General Public Health
Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/21737
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Browsing General Public Health by Author "Davis, Ann"
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Item Adverse Child Experiences and Their Effects on Child Behavior and Mental Health(2015-03) Pulvino, Steven; Mbise-Floyd, Lilian; Patel, Neha; Patel, Tarang; Davis, Ann; Homan, SharonBackground: The association between Adverse Child Exposures (ACEs) and risk for child mental health outcomes such as depression, anxiety problems, and behavior/conduct problems has not been thoroughly investigated for three age groups - ages 6 to 10 (elementary school), ages 11 to 13 (middle school), and ages 14 to 17 (high school). We examined the relationship of these three mental health outcomes with a variety of ACEs among children 6 to 17 years old. We also examined the prevalence of ACEs for each mental health outcome in order to better understand the nature of any influential exposures. Methods: National Survey of Children’s Health 2011-2012 dataset was used to investigate nine ACEs: socioeconomic hardship, divorce/separation of parent, death of a parent, parent served time in jail, witness to domestic violence, victim of neighborhood violence, lived with someone who was mentally ill or suicidal, lived with someone with an alcohol/drug problem, and treated or judged unfairly due to race/ethnicity. Total number of ACE exposures were categorized cumulatively into 5 classes: 0, 1, 2, 3, ≥4. They were then compared with the three child mental health outcomes: depression, anxiety problems, and behavior/conduct problems. Results: A dose response relationship was observed between each of the child mental health outcomes and the number of ACEs for the full model (where age groups are included as a co-variable). The odds for depression in the full model increases by 2.59, 3.08, 6.24, and 9.66 for those exposed to 1, 2, 3, or 4 or more ACEs respectively, when compared to those who had not been exposed to an ACE. Children with 1, 2, 3, or 4 or more ACEs were 2.01, 2.28, 2.88, and 5.45 times more likely to have anxiety problems, respectively. Children with 1, 2, 3, or 4 or more ACEs were 3.21, 3.80, 6.96, and 10.51 times more likely to have behavior/conduct problems, respectively. Conclusion: A dose response relationship was observed between the number of ACEs and risk of developing each of the examined child mental health outcomes (depression, anxiety problems, and behavior/conduct problems). Further examination of relationships between specific ACEs and the chosen mental health outcomes may help researchers identify significant or influential combinations of ACE risk factors.Item Effects of Maternal Health on Child Utilization of Dental Care among Medicaid and CHIP Participants: Results from the 2011-2012 National Survey of Children's Health (NSCH)(2015-03) Patel, Devang A.; Sadath, Mohammad; Deen, Briar; Rendon, Alexis; Lueke, Mark; Davis, Ann; Homan, SharonIntroduction: Understanding the preventive dental health care utilization of children is essential to reducing child dental disease rates in low income families. Previous studies have not examined the relationship between the mother’s health status and the child’s dental care utilization. The aim of this study is to examine the association between maternal health status and use of preventive dental care among children enrolled in Medicaid and CHIP programs. Methods: We conducted a cross sectional study of children enrolled in Medicaid and CHIP programs. A sample of 88,460 children was obtained from the 2011-2012 National Survey of Children’s Health (NSCH). We used multivariable logistic regression modeling (SAS 9.3) to estimate the adjusted odds ratio for having at least one dental visit in the past 12 months associated with self-reported maternal health. We statistically adjusted for child’s age, sex, maternal education, family structure, and parental satisfaction with the child’s health care provider. Results: Our key result is that children of mothers with excellent or very good health were 2.48 times more likely (95% CI 1.41-4.38) to have visited the dentist in the last year as compared to children of mothers with poor general health. There was a 45% reduction in access to dental health care when maternal health status decreased from excellent or very good status to good or fair health status. Conclusion: Our findings suggest that poor maternal health status decreases the likelihood that children will have an annual dental visit. Preventive dental outreach efforts and programs are needed to target these children.Item Perinatal and Neonatal Determinants of the Development and Severity of Autism Spectrum Disorder(2015-03) Patel, Riddhi; Panchal, Hardik; Herell, Maggie; Khalili, Leila; Homan, Sharon; Davis, AnnObjective: Demonstrate the potential effects of breastfeeding, low birth weight, maternal age at the time of childbirth and birth order on the development and severity of Autism Spectrum Disorders (ASD). Methods: We analyzed data from the National Survey of Children’s Health (2012), for 19,957 children aged two to five years. Using multivariate logistic regression, we estimated the association between breastfeeding status, maternal age at the time of childbirth, birth weight and birth order and ASD, adjusting for age, gender, race and poverty level. In addition, we examined the influence of these factors on severity of ASD using ordinal logistic regression. Results: Children with low birth weight had twice the odds for ASD. Children with higher birth order had three times higher odds for ASD. Breastfed children had decreased odds for a severe form of ASD, as compared to those who were never breastfed or breastfed for less than six months. Children born to of mothers aged 25-30 years had higher odds for severe ASD, as compared to children born to mothers under 20 years at childbirth. Higher birth order children had a small (1%) decreased odds of severe ASD. Conclusion: Children with lower birth weight and higher birth order were more likely to have ASD. Children who were breastfed for six or more months had decreased risk for severe ASD. Children of mothers 25 to 30 years were more likely to have more severe form of ASD than children of younger mothers.