Generalized Health Impact of Social and Material Deprivation on Perinatal Outcomes In Nova Scotia, Canada
Notice bibliographique
Résumé
Abstract BACKGROUND: Poverty is associated with multiple adverse perinatal outcomes including low birth weight, small for gestational age, pregnancy induced hypertension, gestational diabetes as well as an increased risk for neonatal death. Recent research has attempted to align social theory (i.e., that adverse social exposures impact multiple outcomes) with new statistical modeling that reflects this theory. The Generalized Health Impact (GHI) model looks at the impact on a myriad of adverse outcomes of exposure to negative social risk factor such as low income or poverty. Growing research examines how multiple perinatal outcomes are influenced by social and material deprivation. In particular, having a lower social and economic position in society (socioeconomic position) or being raised in low-income setting has been independently linked to multiple negative health outcomes. OBJECTIVES: To understand the generalized health impact (GHI) on perinatal health for mothers and their children that socioeconomic position (SEP) can have on health. DESIGN/METHODS: Data from the Nova Scotia Atlee Perinatal Database was used. A partnership with Statistics Canada facilitated a confidential linkage with income tax information for the year in which delivery occurred. Multiple logistic regression models were used to examine the relationship between multiple indicators of family income and multiple adverse perinatal and maternal outcomes. In the second stage of analysis, multinomial logistic regression was used to examine effects on a tally of the number of adverse outcomes (0, 1, 2 or ≥3). The study was approved by the IWK Health Centre Research Ethics Board. RESULTS: 117 734 individuals were included. Total family income was less than $23 587 in approximately 62% of families. Effect of low socioeco-nomic position on concomitant adverse perinatal health outcomes was seen with the risk of having 3 or more conditions was highest amongst single mothers (PR 3.1 CI: 2.92-3.27) and families reported as having an income below the low income cut off (PR 2.33 CI:2.16-2.51). Higher material deprivation in the neighbourhood of residence was associated with increased risk of multiple negative perinatal outcomes including pre-term birth and small for gestational age. CONCLUSION: This study highlights the importance of understanding the cumulative effect of SEP on generalized health outcomes for negative perinatal health outcomes. This research should inform clinical practice to recognize that social determinants of health and negative health outcomes occur not in isolation but as a collective. Further research on adequate screening for poverty and clinical assessment of social determinants of health is required.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,003 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».