Changing contexts of child health: An assessment of unmet physical, psychological and social needs of children with common chronic childhood illness

Raghu Lingam; Nan Hu; Elizabeth Cecil; Julia Forman; James Newham; Rose Marie Satherley; Marina Soley Bori; Simon Cousens; Julia Fox-Rushby; Ingrid Wolfe

doi:10.1136/archdischild-2023-326766

Changing contexts of child health: An assessment of unmet physical, psychological and social needs of children with common chronic childhood illness

Raghu Lingam^*, Nan Hu, Elizabeth Cecil, Julia Forman, James Newham, Rose Marie Satherley, Marina Soley Bori, Simon Cousens, Julia Fox-Rushby, Ingrid Wolfe

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

Abstract

Background We assessed the biopsychosocial needs and key health drivers among children living with a common chronic illness, as baseline for a cluster randomised controlled trial of a child health system strengthening intervention. Methods Cross-sectional data were analysed from a large population sample of children from South London with asthma, eczema or constipation, as exemplar tracer conditions of a new integrated care service. Descriptive and regression analyses, accounting for sociodemographic factors, investigated social needs, psychosocial outcomes and quality of life associated with poor symptom control. Results Among 7779 children, 4371 children (56%) had at least one uncontrolled physical health condition. Across the three domains of physical health, mental health and social needs, 77.5% of children (n=4304 of 5554) aged 4-15 years had at least one unmet need, while 16.3% of children had three unmet needs. Children from the most socioeconomically disadvantaged quintile had a 20% increased risk of at least one poorly controlled physical condition (risk ratio (RR)=1.20, 95% CI: 1.11 to 1.31, p<0.001) compared with those from the least disadvantaged quintile. There was an 85% increased risk of clinically important mental health needs among children with uncontrolled asthma (RR=1.85, 95% CI: 1.65 to 2.07, p<0.001), 57% for active constipation (RR=1.57, 95% CI: 1.12 to 2.20, p<0.01) and 39% for uncontrolled eczema (RR=1.39, 95% CI: 1.24 to 1.56, p<0.001). Health-related quality of life was associated with poor symptom control. Conclusions There is a large burden of unmet biopsychosocial needs among children with chronic illness, signalling an urgent need for prevention, early intervention and integrated biopsychosocial care.

Original language	English
Pages (from-to)	488-496
Number of pages	9
Journal	Archives of Disease in Childhood
Volume	109
Issue number	6
DOIs	https://doi.org/10.1136/archdischild-2023-326766
Publication status	Published - 1 Jun 2024

Keywords

Child Health
Epidemiology
Paediatrics

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1136/archdischild-2023-326766

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Lingam, R., Hu, N., Cecil, E., Forman, J., Newham, J., Satherley, R. M., Bori, M. S., Cousens, S., Fox-Rushby, J., & Wolfe, I. (2024). Changing contexts of child health: An assessment of unmet physical, psychological and social needs of children with common chronic childhood illness. Archives of Disease in Childhood, 109(6), 488-496. https://doi.org/10.1136/archdischild-2023-326766

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title = "Changing contexts of child health: An assessment of unmet physical, psychological and social needs of children with common chronic childhood illness",

abstract = "Background We assessed the biopsychosocial needs and key health drivers among children living with a common chronic illness, as baseline for a cluster randomised controlled trial of a child health system strengthening intervention. Methods Cross-sectional data were analysed from a large population sample of children from South London with asthma, eczema or constipation, as exemplar tracer conditions of a new integrated care service. Descriptive and regression analyses, accounting for sociodemographic factors, investigated social needs, psychosocial outcomes and quality of life associated with poor symptom control. Results Among 7779 children, 4371 children (56%) had at least one uncontrolled physical health condition. Across the three domains of physical health, mental health and social needs, 77.5% of children (n=4304 of 5554) aged 4-15 years had at least one unmet need, while 16.3% of children had three unmet needs. Children from the most socioeconomically disadvantaged quintile had a 20% increased risk of at least one poorly controlled physical condition (risk ratio (RR)=1.20, 95% CI: 1.11 to 1.31, p<0.001) compared with those from the least disadvantaged quintile. There was an 85% increased risk of clinically important mental health needs among children with uncontrolled asthma (RR=1.85, 95% CI: 1.65 to 2.07, p<0.001), 57% for active constipation (RR=1.57, 95% CI: 1.12 to 2.20, p<0.01) and 39% for uncontrolled eczema (RR=1.39, 95% CI: 1.24 to 1.56, p<0.001). Health-related quality of life was associated with poor symptom control. Conclusions There is a large burden of unmet biopsychosocial needs among children with chronic illness, signalling an urgent need for prevention, early intervention and integrated biopsychosocial care.",

keywords = "Child Health, Epidemiology, Paediatrics",

author = "Raghu Lingam and Nan Hu and Elizabeth Cecil and Julia Forman and James Newham and Satherley, {Rose Marie} and Bori, {Marina Soley} and Simon Cousens and Julia Fox-Rushby and Ingrid Wolfe",

