friends, and employers) reported by single mothers was associated with a lower probability of asthma diagnosis at three years of age (p = 0.03), but this effect was not observed in other (partnered) mothers. Sociodemographic and lifestyle variables included in the model which were not significant were mother’s age, income level, medical insurance, education levels of mother, father, and mother’s parents, breast feeding, mother’s smoking status, exposure to smoke in the home, and self reported pollution in the environment. Conclusions: A diagnosis of asthma is more likely in the children of single mothers who do not report high levels of social support. The level of social support in other mothers does not have an impact on the likelihood of asthma by age 3 years. This suggests that networks of support have an influence on children’s health in settings with higher levels of deprivation.
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