Family‐based social determinants and child health: Cross‐sectional study

Protano, Carmela; Valeriani, Federica; A, Macedonio; Cammarota, Flavia; Spica, Vincenzo Romano; Orsi, Giovanni Battista; Vitali, Matteo

doi:10.1111/ped.13097

Cited by 17 publications

(15 citation statements)

References 30 publications

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“…In partial contrast with the results related to nationality, we found a significant influence of the educational level on the smoking dependence: lower maternal or paternal educational level were significant predictors of ETS exposure. This is in line with the results of previous studies performed in Italy [18] and in other countries [33,34,35,36], and it highlights the needs for specific smoking cessation interventions performed on smokers with a low educational level. These results were also confirmed by multivariate analyses, revealing that the lower education of the father or mother significantly increased the risk of children being exposed to ETS.…”

Section: Discussionsupporting

confidence: 91%

“…These results are consistent with the occurrence of exposure to SHS alone or in combination with THS. The ETS exposure profile of children in domestic environments changes also in relationship with some characteristics of the children themselves and their parents, such as ponderal status according to body mass index of children, paternal educational level [17,18,19], family income [20], parental status (e.g., single mother), use of prenatal preventive care, and parenting satisfaction [21]. Furthermore, in recent years, several studies focalized the attention on the contribution of smoking fathers or mothers to the exposure of cohabiting children to ETS [22,23].…”

Section: Introductionmentioning

confidence: 99%

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Further Insights on Predictors of Environmental Tobacco Smoke Exposure during the Pediatric Age

Protano

Cammalleri

Antonucci

et al. 2019

IJERPH

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Background: The smoking ban in public places has reduced Environmental Tobacco Smoke (ETS) exposure for non-smokers, but despite this, domestic environments still remain places at high risk of exposure, and, today, about 40% of children worldwide are exposed to ETS at home. The aims of the study are to investigate the contribution of several factors on ETS exposure among a group of Italian children and to evaluate the changes in smoking precautions adopted at home when the smoker is the mother, the father, or both parents, respectively. Methods: A cross-sectional study was performed on a sample of 519 Italian schoolchildren. Information was collected via a questionnaire. Results: 41.4% of the participants lived with at least one smoker. Almost half of the children exposed to ETS lived with one or more smokers who do not observe any home smoking ban. Lower maternal or paternal educational levels significantly increase the risk of ETS exposure at home and the “worst case” is represented by both parents who smoke. Conclusions: More effective preventive interventions are needed to protect children from ETS exposure. Some interventions should be specifically dedicated to smokers with a low educational level and to mothers that smoke.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Further Insights on Predictors of Environmental Tobacco Smoke Exposure during the Pediatric Age

Protano

Cammalleri

Antonucci

et al. 2019

IJERPH

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“…A cross-sectional human biomonitoring survey was performed on a sample of healthy schoolchildren, aged between 5 and 11 years, living in Central Italy and attending some primary school districts. Details on the selected areas, the enrolment of children, and methods for gathering information on participants and for collecting urine samples were previously reported [ 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. Briefly, information on children and their parents (gender, birth date, height, weight, exposure to ETS, parents’ educational level, and the activities taken place during the sampling day) was collected through an ad hoc questionnaire filled in by parents together with the informed consent.…”

Section: Methodsmentioning

confidence: 99%

Reference Intervals for Urinary Cotinine Levels and the Influence of Sampling Time and Other Predictors on Its Excretion Among Italian Schoolchildren

