Welfare Reform and Children's Health.

Time limits are among the most fundamental of recent welfare reforms. Whereas welfare benefits were an entitlement under the old Aid to Families with Dependent Children (AFDC) program, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), which replaced AFDC with the Temporary Aid to Needy Families (TANF) program, restricts most families to 60 months of federally funded benefits. Although the states are free to extend benefits further using their own funds, almost all have incorporated some sort of time limit into their TANF programs. Time limits may affect welfare receipt in two distinct ways. The most obvious effect is mechanical, reducing welfare use once recipients exhaust their benefits. However, time limits may also reduce welfare receipt before recipients reach the limit. If families are forwardlooking, they may reduce their current welfare use in order to preserve their benefits for the future. The purpose of this paper is to provide evidence on such anticipatory, or behavioral, effects of time limits. I use data from the Survey of Income and Program Participation (SIPP) to replicate my earlier estimates based on the Current Population Survey (CPS). I also exploit the SIPP to relax some of the restrictive assumptions that were implicit in my previous work.

We investigated whether uncertainty about the impact of children's chronic health conditions on their daily lives leads to changes in mothers' and fathers' mental and physical health. Three waves of data were collected over three years from parents of 228 children with chronic health conditions. Parents reported their level of uncertainty about how the child's health condition affected the child's daily life, as well as measures of their own mental and physical health at each wave of data collection. Results of structural equation models indicate that, among mothers, more illness-related uncertainty was associated with a subsequent increase in psychological symptoms relative to other mothers in the study. Psychological symptoms, in turn, were associated with a subsequent increase in physical symptoms among mothers. Uncertainty did not affect fathers' health. Illness-related uncertainty may be a risk factor for psychological and physical symptoms in mothers of children with chronic health conditions. As such, interventions that address uncertainty related to the child's chronic health condition may improve psychological and physical well-being of mothers of children with chronic health conditions.

Background. Assisted reproductive technology (ART) poses an increased risk for preterm birth. Women with high body mass index, who opted for ART, have the elevated levels of the insulin-like growth factor 1 (IGF-1) which is involved in the development of pathologic vasoproliferation in retinopathy of prematurity (ROP). Children with ROP are at increased risk for co-morbid pathology.Objective. The study aims at evaluating physical development and state of health in ART-conceived children with ROP.Methods. This is a population, one-time study to evaluate physical development and state of health in children with ROP. Statistical analysis was carried out using the SPSS v. 14.0 software package, and included determination of normality (Shapiro-Wilk test), descriptive statistics (М — mean value, σ — standard deviation of the mean), and non-parametric methods (Mann-Whitney U-test, Z-test of a proportion).Results. The anthropometric characteristics of infants with ROP did not differ from those in spontaneously conceived babies. Children with ROP born to mothers with high BMI had lower anthropometric parameters (p < 0.001) and required longer dynamic follow-up while being diagnosed as “risk group for ROP”. A significantly higher number (a total of 65) of nosologies has been revealed in the ART-conceived infants. Statistically significant predominant diagnoses (p = 0.0047) included dwarfism and obesity despite the absence of anthropometric differences at birth (p = 0.123).Conclusion. The ART-conceived infants with ROP at birth do not differ in their physical development from infants in the general population, however, on prospective follow-up the former developed dwarfism and obesity significantly more often. Children born to mothers with high BMI have significantly lower parameters of weight and height, and require longer follow-up period while being diagnosed with ROP. The ART-conceived infants with ROP have co-morbid pathology significantly more often than children with ROP in the control group.

Racial/Ethnic Disparities in Health-Related Quality of Life and Health in Children Are Largely Mediated by Family Contextual Differences

Grandparents are often highly involved as secondary caregivers for their grandchildren and may influence children's psychological and physical health outcomes. The purpose of the current review was to gather and synthesize research findings on the effects of grandparent involvement on children's physical health outcomes. PubMed, PsycInfo, and MedLine were searched by 3 independent reviewers for articles that reported on grandparent involvement and children's health. Twenty-six articles were included for final review based on selection criteria. Relatively few studies have examined the effects of grandparent involvement on children's health outcomes; therefore, the degree of their influence remains unclear. Four categories of children's health outcomes (disease/illness, weight, eating behaviors, and injury/safety) emerged during this review. Results indicated that the majority of studies available reported a negative effect of grandparent involvement on child's weight status. However, it is important to note that in most of these studies, the effects of grandparent involvement were not a primary outcome, and the amount of time grandparents spent with their grandchildren was not accounted for. Many studies in this review were qualitative studies, limiting the types of analyses that could be conducted. In addition, few longitudinal studies have been conducted in this area. Based on this review, it is clear that grandparents are involved in caretaking for children across many cultures but to understand their role in children's health outcomes, more systematic and longitudinal research needs to be conducted. (PsycINFO Database Record

