Introduction The child's health in first 5 years of growth has critical adult and intergenerational consequences. Material, psycho-social and lifestyle factors are principal pathways determining health inequalities in children, and families constitute significant contributory micro-ecosystems. We examined the relationship of familial demographic, social and behavioural predictors with self-reported health (SRH) by mothers of their children, followed prospectively from ante-natal recruitment. SRH has been established as a valid measure of morbidity.
Methods Of 1082 original birth families, 547 mothers responded, when children averaged age 5, at school entry point. Univariate associations were first analysed between SRH of children and 4 groups of characteristics (family-related, child-related, mother-related and father-related). A multivariable logistic regression analysis then re-examined the statistically qualifying predictors.
Results In univariate analysis, the following were associated with rating of child's SRH as excellent or very good: families where father participated also in the study [OR (95% CI)=2.1 (1.0 to 4.3)], families not entitled to means-tested healthcare [OR (95% CI)=2.1 (1.0 to 4.3)], families with high weekly household income [OR (95% CI)=3.0 (1.6 to 5.9)], mothers' own SRH positive [OR (95% CI)=5.1 (2.6 to 9.9)], mothers consuming lower energy diet [OR (95% CI)=2.2 (1.1 to 4.3)], fathers' own SRH positive [OR (95% CI)=3.0 (1.5 to 6.0)], and fathers not smoking [OR (95% CI)=2.2 (1.1 to 4.4)]. In the final multivariable model (χ2=45.3, df=17, N=353, p<0.001) four variables remained predictive of favourable SRH of children: mothers' SRH positive [OR (95% CI)=6.2 (2.1 to 17.7)], mothers consuming lower energy diet [OR (95% CI)=3.6 (1.3 to 10.3)], family with high weekly household income [OR (95% CI)=3.4 (1.1 to 10.4)], and fathers' employment status positive [OR (95% CI)=5.4 (1.0 to 28.2)].
Conclusion The findings substantiate the familial influence on child health during the early developmental stage, which is socially patterned and related particularly to economic circumstances.
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