Protano

Andreoli

Mutti

et al. 2018

IJERPH

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(1) Background: Environmental Tobacco Smoke (ETS) exposure remains a public health problem worldwide. The aims are to establish urinary (u-) cotinine reference values for healthy Italian children, to evaluate the role of the sampling time and of other factors on children’s u-cotinine excretion. (2) Methods: A cross-sectional study was performed on 330 children. Information on participants was gathered by a questionnaire and u-cotinine was determined in two samples for each child, collected during the evening and the next morning. (3) Results: Reference intervals (as the 2.5th and 97.5th percentiles of the distribution) in evening and morning samples were respectively equal to 0.98–4.29 and 0.91–4.50 µg L−1 (ETS unexposed) and 1.39–16.34 and 1.49–20.95 µg L−1 (ETS exposed). No statistical differences were recovered between median values found in evening and morning samples, both in ETS unexposed and exposed. Significant predictors of u-cotinine excretions were ponderal status according to body mass index of children (β = 0.202; p-value = 0.041 for evening samples; β = 0.169; p-value = 0.039 for morning samples) and paternal educational level (β = −0.258; p-value = 0.010; for evening samples; β = −0.013; p-value = 0.003 for morning samples). (4) Conclusions: The results evidenced the need of further studies for assessing the role of confounding factors on ETS exposure, and the necessity of educational interventions on smokers for rising their awareness about ETS.

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“…Nevertheless, socioeconomic disparities in the prevalence of SHS exposure among children exist. For instance, exposure to SHS is highest among children of parents with lower education attainment [14][15][16] . Similarly, family income has been shown to be inversely associated with childhood exposure to SHS [16][17][18] .…”

Section: Introductionmentioning

confidence: 99%

Exposure to household secondhand smoke among adolescents in Kuwait: Results from two school-based cross-sectional studies

Ziyab¹,

Almari²,

Al-Taiar³

2020

Tob. Induc. Dis.

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INTRODUCTION Detrimental effects of secondhand smoke (SHS) exposure are well established; however, data on SHS exposure among adolescents in Kuwait are lacking. Hence, this study sought to estimate the prevalence of household SHS exposure among two samples of adolescents in Kuwait and assess its variation by socioeconomic status and parental education level. METHODS Data from two large school-based cross-sectional studies were analyzed. Adolescents attending public middle (n=3864; aged 11-14 years) and high (n=1959; aged 14-19 years) schools throughout Kuwait were enrolled in 2016-2017, and parental self-reported household SHS exposure was ascertained. Associations were assessed using Poisson regression with robust variance estimation, and adjusted prevalence ratios (APRs) and 95% confidence intervals (CIs) were estimated. RESULTS Overall, 45.8% (1755/3836; 95% CI: 44.2-47.3%) of the enrolled middle school students and 51.6% (998/1936; 95% CI: 49.3-53.8%) of the enrolled high school students were exposed to household SHS. Among middle and high school students, the prevalence of household SHS exposure increased as maternal/ paternal education level and family income decreased. Among middle school students, paternal educational attainment of middle school or less compared to bachelor's degree or higher was associated with 1.60 times (95% CI: 1.44-1.79) higher household SHS exposure. Similarly, in the sample of middle school students, the prevalence of household SHS exposure significantly increased from 35.8% among children from families reporting the highest household income to 50.5% among children from families with the lowest reported household income (p-trend<0.001). CONCLUSIONS Household SHS exposure is substantially high among adolescents in Kuwait. Enrolled adolescents from families with low socioeconomic status or with low parental education level have the highest household SHS exposure. These findings highlight the need for national comprehensive tobacco control policies and increasing parental awareness of the impact of SHS exposure on children.

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Family‐based social determinants and child health: Cross‐sectional study

Abstract: It is essential to investigate the reasons underlying the higher frequency of overweight/obesity in children living in rural environments compared with those in urban areas; and preventative actions should be designed to be easily understood by those with lower education levels.

Cited by 17 publications

References 30 publications

Further Insights on Predictors of Environmental Tobacco Smoke Exposure during the Pediatric Age

Further Insights on Predictors of Environmental Tobacco Smoke Exposure during the Pediatric Age

Reference Intervals for Urinary Cotinine Levels and the Influence of Sampling Time and Other Predictors on Its Excretion Among Italian Schoolchildren

Exposure to household secondhand smoke among adolescents in Kuwait: Results from two school-based cross-sectional studies

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