Distribution of Accidents, Injuries, and Illnesses by Family Type

Abstract

ABSTRACT. Objective. To investigate whether family type and psychosocial risks indexed by family type were systematically associated with differences in health outcomes in children.Design and Subjects. The study is based on a longitudinal, prospective study of a large (n ‫؍‬ ϳ10 000) community sample of families, the Avon Longitudinal Study of Pregnancy and Childhood.Main Outcome Measures. Frequency of accidents, illnesses, and medical interventions.Results. At 2 years of age, children in single-parent and stepfamilies were disproportionately likely to experience accidents and receive medical treatment for physical illnesses. In addition, children in single-parent families and stepfamilies were more likely to be hospitalized or receive attention from a hospital doctor for an injury or illness. Exposure to psychosocial risks also were elevated in single-parent families and stepfamilies, compared with intact or nonstepfamilies, and these factors primarily accounted for the connection between family type and children's physical health.Conclusions. The consequences of family transitions on children's health extend beyond traditional mental health and behavioral outcomes and include accident proneness, illness, and receipt of medical attention. The mediating processes are not entirely attributable to social class differences connected to family type and may instead be associated with a range of psychosocial risks that are more frequently found in single-parent families and stepfamilies, compared with intact or nonstepfamilies. Prevention and intervention efforts directed toward children at risk for poor behavioral and mental health adjustment secondary to family disruption should consider children's physical health and health-related behaviors. Pediatrics 2000;106(5). URL: http://www. pediatrics.org/cgi/content/full/106/5/e68; family type, childhood, accidents, injuries, illnesses.ABBREVIATIONS. ALSPAC, Avon Longitudinal Study of Pregnancy and Childhood; OR, odds ratio. M embership in a single-parent family or stepfamily is associated with increased levels of significant behavioral, emotional, and academic problems in children. 1,2 The mechanisms underlying this connection are likely to involve, among other factors, financial adversity, increased stress directly related to family transitions, and increased exposure to additional psychosocial risks. 3,4 Compared with the extensive research base connecting family type (ie, membership in a 2-parent biological family, stepfamily, or single-parent family) and children's psychological adjustment, little is known about the physical health consequences of membership in diverse family types. One study 5 found that children in both single-parent families and stepfamilies were more likely to experience hospitalization or an injury attributable to accident than were children living with both biological parents. A smaller study found that children in single-parent families visited the general practitioner more and experienced more psychosomatic health problems. 6 A further study ...

Maternal perceptions of supervision in pre-school-aged children: a qualitative approach to understanding differences between families living in affluent and disadvantaged areas

“…Low maternal age is also a factor associated with increased injury risk (O'Connor, Davies et al 2000;Kendrick, Mulvaney et al 2005). Combined with living in poor quality rented accommodation this may provide some explanation for the difference in injury rates between the areas.…”

Acidentes e violências na infância e adolescência: fatores de risco e de proteção

“…Um estudo de coorte prospectivo com crianças inglesas concluiu que aquelas que residiam com pais substitutos (madrasta ou padrasto) foram vítimas de acidentes como queimaduras, quedas e aspiração de corpo estranho numa proporção bem maior em relação às crianças que residiam com os pais biológicos (16) . O estudo também aponta como fatores associados o nível de escolaridade da mãe, hiperatividade da criança, depressão materna e fatores relativos à maternidade como a gravidez na adolescência.…”

Variations in Family Composition

“…Children in single parent families are more likely to experience accidentssuggesting lower levels of child supervision-and to see a physician, to receive medical treatment for physical illnesses, and to be hospitalized than children from two parent families (O'Connor et al, 2000). Single parents have higher levels of mental health problems, which could result partly from the stress of trying to balance the needs of employment, home responsibilities, child rearing, and interactions with the child's school with limited time, personal, and social support (Cairney, 2003).…”

“…Children in single parent families also are more likely to live with adults unrelated to them. This situation can be concerning because these children are eight times more likely to die of maltreatment than children in households with two biologic parents (O'Connor et al, 2000).…”