BackgroundDirect and indirect associations have been identified among health literacy, health behavior, and health status. Thus, we aimed to investigate the influence of oral health literacy and behaviors in parents on their children's oral health status. Moreover, we aimed to analyze the mentioned mediating effects through oral health behavior management.MethodsOral health information of 1,102 preschool children aged 3 to 6 years was collected from five primary schools in Jinjiang District, Chengdu City, Sichuan Province, China. The decay-missing-filled teeth (DMFT) index and soft scale plaque index (PI) were used by professional dentists aided by school teachers to assess caries and periodontal health among the children. Simultaneously, we conducted a questionnaire-based survey among the parents to determine their oral health literacy and health behavior and their children's oral health behavior. The probit model, instrumental variables, and mediation effect model were used to evaluate the association of parents' oral health literacy and behavior with their children's oral health status.ResultsThe DFMT index was 1.58 among the children, with zero caries in 646 (58.6%) children. The PI was 0.68, with zero gum disease in 517 (46.9%). The univariate analysis suggested that the parents' health literacy and behavior were correlated with their children's oral health status (P < 0.01). Parents' oral health behavior significantly affected their children's oral health status. Simultaneously, a stronger correlation was observed upon using parents' health literacy as an instrumental variable to assess the endogeneity, indicating endogeneity problems. Parents' health-related behaviors exerted a mediating effect on children's oral health, with parents helping children brush their teeth demonstrating the strongest effect.ConclusionParents' oral health-related behaviors can affect their children's oral health status. We recommend enhancing parents' oral health literacy to improve children's oral health status.

BackgroundThe Great East Japan Earthquake inflicted severe damage on the Pacific coastal areas of northeast Japan. Although possible health impacts on aged or handicapped populations have been highlighted, little is known about how the serious disaster affected preschool children’s health. We conducted a nationwide nursery school survey to investigate preschool children’s physical development and health status throughout the disaster.MethodsThe survey was conducted from September to December 2012. We mailed three kinds of questionnaires to nursery schools in all 47 prefectures in Japan. Questionnaire “A” addressed nursery school information, and questionnaires “B1” and “B2” addressed individuals’ data. Our targets were children who were born from April 2, 2004, to April 1, 2005 (those who did not experience the disaster during their preschool days) and children who were born from April 2, 2006, to April 1, 2007 (those who experienced the disaster during their preschool days). The questionnaire inquired about disaster experiences, anthropometric measurements, and presence of diseases.ResultsIn total, 3624 nursery schools from all 47 prefectures participated in the survey. We established two nationwide retrospective cohorts of preschool children; 53 747 children who were born from April 2, 2004, to April 1, 2005, and 69 004 children who were born from April 2, 2006, to April 1, 2007. Among the latter cohort, 1003 were reported to have specific personal experiences with the disaster.ConclusionsWith the large dataset, we expect to yield comprehensive study results about preschool children’s physical development and health status throughout the disaster.

The main objective of this population-based and cross-sectional study was to determine the validity of maternal perception as an indicator of the 17-month-old child's health status. Data from this study came from the Quebec Longitudinal Study of Child Development (QLSCD, Round 1999) which was based on a representative sample of babies born in Québec in 1997 and 1998. The analyses were based on the 2045 children aged 17 months who participated in the survey in 1999. Maternal perception of the child's health status was examined as a function of a series of children's health indicators, namely the presence of acute health problems (last 3 months), asthma attacks since birth, presence of chronic problem and hospitalizations during the previous 12 months. Confounding influences of both maternal and child-related characteristics were controlled in the analyses. Sequential logistic regressions indicated that maternal perception was strongly associated with the different health indicators even after controlling for confounding variables. However, a significant interaction between the child's gender and the presence of chronic health problems was observed. The association between maternal perception of the child's health and the presence of chronic health problems was stronger for boys than for girls. The analyses confirm that the mother's perception of the health status of her 17-month-old child corresponds with the actual health status of the child as reflected by the presence or absence of selected health problems.