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doi = "10.1136/archdischild-2023-326766",

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Lingam, R, Hu, N, Cecil, E , Forman, J , Newham, J , Satherley, RM , Bori, MS, Cousens, S, Fox-Rushby, J & Wolfe, I 2024, 'Changing contexts of child health: An assessment of unmet physical, psychological and social needs of children with common chronic childhood illness', Archives of Disease in Childhood, vol. 109, no. 6, pp. 488-496. https://doi.org/10.1136/archdischild-2023-326766

TY - JOUR

T1 - Changing contexts of child health

T2 - An assessment of unmet physical, psychological and social needs of children with common chronic childhood illness

AU - Lingam, Raghu

AU - Hu, Nan

AU - Cecil, Elizabeth

AU - Forman, Julia

AU - Newham, James

AU - Satherley, Rose Marie

AU - Bori, Marina Soley

AU - Cousens, Simon

AU - Fox-Rushby, Julia

AU - Wolfe, Ingrid

PY - 2024/6/1

Y1 - 2024/6/1

N2 - Background We assessed the biopsychosocial needs and key health drivers among children living with a common chronic illness, as baseline for a cluster randomised controlled trial of a child health system strengthening intervention. Methods Cross-sectional data were analysed from a large population sample of children from South London with asthma, eczema or constipation, as exemplar tracer conditions of a new integrated care service. Descriptive and regression analyses, accounting for sociodemographic factors, investigated social needs, psychosocial outcomes and quality of life associated with poor symptom control. Results Among 7779 children, 4371 children (56%) had at least one uncontrolled physical health condition. Across the three domains of physical health, mental health and social needs, 77.5% of children (n=4304 of 5554) aged 4-15 years had at least one unmet need, while 16.3% of children had three unmet needs. Children from the most socioeconomically disadvantaged quintile had a 20% increased risk of at least one poorly controlled physical condition (risk ratio (RR)=1.20, 95% CI: 1.11 to 1.31, p<0.001) compared with those from the least disadvantaged quintile. There was an 85% increased risk of clinically important mental health needs among children with uncontrolled asthma (RR=1.85, 95% CI: 1.65 to 2.07, p<0.001), 57% for active constipation (RR=1.57, 95% CI: 1.12 to 2.20, p<0.01) and 39% for uncontrolled eczema (RR=1.39, 95% CI: 1.24 to 1.56, p<0.001). Health-related quality of life was associated with poor symptom control. Conclusions There is a large burden of unmet biopsychosocial needs among children with chronic illness, signalling an urgent need for prevention, early intervention and integrated biopsychosocial care.

AB - Background We assessed the biopsychosocial needs and key health drivers among children living with a common chronic illness, as baseline for a cluster randomised controlled trial of a child health system strengthening intervention. Methods Cross-sectional data were analysed from a large population sample of children from South London with asthma, eczema or constipation, as exemplar tracer conditions of a new integrated care service. Descriptive and regression analyses, accounting for sociodemographic factors, investigated social needs, psychosocial outcomes and quality of life associated with poor symptom control. Results Among 7779 children, 4371 children (56%) had at least one uncontrolled physical health condition. Across the three domains of physical health, mental health and social needs, 77.5% of children (n=4304 of 5554) aged 4-15 years had at least one unmet need, while 16.3% of children had three unmet needs. Children from the most socioeconomically disadvantaged quintile had a 20% increased risk of at least one poorly controlled physical condition (risk ratio (RR)=1.20, 95% CI: 1.11 to 1.31, p<0.001) compared with those from the least disadvantaged quintile. There was an 85% increased risk of clinically important mental health needs among children with uncontrolled asthma (RR=1.85, 95% CI: 1.65 to 2.07, p<0.001), 57% for active constipation (RR=1.57, 95% CI: 1.12 to 2.20, p<0.01) and 39% for uncontrolled eczema (RR=1.39, 95% CI: 1.24 to 1.56, p<0.001). Health-related quality of life was associated with poor symptom control. Conclusions There is a large burden of unmet biopsychosocial needs among children with chronic illness, signalling an urgent need for prevention, early intervention and integrated biopsychosocial care.

KW - Child Health

KW - Epidemiology

KW - Paediatrics

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U2 - 10.1136/archdischild-2023-326766

DO - 10.1136/archdischild-2023-326766

M3 - Article

C2 - 38383134

AN - SCOPUS:85185968990

SN - 0003-9888

VL - 109

SP - 488

EP - 496

JO - Archives of Disease in Childhood

JF - Archives of Disease in Childhood

IS - 6

ER -

Changing contexts of child health: An assessment of unmet physical, psychological and social needs of children with common chronic childhood illness

Abstract

Keywords

UN SDGs

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