Uppsala Global Health Research on Implementation and Sustainability (UGHRIS), Department of Women's and Children's Health, Uppsala University, Sweden.
Scand J Public Health. 2021 Jul;49(5):563-570. doi: 10.1177/1403494820980261. Epub 2020 Dec 18.
Children's health is affected by the environment in which they live and grow. Within Sweden's urban areas, several city districts can be classified as socio-economically disadvantaged. This article describes the creation of a child health index to visualise disparities within and between Sweden's three major cities, and how these relate to indicators of demography and socio-economic status.
Data were collected for seven child health indicators and seven socio-economic and demographic indicators from the Swedish Pregnancy Register, Child Health Services and Statistics Sweden. An index was created from the health indicators using principal component analysis, generating weights for each indicator. Correlations between index outcomes and socio-economic and demographic indicators were analysed using linear regression.
The largest variance in index values could be seen in Stockholm followed by Malmö, and the poorest mean index outcome was seen in Malmö followed by Gothenburg. The largest intra-urban percentage range in health indicators could be seen for tobacco exposure at 0-4 weeks (0.8-33.9%, standard deviation ()=8.8%) and, for the socio-economic and demographic indicators, foreign background (19.9-88.5%, =19.8%). In the multivariate analysis, index outcomes correlated most strongly with foreign background (=0.364, =0.001).
Children's health follows a social gradient and a pattern of ethnic segregation in Swedish cities, where it can be visualised using an index of child health. The resulting map highlights the geographical distribution of these disparities, and displays in which city districts child health interventions may be most needed.
儿童的健康受到其生活和成长环境的影响。在瑞典的城市地区，有几个城区可以被归类为社会经济条件较差。本文描述了创建儿童健康指数的过程，以直观地展示瑞典三个主要城市内部和之间的差异，并探讨这些差异与人口统计学和社会经济地位指标之间的关系。
从瑞典妊娠登记处、儿童健康服务处和瑞典统计局收集了七个儿童健康指标和七个社会经济和人口统计学指标的数据。使用主成分分析从健康指标中创建指数，为每个指标生成权重。使用线性回归分析指数结果与社会经济和人口统计学指标之间的相关性。
斯德哥尔摩的指数值变化最大，其次是马尔默，而哥德堡和马尔默的平均指数结果最差。在 0-4 周的烟草暴露等健康指标中，城乡内百分比范围最大（0.8-33.9%，标准差（）=8.8%），而在社会经济和人口统计学指标中，外国背景的范围最大（19.9-88.5%，=19.8%）。在多变量分析中，指数结果与外国背景相关性最强（=0.364，=0.001）。
在瑞典城市中，儿童健康状况呈现出社会阶层差异和族裔隔离的模式，可以通过儿童健康指数直观地显示出来。由此产生的地图突出显示了这些差异的地理分布，并显示了在哪些城市区域可能最需要进行儿童健康干预。
