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 cant 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).
01 - 03 Oct 2015
European Society for Paediatric Endocrinology