TRENDS IN RISK FACTORS AND HEALTH STATUS OF EKATERINBURG PRESCHOOL CHILDREN IN 2001-2011: FINDING SETS OF RISK FACTORS THAT HAVE MOST NEGATIVE HEALTH EFFECT

摘要

Background: Temporal trends in risk factors (RF) are well-defined and multidirectional whereas their health impact is not always obvious. This study aims to analyze the trends in the health status and RF, development of methods to identify the set of RF having most negative health effect and formulation of management decisions. Methods: We conducted study of most prevalent kinds of diseases in preschool age children and RF in 2001-2011 in Ekaterinburg (Russia). Analyzed RF included indoor air pollution (gas stoves usage, tobacco smoke) environmental pollution (outdoor air and the drink water quality); socioeconomic factors (mother education level, child's physical activity level). 2215 preschool age children were examined. The Classification tree method and the logistic regression analysis were applied for examine a link between RF and children health (CH). NO2 concentration in outdoor air was estimated from Land Use Regression models. Results: 10-year long study found such trends as increasing the number of cars in 2,1 times, some improving the quality of drink water. The prevalence of cardiovascular and musculoskeletal system diseases has noticeably increased. Methods to determine combinations of RF negatively affecting health and to find the social factors that can offset the negative impact of environmental pollution on CH were elaborated.Examples: combination of high level of outdoor air pollution with gas stove in the flat and physical inactivity in children lead to increase the prevalence of respiratory diseases by 2,4 times. The combination of a physical activity in children with higher maternal education and nonsmoking mother can offset the negative health effects of indoor air pollution from gas combustion. The prevalence of cardiovascular diseases could be reduced in 2,1 times. Conclusions: During study period we have observed multidirectional and well-defined trends in RF and in the diseases prevalence. Detected sets of RF can be used by public health practitioners to allocate of limited resources for CH improvement.