The Association between Child Health Status and Family Functioning with Risk for Type 2 Diabetes among 10-14 Year Olds
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The Association between Child Health Status and Family Functioning with Risk for Type 2 Diabetes among 10-14 Year Olds Authors: Peng Chen – School of Public Health; Kimberly G Fulda, DrPH, Department of Family Medicine, Texas College of Osteopathic Medicine; Susan Franks, PhD, Department of Family Medicine, Texas College of Osteopathic Medicine; Shane Fernando, PhD, Department of Pediatrics, Texas College of Osteopathic Medicine; Nusrath Habiba, MD, Department of Pediatrics, Texas College of Osteopathic Medicine IRB # 2012-151 Abstract Introduction: Obesity is a risk factor for type 2 diabetes (DM2), and family environment stressors can increase risk of obesity among children and adolescents. Family factors such as parental divorce, cohabitation, and remarried family relationships are among these stressors. For example, living in a single-parent family is positively associated with BMI and greater risk of obesity. Poor family functioning has also been linked to overweight and obesity in children. Research, however, has not assessed associations between these stressors and risk for DM2. The purpose of this study was to assess whether child health status and family functioning are associated with being high risk for DM2 among Mexican American children aged 10-14 years. Methods: This cross-sectional study included 298 children and a parent/caregiver. High risk for DM2 was determined by having ≥ 3 of these 5 risk factors: first or second degree relative with DM2, BMI ≥ 95th percentile, blood pressure ≥ 95th percentile, elevated glucose, positive for Acanthosis Nigricans. Logistic regression was used to estimate odds ratio (ORs) and 95% confidence intervals (CIs) for the association between child’s health status and family functioning with being high risk for DM2. Multiple regression controlled for child factors (age, ethnicity, gender), parent/legal guardian’s factors (marital status, health status, relationship to child), and household factors (primary language spoken in the household and highest household education). Results: Of 298 children, 91 (31%) were high risk for DM2. Parents rated the child’s health as poor/fair/good for 105 (35%) of child participants. Children with poor/fair/good health status were over 5 times (OR: 5.37; 95% CI: 2.84-10.14) more likely to be high risk for DM2 compared to children with very good/excellent health status. None of the family functioning predictors (sharing ideas about things that matter, relationship to child, making decisions together, and coping with demands of parenting) were significantly associated with being high risk for DM2. Conclusions: Our research shows that a parent’s assessment of their child’s health predicts risk for DM2. This may be important for clinical visits, such as well child visits, or for programs aimed at reducing DM2 in children. While our research did not demonstrate an association between family functioning and risk for DM2, these factors should be explored further with questions obtained from validated measures.