Demographic Differences in Parental Perception of Childrens Health

1
Demographic Differences in Parental Perception of
Childrens Health

• Michele Morrone, Ph.D., R.S.
• Kevin Crist, Ph.D.
• Environmental Health Science
• Ohio University

2
Acknowledgements

• Ohio Air Quality Development Authority
• www.ohioairquality.org
• Ohio Environmental Protection Agency
• www.epa.state.oh.us

3
Question?

• When comparing parental perception of childrens
  health in urban, rural and suburban areaswho do
  you think perceives their children to be least
  healthy?

4
Why Compare Groups?

• Understand risk factors
• Target education/intervention strategies
• Focus health policy

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Health Status

• Health status
• How well or ill a person feels
• Subjective measure
• Differences among groups
• Proximity to pollution
• Age
• Risk perception

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Air Pollution and Pediatric Health Impact
Assessment Project

• Evaluate the impact of air pollution on children
  in Ohio
• Three elementary schools in Ohio
• Three research components prospective,
  retrospective, and air toxics analysis

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Location of Schools
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Prospective Component

• Particulate matter measurements
• Chemical characterization of particulate matter
• Health status evaluation (the focus of this
  presentation)

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Particulate Matter Measurements

• Personal, ambient, and indoor measures

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Personal and Indoor PM
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Mean PM Summary (µg/m3)
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Summary of PM2.5 Monitoring

• Indoor concentrations were higher than outdoor
  concentrations
• Outdoor ambient concentrations modestly higher at
  urban site
• Weather affects PM concentrations

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Health Status Evaluation

• Consent obtained
• Components
• Emergency room visits
• Daily pulmonary function monitoring
• Absenteeism data
• Cross-sectional health survey

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Health Status Survey

• Child Health Questionnaire Parent Form
• Developed by Landgraf, Abetz, and Ware (1996)
• Available to researchers who purchase the manual
  and pay a fee
• Measures 13 health concepts

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CHQ Concepts

• General Health Perception
• Parents perception of overall health of their
  child
• Self-Esteem
• Parents perception of childs satisfaction with
  many facets, including appearance, athletic
  ability and others
• Childs Health
• Assessment of childs health compared to one year
  ago

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CHQ Concepts (cont.)

• Mental Health
• Frequency of different states of mind including
  negative (depression) and positive
• General Behavior
• Behavior problems and the ability to get along
  with others
• Bodily Pain and Discomfort
• Intensity and frequency of overall pain

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CHQ Concepts (cont.)

• Physical Functioning
• Presence of health-related physical limitations
• Role/Social Limitations Physical
• Presence of health-related social limitations,
  such as the ability to complete school work

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CHQ Concepts (cont.)

• Role/Social Limitations Behavioral
• Presence of behavior-related social limitations,
  such as the ability to complete school work due
  to emotional factors
• Emotional Impact on Parent
• Parental distress related to childs health
  status

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CHQ Concepts (cont.)

• Time Impact on Parent
• Limits to parents time due to childs health
  status
• Family Activities
• Disruption of regular family activities due to
  childs health status
• Family Cohesion
• Familys ability to get along

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Other Survey Components

• Childs overall health status
• Childs activities
• Demographics for child and parent
• Diagnosed health conditions
• Presence of respiratory symptoms

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Most Parents Perceive Their Childs Health as
Very Good or Excellent
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Racial Composition of Schools (Percentage of
Respondents)
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Household Characteristics

• Urban children
• African-American
• Parents are least educated
• Houses are smallest
• Most likely to live with smokers

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Urban Parents Think Their Children are Least
Healthy
Rated on a scale of 1excellent to 5poor
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Urban Parents Worry Most About Their Childs
Health

• Do you worry about your childs health more than
  other parents, 1definitely true, 5definitely
  false

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Lowers Scores Indicate More Negative Perceptions
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Prominent Differences
REB Limits due to behavioral/emotional
problems Behavior Aggressive behavior GHP
Overall health perception SE Self esteem
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Urban Parents Indicate Most Negative CHQ Responses

• Lowest in 9 of 13 categories
• General health perception
• Self-esteem
• General behavior
• Role/Social physical
• Role/Social Behavioral
• Emotional impact
• Time impact
• Family activities
• Family cohesion

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Rural Parent Perception

• Lowest in 2 of 13 categories
• Childs health change
• Physical functioning

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Suburban Parents Perceptions

• Lowest in 2 of 13 categories
• Mental health
• Bodily pain and discomfort

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Significant Difference Among Groups

• Analysis of variance shows statistically
  significant differences among the groups in 4 of
  the 13 categories
• General health
• Behavioral scale
• Physical functioning
• Family cohesion

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Parents Perceptions Based on CHQ Analysis

• Urban parents think their children are least
  healthy
• Urban parents perceive that children are most
  likely to have behavioral problems
• Urban parents perceive their families ability to
  get along as most negative
• Rural parents perceive that their childs health
  has led to physical limitations

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Summary Of Results

• Air Pollution Measurements
• Indoor PM concentrations are higher than outdoor
  concentrations
• The rural school posted the highest personal and
  indoor PM readings
• Urban outdoor concentrations highest among three
  schools

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Summary of Results

• Urban parents generally perceive their childs
  health worse than parents in rural and suburban
  schools
• Living conditions of urban children are worse
  than children in suburban and rural schools

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Summary of Results

• There are significant differences between groups
  in terms of how parents perceive their childs
  overall health, behavior, family cohesion, and
  physical limitations

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WHY?

• Why do urban parents perceive their childs
  health worse than others, in spite of the data
  suggesting
• That rural children may be more exposed to PM?
• That air quality does not appear to be a major
  factor in measured health variables?