Poster #96 - Health inequalities: child development and social groups.

• In Event: 2-055 - Poster Session 06
  In Poster Session: PS 06 Section - Family Context & Processes

Integrative Statement

Introduction: Despite the global health strategies proposed to promote child health, more than 200 million children under the age of five are unable to reach their full development potential because of poverty, poor health, poor nutrition and nurturing care. In Brazil, the few studies conducted seek to find an association between several risk factors and delays in child development, but with difficulty in identifying the social roots of this process. In addition, although the monitoring of child development has integrated childcare in Primary Care since the 1980s, progress is still needed in its follow-up. It is therefore justified to deepen the knowledge in the network of social determinants related to probable problems in the development of children enrolled in primary care. Objective: To analyze the domains of child development (maturative, psychomotor, social and psychic) and the association with social groups of families and maternal/paternal and child characteristics. Method: A cross-sectional study developed in a representative sample of 348 children under three years of age, enrolled in the 12 basic health units of a small municipality in the state of São Paulo, Brazil, approved by the Research Ethics Committee. Mothers were interviewed from February to April 2013 and data on child development were obtained from the "Development Follow-up File" proposed by the Ministry of Health, which evaluates maturity, psychomotor, social and psychic development domains. Families were classified into three social groups according to ways of working and living, using Social Reproduction Index. The data were double-typed in the EpiInfo 6.04 program for consistency assessment. Univariate and multiple analyzes were performed in the STATA 14.1 program. Four dependent variables were formed: Aspects associated with dependent variables were verified through logistic regressions, independent variables with a value of p <0.20 in the univariate analysis were maintained in the model. The magnitude of the strength of association between the dependent and independent variables was estimated by the odds ratio (OR) either in univariate (gross OR) or multiple (adjusted OR) analysis, their respective 95% confidence intervals and confidence level 5%. Results: Among the developmental domains analyzed, a maturative development problem was observed in 27.6% of the children, psychomotor in 23.6%, social in 21.5% and psychic in 17.2%. The social group of the less privileged concentrated a larger proportion of children with a problem in child development in the three domains: maturative (OR: 3.05, CI: 1.08-8.56), psychomotor (OR: 3.11; 1.05-9.17) and social (OR: 2.44; CI: 1.02-5.84). There was no association with maternal/paternal variables. Social and psychomotor development were associated with age range ≥ 12 months and the hospitalization variable showed an independent effect in the model adjusted for the psychomotor frame. Conclusion: Children belonging to the families of the less privileged social groups are more vulnerable to presenting problems in maturation, psychomotor and social development. It is, therefore, necessary for health professionals to routinely assess child development in their childcare consultations, with sensitivity to the network of social determinants, with a view to minimizing the inequities observed in child development.

Authors

• Clariana Vitória Ramos de Oliveira, Harvard School of Public Health
  Presenting Author

• Cláudia Teixeira Palombo, University of São Paulo
  Non-Presenting Author

• Áurea Tamami Minagawa Toriyama, University of São Paulo
  Non-Presenting Author

• Elizabeth Fujimori, University of São Paulo
  Non-Presenting Author