Objectives The aims of the present study were to: (1) describe the health status and health indicators for urban Aboriginal children (age 0-16 years) in south-east Sydney; and (2) evaluate the quality of routinely collected clinical data and its usefulness in monitoring local progress of health outcomes. Methods Aboriginal maternal and child health routine data, from multiple databases, for individuals accessing maternal and child health services between January 2007 and December 2012 were examined and compared with state and national health indicators. Results Reductions in maternal smoking, premature delivery and low birthweight delivery rates were achieved in some years, but no consistent trends emerged. Paediatric services had increased referrals each year. The most frequent diagnoses were nutritional problems, language delay or disorder and developmental delay or learning difficulties. Twenty per cent of children had a chronic medical condition requiring long-term follow-up. Aboriginal children were more likely to be discharged from hospital against medical advice than non-Aboriginal children. Routinely collected data did not include some information essential to monitor determinants of health and health outcomes. Conclusions Aboriginal children living in this urban setting had high levels of need. Routinely recorded data were suboptimal for monitoring local health status and needed to reflect national and state health indicators. Routinely collected data can identify service gaps and guide service development. What is known about this topic? Despite improvements in some areas, there continue to be significant gaps in maternal and child health outcomes between Aboriginal and non-Aboriginal Australians. These are poorly documented at a local service level. What does this paper add? Intensive, local services offered to Aboriginal women and children can result in rapid service engagement. Health service data routinely collected by local services can be used to demonstrate reductions in antenatal risk factors in pregnant Aboriginal women, even within the short time frame of 6 years. However, improvements in child health outcomes may require longer time frames. In this urban setting, the most frequent diagnoses in Aboriginal children attending the service were nutritional problems, language delay or disorder and developmental delay or learning difficulties. What are the implications for practitioners? Key information regarding determinants of health should be routinely monitored at a local level to understand local rates and health needs in addition to evaluating and quantifying the effectiveness of service delivery or health promotion activities.

While child health and health care disparities arising from unequal distribution of resources are well documented, a nationally representative inventory of health and well-being for children across the spectrum of opportunity is lacking. Using the nationally representative sample of children from pooled 2013-2017 Medical Expenditure Panel Survey data linked to the census-tract-level Child Opportunity Index 2.0, a composite measure of neighborhood health, education, and socioeconomic conditions, we describe US children's socioeconomic characteristics, health care utilization and expenditures across the spectrum of child neighborhood opportunity levels. We found that neighborhood level of child opportunity was associated with almost all of children's health status, health care utilization, expenditures, access to care, and satisfaction with care outcomes. Children living in lower-opportunity neighborhoods had the highest rates of poor physical and mental health status and fewest ambulatory care visits but accounted for the highest share of emergency department visits. Their parents were also least likely to report having positive experiences with health care, good communication with providers, and easy access to care. Our findings underscore the myriad harms to children of gaps in health, education, and financial resources at the community level and provide targets for public investments to improve child-focused outcomes.

Overall, the results of these analyses support the notion of adverse selection and retention in the SCHIP program. This is unlikely to be the result of aggressive marketing in enrollment sites that serve children with more medical problems, as Florida health care providers rank third as a source of information about the Title XXI program after family and friends and the schools. In addition, Florida has active outreach and single-page application process for Medicaid and an aggressive program to move children to Title V, which also should minimize the numbers of children with special health care needs enrolled in SCHIP. Nevertheless, these findings suggest that the children being enrolled in Florida's SCHIP program are not the largely healthy population that was envisioned. If replicated in other SCHIP programs, these findings raise questions about the basic underlying assumptions concerning the health of potential enrollees and could have implications for the long-term fiscal viability of the program.

