TY - JOUR
T1 - Assessing cardiometabolic health risk among U.S. children living in grandparent-headed households
AU - Song, Min Kyoung
AU - Hayman, Laura L.
AU - Lyons, Karen
AU - Dieckmann, Nathan F.
AU - Musil, Carol M.
N1 - Funding Information:
We used data from the 2017–2018 National Survey of Children's Health (NSCH) ( Child and Adolescent Health Measurement Initiative, 2020 ), a nationally representative survey completed by parent-caregivers or other caregivers for U.S. children younger than 18 years. NSCH is funded and directed by the Health Resources and Services Administration and conducted by the U.S. Census Bureau. In 2017 and 2018, the NSCH used a mailed, self-administered survey with paper and web-based response options. Households were randomly sampled and contacted by mail in order to identify those with one or more children under 18 years of age. In each household, one child was randomly selected to be the subject of the survey. Surveys were available in both English and Spanish. A total of 52,129 surveys were completed for 2017 and 2018 combined (21,599 in 2017 and 30,530 in 2018). The overall weighted response rate for the 2017 and 2018 surveys (combined into the 2017–2018 NSCH dataset) was 37.4% and 43.1%, respectively, which may have resulted in nonresponse bias; however, analyses showed that there is no strong or consistent evidence of nonresponse bias after survey weights were applied (U.S. Census Bureau, 2019a, 2019b ). All analyses were weighted to account for the unequal probability of selection and differential of nonresponse by various sociodemographic factors, and was considered representative for all noninstitutionalized U.S. children residing in housing units. Additional details of the NSCH are available elsewhere (U.S. Census Bureau, 2017, 2018 ).
Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2021/11/1
Y1 - 2021/11/1
N2 - Purpose: We evaluated children's cardiometabolic health (CMH) risk indicators and adverse childhood experiences (ACEs) stratified by family structure type (grandparent-headed, two-parent headed, and single-parent headed households). Separately, we assessed whether family structure type and number of ACEs were independently associated with the CMH risk indicators. Design and methods: Utilizing data from the 2017–2018 National Survey of Children's Health, we evaluated five CMH risk indicators (obesity, physical activity, secondhand smoke exposure, sleep, and sports participation). We used multivariable logistic regressions to assess the association of CMH risk indicators with family structure type and ACEs. We controlled for sex, age, race/ethnicity, health insurance, household poverty level, and overall health status. Results: Among children aged 10–17 years (n = 24,885), we found the number of ACEs differed by family structure type (P < 0.001) and was independently associated with obesity, secondhand smoke exposure, sleep, and sports participation. Adjusting for all covariates except ACEs, family structure type was significantly associated with children's CMH risk; but after controlling for ACEs that association was attenuated - except for sleep (less adequate sleep in grandparent-headed households) and exposure to secondhand smoke (less exposure in single-parent headed households). Conclusions: ACEs were highest among children living in grandparent-headed households and independently associated with a majority of the CMH risk indicators. Findings suggest that children living in grandparent-headed households may be at elevated risk for poor CMH, potentially due to higher risk for ACEs. Practice implications: It is recommended to consider ACEs and family structure type when assessing CMH risk in children.
AB - Purpose: We evaluated children's cardiometabolic health (CMH) risk indicators and adverse childhood experiences (ACEs) stratified by family structure type (grandparent-headed, two-parent headed, and single-parent headed households). Separately, we assessed whether family structure type and number of ACEs were independently associated with the CMH risk indicators. Design and methods: Utilizing data from the 2017–2018 National Survey of Children's Health, we evaluated five CMH risk indicators (obesity, physical activity, secondhand smoke exposure, sleep, and sports participation). We used multivariable logistic regressions to assess the association of CMH risk indicators with family structure type and ACEs. We controlled for sex, age, race/ethnicity, health insurance, household poverty level, and overall health status. Results: Among children aged 10–17 years (n = 24,885), we found the number of ACEs differed by family structure type (P < 0.001) and was independently associated with obesity, secondhand smoke exposure, sleep, and sports participation. Adjusting for all covariates except ACEs, family structure type was significantly associated with children's CMH risk; but after controlling for ACEs that association was attenuated - except for sleep (less adequate sleep in grandparent-headed households) and exposure to secondhand smoke (less exposure in single-parent headed households). Conclusions: ACEs were highest among children living in grandparent-headed households and independently associated with a majority of the CMH risk indicators. Findings suggest that children living in grandparent-headed households may be at elevated risk for poor CMH, potentially due to higher risk for ACEs. Practice implications: It is recommended to consider ACEs and family structure type when assessing CMH risk in children.
KW - Adverse childhood experiences
KW - Cardiometabolic health risk
KW - Family structure type
KW - Grandparent-headed households
KW - National survey of children's health
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U2 - 10.1016/j.pedn.2021.09.003
DO - 10.1016/j.pedn.2021.09.003
M3 - Article
C2 - 34543828
AN - SCOPUS:85115191362
SN - 0882-5963
VL - 61
SP - 331
EP - 339
JO - Journal of Pediatric Nursing
JF - Journal of Pediatric Nursing
ER -