HLTA02H3 Chapter Notes - Chapter 15: Preterm Birth, Birth Weight, Health Equity

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12 Dec 2012
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Chapter 15- Inequality, Family and Child Health
-Intro
-inequalities of wealth and income produce unequal life chances
INEQUALITY AND POVERTY
-the number of poor people was nearly 5 million in 2003, poverty rate was nearly 16%
-poverty figures fluctuate with economic conditions, particularly fluctuations in labour market
-Poverty rates vary by family structure
-poverty rates are relatively low for two-parent families and quite high for families with single-parent
mothers
-certain groups face a high risk of poverty, these include:
-unemployed persons
-people whose participation in teh labour force is irregular
-those with low education
-those in certain occupations
-income disparities produce an inequality of opportunities and life chances, and have negative outcomes
for individuals in low-income and poor families
-“poverty of opportunity” and family income levels are factors detrimental to healthy child development
and child well-being
INEQUALITY, POVERTY, AND HEALTH STATUS
-Epidemiological data in Canada and elsewhere show a persistent and pervasive association between
socioeconomic status and health status
-those who are advantaged with respect to socio-economic status are also advantaged in health status
-those with high incomes, live longer, healthier, and more disability-free lives on average than those
who are poor
-poor housing, poor nutrition, poor neighbourhoods and poor environments all contribute to high
morbidity and mortality in low-income and poor populations
INFANT MORTALITY
-infant mortality is one of the most important indicators of population health of a country because of its
association with both adult mortality and life expectancy
-there has been a decline in infant mortality rates
-infant mortality in the Aboriginal population is almost twice that of the general population
-children of parents in the poorest neighbourhoods have twice the infant mortality rates of children in
the richest neighbourhoods
-disparities in birth outcomes are linked to neighbourhood income
-those in the lower-income groups experience above-average infant mortality rates
-infant mortality rate in 1996 was highest in Northwest Territories
-among the provinces, Saskatchewan ranked highest and Quebec the lowest
-in 1990, Canada ranked fifth among the seventeen OECD countries; its ranking dropped to 12th
by 1996
-it is apparent that the association b/w socio-economic status and health status arises very early in life
the first injustice”
-this first injustice is followed by an enduring association between Socioeconomic Status and the risk of
death that persists throughout adult life
-there are various reasons for variations in infant mortality rates, including:
-low birth weight
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-preventable communicable diseases
-malnutrition
-injuries
-household incomes
-neighbourhood
-mother’s education
HEALTH AT BIRTH: BIRTH OUTCOMES AND BIRTH WEIGHT
-weight at birth is one of the most important measures of overall health adn well-being later in life
-standard definition of low birth weight is less than 2500 g (5.5 pounds) at birth
-the avg weight at birth of a full-term infant is 7.5 pounds 3400 g
-low birth weight is the major cause of infant mortality
-children who survive face a high risk of other developmental and health-related problems such as :
-impaired learning
- neurodevelopment
- loss of sight and hearing
-the negative effect of low birth weight extends into adult life and contributes to differences in mortality
-several factors are associated with low birth weight, including:
-mother’s age and health
-tobacco and alcohol use during pregnancy
-nutrition
-premature delivery
-low-birth-weight children are likely to be born to very young mothers (10-14 years) and to older
mothers (>45yrs)
-mothers younger than 15 years of age and those 45 years of age and older are almost twice as likely as
the average Canadian mother to have an underweight newborn infant
-maternal health and nutrition during pregnancy are important factors in healthy pregnancy and in the
weight and health of newborn
-these are linked to income levels
-factors that need to be considered here include women’s reproductive health and nutritional health
needs during pregnancy and children’s nutritional needs
-the effects of malnutrition and vitamin deficiencies have begun to appear in some cases
-mothers’ lifestyle and social consumption patterns can also contribute to poor birth outcomes
-tobacco and alcohol consumption during pregnancy may be implicated in negative health outcomes for
children
-smoking during pregnancy may contribute to low birth weight and high rates of respiratory illness
-lower education and lower incomes are implicated in high tobacco consumption
-fetal alcohol spectrum disorder (FASD) is the term used to describe a range of effects that can occur in
children whose mothers drank during pregnancy
-FASD is a result of maternal alcohol consumption during pregnancy and its effects may include
developmental and cognitive disabilities-physical, mental, behaviour and learning problems-which have
lifelong implications
-the risk factors for prenatal alcohol exposure include
-lower maternal SES
-lower education
-paternal drinking
-poor developmental environment
-low incomes, poverty, dependency on food banks, poor nutrition, and inadequate health care all
contribute to low birth weight and high infant mortality
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