The equity impact of a universal child health promotion programme
BACKGROUND: Real-world evaluations of complex interventions are scarce. We evaluated the effect of the Salut Programme, a universal child health promotion intervention in northern Sweden, on income-related inequalities in positive birth outcomes and healthcare utilisation up to 2 years after deliver...
Published in: | Journal of Epidemiology and Community Health |
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Umeå universitet, Institutionen för epidemiologi och global hälsa
2020
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Online Access: | http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-169927 https://doi.org/10.1136/jech-2019-213503 |
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ftumeauniv:oai:DiVA.org:umu-169927 2023-10-09T21:54:31+02:00 The equity impact of a universal child health promotion programme Pulkki-Brännström, Anni-Maria Lindkvist, Marie Eurenius, Eva Häggström, Jenny Ivarsson, Anneli Sampaio, Filipa Feldman, Inna 2020 application/pdf http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-169927 https://doi.org/10.1136/jech-2019-213503 eng eng Umeå universitet, Institutionen för epidemiologi och global hälsa Umeå universitet, Statistik Journal of Epidemiology and Community Health, 0143-005X, 2020, 74, s. 605-611 0000-00018723-8131 orcid:0000-0002-8184-6360 orcid:0000-0002-9086-7403 orcid:0000-0001-8944-2558 http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-169927 doi:10.1136/jech-2019-213503 PMID 32303594 ISI:000568209000009 Scopus 2-s2.0-85083690730 info:eu-repo/semantics/openAccess health promotion income pregnancy outcome public health registries Global Health Social Medicine and Epidemiology Folkhälsovetenskap global hälsa socialmedicin och epidemiologi Article in journal info:eu-repo/semantics/article text 2020 ftumeauniv https://doi.org/10.1136/jech-2019-213503 2023-09-22T13:59:36Z BACKGROUND: Real-world evaluations of complex interventions are scarce. We evaluated the effect of the Salut Programme, a universal child health promotion intervention in northern Sweden, on income-related inequalities in positive birth outcomes and healthcare utilisation up to 2 years after delivery. METHODS: Using the mother's place of residence at delivery, the child and the mother were classified as belonging to either the control area (received care-as-usual) or the intervention area (where the intervention was implemented from 2006) and either the premeasure (children born between 2002 and 2004) or the postmeasure (children born between 2006 and 2008) period. Parents' earned income was used as the socioeconomic ranking variable. The Relative Concentration Index was computed for six binary birth outcome indicators and for inpatient and day patient care for children and their mothers. Changes in inequality over time were compared using a difference-in-difference approach. RESULTS: Income-related inequalities in birth outcomes and child healthcare utilisation were absent, except that full-term pregnancies were concentrated among the poor at premeasure in the intervention area. In contrast, mothers' healthcare utilisation was significantly pro-poor in the control area. The extent of inequality changed differentially between premeasure and postmeasure for two birth outcomes: full-term pregnancies and infants with normal birth weight. Inequalities in healthcare utilisation did not change significantly in either area over time. CONCLUSION: In northern Sweden, income-related inequalities in birth outcomes and child healthcare utilisation are largely absent. However, relative inequalities in mothers' healthcare utilisation are large. We found no evidence that the Salut Programme affected changes in inequality over time. Article in Journal/Newspaper Northern Sweden Umeå University: Publications (DiVA) Journal of Epidemiology and Community Health jech-2019-213503 |
institution |
Open Polar |
collection |
Umeå University: Publications (DiVA) |
op_collection_id |
ftumeauniv |
language |
English |
topic |
health promotion income pregnancy outcome public health registries Global Health Social Medicine and Epidemiology Folkhälsovetenskap global hälsa socialmedicin och epidemiologi |
spellingShingle |
health promotion income pregnancy outcome public health registries Global Health Social Medicine and Epidemiology Folkhälsovetenskap global hälsa socialmedicin och epidemiologi Pulkki-Brännström, Anni-Maria Lindkvist, Marie Eurenius, Eva Häggström, Jenny Ivarsson, Anneli Sampaio, Filipa Feldman, Inna The equity impact of a universal child health promotion programme |
topic_facet |
health promotion income pregnancy outcome public health registries Global Health Social Medicine and Epidemiology Folkhälsovetenskap global hälsa socialmedicin och epidemiologi |
description |
BACKGROUND: Real-world evaluations of complex interventions are scarce. We evaluated the effect of the Salut Programme, a universal child health promotion intervention in northern Sweden, on income-related inequalities in positive birth outcomes and healthcare utilisation up to 2 years after delivery. METHODS: Using the mother's place of residence at delivery, the child and the mother were classified as belonging to either the control area (received care-as-usual) or the intervention area (where the intervention was implemented from 2006) and either the premeasure (children born between 2002 and 2004) or the postmeasure (children born between 2006 and 2008) period. Parents' earned income was used as the socioeconomic ranking variable. The Relative Concentration Index was computed for six binary birth outcome indicators and for inpatient and day patient care for children and their mothers. Changes in inequality over time were compared using a difference-in-difference approach. RESULTS: Income-related inequalities in birth outcomes and child healthcare utilisation were absent, except that full-term pregnancies were concentrated among the poor at premeasure in the intervention area. In contrast, mothers' healthcare utilisation was significantly pro-poor in the control area. The extent of inequality changed differentially between premeasure and postmeasure for two birth outcomes: full-term pregnancies and infants with normal birth weight. Inequalities in healthcare utilisation did not change significantly in either area over time. CONCLUSION: In northern Sweden, income-related inequalities in birth outcomes and child healthcare utilisation are largely absent. However, relative inequalities in mothers' healthcare utilisation are large. We found no evidence that the Salut Programme affected changes in inequality over time. |
format |
Article in Journal/Newspaper |
author |
Pulkki-Brännström, Anni-Maria Lindkvist, Marie Eurenius, Eva Häggström, Jenny Ivarsson, Anneli Sampaio, Filipa Feldman, Inna |
author_facet |
Pulkki-Brännström, Anni-Maria Lindkvist, Marie Eurenius, Eva Häggström, Jenny Ivarsson, Anneli Sampaio, Filipa Feldman, Inna |
author_sort |
Pulkki-Brännström, Anni-Maria |
title |
The equity impact of a universal child health promotion programme |
title_short |
The equity impact of a universal child health promotion programme |
title_full |
The equity impact of a universal child health promotion programme |
title_fullStr |
The equity impact of a universal child health promotion programme |
title_full_unstemmed |
The equity impact of a universal child health promotion programme |
title_sort |
equity impact of a universal child health promotion programme |
publisher |
Umeå universitet, Institutionen för epidemiologi och global hälsa |
publishDate |
2020 |
url |
http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-169927 https://doi.org/10.1136/jech-2019-213503 |
genre |
Northern Sweden |
genre_facet |
Northern Sweden |
op_relation |
Journal of Epidemiology and Community Health, 0143-005X, 2020, 74, s. 605-611 0000-00018723-8131 orcid:0000-0002-8184-6360 orcid:0000-0002-9086-7403 orcid:0000-0001-8944-2558 http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-169927 doi:10.1136/jech-2019-213503 PMID 32303594 ISI:000568209000009 Scopus 2-s2.0-85083690730 |
op_rights |
info:eu-repo/semantics/openAccess |
op_doi |
https://doi.org/10.1136/jech-2019-213503 |
container_title |
Journal of Epidemiology and Community Health |
container_start_page |
jech-2019-213503 |
_version_ |
1779318104471371776 |