The modernization of technology today has raised concerns among parents and health professionals about its probable impact on children's sleep, vision, behavior, and school performance. This study explores the effects of digital screen use on children's health and behavior, focusing on screen time duration, parental screen use, device types, and supervision. It examines key risk factors and correlations. A descriptive study design was used to explore the impacts of digital screen usage on children's health and behavior. Parents of 580 children aged 1-12 years from Duhok City, Iraq, were included. The data were collected through online questionnaires to parents addressing demographic data, screen time, and physical and behavioral issues. IBM SPSS Statistics for Windows, Version 27.0 (2020; IBM Corp., Armonk, New York, United States) was used to analyze the variables, and a p-value < 0.05 was considered significant. A total of 580 children were involved in this study. The majority (41.6%) were aged 1-3 years, with 59.7% were male. The phone was the most commonly used (39.0%) device and 38.8% of children owned a digital device; 59.5% of parents reported moderate control over screen time, and most of them (46.4%) had secondary or institute education. Post-device use, 51% of parents reported no change in cognition, but 27.6% reported worse cognition and 41.2% noted increased nervousness. Approximately 45.9% of parents supervised screen time. Supervision did not appear to significantly influence sleep disturbances as compared to unsupervised (39.1% vs.33.1%, p=0.135). However, eye problems showed a significant correlation (66.9% vs. 76.4%, p=0.009). Younger parents (25-35 years) were more likely to monitor screen time (58.6%) compared to older parents (>36 years, 23.3%). Regression analysis confirms parents' own screen time notably predicted children's screen time (B=0.155, p<0.001). These findings highlight the importance of parental behavior in influencing children's screen habits and health outcomes. This study reveals the significant impact of parental screen time on children's digital habits and health outcomes. The findings suggest that children with supervised screen time have fewer sleep and eye problems. Younger parents are more likely to control their children's screen time, highlighting the role of parental involvement. The results highlight the need for evidence-based guidelines and increased awareness to manage screen time effectively, promoting healthier growth in children.

During the ongoing national discussion of proposals to reform health care financing, effects on the health status of children emerged as a special concern. Public attention has shifted away from comprehensive reform of the health care system and toward reform of the welfare system (primarily the Aid to Families with Dependent Children [AFDC] program), but this debate with its focus on parental behavior has not attended to the effects of reform on children's health and well-being. Yet the changes proposed will have a profound effect on the lives of children. Children's health status is determined by a multiplicity of factors, among which social and economic factors are especially important.^1,2Children living in poverty have poorer health than their more affluent peers,^1-16consequently, welfare system reform carries great implications for children's health. Welfare system reforms that reduce resources for low-income families will lead to a predictable increase in adverse

Parents are the principal decision-makers regarding their child's health. Awareness of mothers' view about their children's health, particularly with special health care needs (SHCN) (include hearing impaired children), is essential for health care providers. Therefore, the present study aimed to assess the mothers view about oral health status, oral hygiene practices, and dental services utilization of their children with hearing impairment attending special schools. A cross-sectional study was conducted between May and September 2020 among mothers of students with hearing impairment attending special schools. Also, the telephone structured interview was used to gathering mothers view. 57.4% of the mothers rated their children's oral health status as excellent or good, 27.9% as moderate, and 14.7% as poor. About half of the mothers (49.2%) stated that their children used toothbrushes once daily, and 15% use dental floss. Also, 54% of the children visited the dentist before this survey's conduct. The findings of the present study suggest that children with hearing impairment can also have good oral health status and behaviors. These results may be attributed to the fact that the study sample was taken from two special schools. Also, only the mothers' perception assessment of students' oral health status was done. Further studies are required to increase the strength of evidence.

Aim: The aim of the study is to find the association between child socioeconomic background (SEB) and health conditions of children of south Mumbai of Maharashtra. Methodology: Ahospital cross-sectional research design was used by selecting 40 children from selected hospitals of south Mumbai using probability simple random technique. Data were collected with the help of structured interviews, structured questionnaires, and rating scale. Data get analyzed using descriptive and inferential statistics. Results: For parameter, “body mass index (BMI),” the beta value is (0.03), it means when we increase value of independent variable (child SEB) by 1, the value of dependent variable (BMI) will increase by 0.03, and there is very poor positive relation among BMI and composite score of socioeconomic background parameters. For parameter, “behavioral difficulty,” the beta value is −0.42, it means when we increase independent variable (child SEB) by 1, the value of dependent variable (behavioral difficulty) will decrease by 0.42. It indicated that there is inverse relation among behavioral difficulties and composite score of socioeconomic background parameters. For parameter, “sleep problem,” the beta value is (−0.67), it means when we increase independent variable (child SEB) on X axis by 1, the value of dependent variable (sleep problem) on Y axis will decrease by 0.67 and that’s why there is an inverse relationship among composite score of socioeconomic background parameters and sleep problems. Conclusion: Study has shown that there is a strong positive relation between child socioeconomic status and health condition of children.