The equity impact of a universal child health promotion programme
| Autor: | Marie Lindkvist, Inna Feldman, Jenny Häggström, Eva Eurenius, Anneli Ivarsson, Anni-Maria Pulkki-Brännström, Filipa Sampaio |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Evidence-Based Public Health Policy and Practice medicine.medical_specialty Normal birth weight infant health promotion Epidemiology 030209 endocrinology & metabolism Complex interventions Health Services Accessibility Child health 03 medical and health sciences 0302 clinical medicine Nursing Residence Characteristics Environmental health medicine Humans 030212 general & internal medicine Healthcare Disparities Child Sweden Pregnancy pregnancy outcome Equity (economics) business.industry Public health public health Child Health Public Health Environmental and Occupational Health registries Infant Public Health Global Health Social Medicine and Epidemiology Health Services Patient Acceptance of Health Care medicine.disease Folkhälsovetenskap global hälsa socialmedicin och epidemiologi income Health promotion Socioeconomic Factors Child Preschool Health Care Surveys Female Psychology business |
| Zdroj: | Journal of Epidemiology and Community Health |
| ISSN: | 1470-2738 0143-005X |
| DOI: | 10.1136/jech-2019-213503 |
| Popis: | Background We aimed to evaluate whether the Salut Programme, a universal child health promotion intervention, aimed to strengthen healthy lifestyles in northern Sweden, had any effect on income-related inequalities in positive birth outcomes for children and on healthcare use for children and their mothers. Methods Mother’s residence and child’s date of birth determined whether the child and the mother belonged to the control group (areas that received care-as-usual) or the intervention group (areas with the intervention implemented from 2005), during the pre-measure period (children born 2002-2004) and the post-measure period (children born 2006-2008). The sum of parents’ taxable income was used for socioeconomic ranking. We computed the standard concentration index for six binary indicators of positive birth outcomes, and for inpatient and day patient care for children and mothers during the two years after delivery. Using a difference-in-difference approach, we assessed whether the extent of inequality changed over time between areas. Results Income-related inequalities in child health status at birth and in child healthcare use were absent, except that full-term pregnancies were concentrated among the poor at pre-measure in the intervention group. However, mothers’ healthcare use was significantly pro-poor in the control group. The extent of inequality changed between pre- and post-measure periods for two outcomes: the pro-poor concentration of full-term pregnancies in the intervention group at pre-measure disappeared at post-measure; and an increase in pro-poor concentration of normal birth weight in the control group was not matched by a similar increase in the intervention group. Inequalities in healthcare use did not change significantly. Conclusions Birth outcomes and child healthcare use seemed to be equitably distributed. However, the results raise concerns whether the intervention may have reduced the pro-poor concentration of positive birth outcomes. Key messages There are concerns that participation in universal health promotion programmes differs by socioeconomic status, although few public health interventions have been evaluated from an equity perspective. Birth outcomes and child healthcare use in Northern Sweden seemed to be equitably distributed across different socioeconomic groups. |
| Databáze: | OpenAIRE |
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