ESPE2015 Poster Category 3 Diabetes (94 abstracts)
Social Risk Assessment in Children with Diabetes Mellitus to Plan Medical and Social Care
Anna Karpushkina a , Valentina Peterkova b , Natalia Vartapetova c , Elena Dedyukina d , Alla Philimonova f , Evgenia Mikhailova e , Oleg Malievsky g , Yulia Samoylova h , Elena Bashnina i , Elena Khramova d , Oleg Shvabsky c , Maria Pankratova b & Mikhail Starovoitov c
aCAF Foundation, Moscow, Russia; bFederal Endocrinology Scientific Center, Moscow, Russia; cInstitute for Family Health, Moscow, Russia; dHealth Department of Tyumen Oblast, Tyumen, Russia; eMinistry of Health of Samara Oblast, Samara, Russia; fMinistry of Health of of Ryazan Oblast, Ryazan, Russia; gMinistry of Health of Bashkortostan Republic, Ufa, Russia; hTomsk State Medical University, Tomsk, Russia; iSt-Petersburg Health Department, St-Petersburg, Russia
Background: According to the World Health Organization, the social determinants of health, the conditions in which people are born, grow, live and work – significantly influences on health. The CAF Foundation, the Endocrinology Scientific Center and the Institute for Family Health under the Alfa-Endo Program studied prevalence of some social determinants in families of children with type 1 diabetes mellitus.
Objective and hypotheses: Investigate social conditions of families with children with type 1 diabetes mellitus to plan social care. Research question: does the social conditions of families influence on diabetes control in children?
Method: The study was conducted in 2014 in the six Russian regions. In total, 221 mothers of children with type 1 diabetes mellitus (diabetes) were interviewed in health facilities (187 included in the analysis). The indicator of poor control of diabetes was glycated haemoglobin (HbA1C) higher than 8% (the Russian National Recommendations).
Results: Mean age of the children, whose mothers were interviewed, was 10.2 years (from 2 to 18), mean duration of diabetes – 4 years, 60% were girls. About 18% of the families had income < mean live-wage; 16% with single parent. One parent works in 52% of families; mothers can’t work mainly because of the child diseases. Both parents are unemployed in 3% families. All children are provided by the State with complete medical care. The most needed social support: financial (50%), better housing condition (39%), psychological counseling (39%), legal advice (35%). Half of children with diabetes had level of HbA1C higher than 8%. No one independent social factor correlated with poor diabetes control. However, combination of poverty, single maternity, parent unemployment in 3% of families correlated with high HbA1C (Pearson Chi-Square 5 510, the minimum expected count is 2.82, P=0.025).
Conclusion: The study confirmed necessity of screening social risk factors in families of children with diabetes to provide comprehensive social and health care.
Funding: This work was supported by the Alfa Banking Group (Donation Agreement #48, 2013).
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