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APHA Scientific Session and Event Listing

Duration of Exposure to Poverty and Child Morbidity: A Population-Based Longitudinal Study

Louise Seguin, MD, MPH, Béatrice Nikiéma, MD, MSc, Maria-Victoria Zunzunegui, PhD, and Lise Gauvin, PhD. Department of Social and Preventive Medicine, University of Montreal, P.O. Box 6128, Succ Downtown, Montreal, QC H3C 3J7, Canada, 514-343-7665, Louise.Seguin@umontreal.ca

Objective:To examine children's health at six years of age as a function of the duration of poverty since birth. The study was conducted in Quebec, where there is universal health care. Method:A representative birth cohort of 2120 singleton infants was recruited at the age of 5 months, and followed-up annually up to 77 months as part of the Quebec Longitudinal Study of Child Development (QLSCD). Health outcomes used here are: asthma, mother's perception of child's health, and use of medical and emergency services. Duration of poverty was defined as the number of times an insufficient income (below the Canadian low-income threshold) was reported between 5 and 41 months. Logistic regression was used to predict health outcomes at 6 years as a function of duration of poverty. Results:Twenty eight percent of the 1492 children followed up to 6 years experienced poverty at least once and 14 % were chronically poor since birth. Compared to children from households who had always had sufficient income, the chronically (3-4 periods) poor children and children with intermittent (1-2 period) poverty were more likely to have a diagnosis of asthma and more likely to be perceived in less good health. These associations remained statistically significant after controlling for neonatal health and maternal characteristics. Unexpectedly, chronically poor children were less likely to use emergency rooms even if facing higher health hazards. Conclusions: Chronic exposure to poverty since birth is detrimental to children's health above and beyond maternal characteristics and neonatal health.

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