Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Child health in Greenland.
Nordic Council of Ministers, Nordic School of Public Health NHV.
Centre for Health Research in Greenland, National Institute of Public Health, Denmark.
2007 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 35, no 3, 313-22 p.Article in journal (Refereed) Published
Abstract [en]

AIM: To review the knowledge on child health and child health problems in Greenland.

METHOD: The review was based on theses, national statistics, national and international reports, and a search in Pub Med, PsycINFO, Web of Science, and WHOLIB databases from 1985 to 2005. The resulting articles were sorted by topic, type, quality of study, and relevance for child health today, providing 47 articles.

RESULTS: Children in Greenland have become taller and have improved their general health. The morbidity found in Greenlandic children is similar to that found elsewhere even though the magnitude of problems might differ. The child mortality is relatively high and unevenly distributed. The acute disease pattern is dominated by infections, mostly airway infections. Otitis and its sequelae is a problem. An increase in chronic conditions such as atopy, asthma, obesity, and disabilities has taken place. Overweight and obesity have tripled in 20 years and are a health threat as well as constituting negative health behaviour. Social ill health, socioeconomic inequity, and sociocultural changes also influence health but their consequences are not well investigated in children.

CONCLUSIONS: A relatively high child mortality but the same morbidity pattern as in other Western societies was found. Negative health behaviour is frequent in schoolchildren. The influence of rapid cultural changes, and familial and societal factors related to social ill health, together with socioeconomic inequity, are of major importance to the health of children in Greenland. More accurate data on child health are necessary in the future to secure better prioritization. It is suggested to construct a set of reliable indicators of child health in Greenland to monitor the health of children on a national and regional basis.

Place, publisher, year, edition, pages
2007. Vol. 35, no 3, 313-22 p.
Keyword [en]
Adolescents, children, disease pattern, inequity, Inuit, Greenland, social ill-health
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:norden:org:diva-3674DOI: 10.1080/14034940600975781PubMedID: 17530554OAI: oai:DiVA.org:norden-3674DiVA: diva2:785532
Available from: 2015-02-03 Created: 2015-02-03 Last updated: 2015-02-03Bibliographically approved
In thesis
1. Folkesundhed i børnehøjde: indikatorer for børns sundhed og velbefindende i Grønland
Open this publication in new window or tab >>Folkesundhed i børnehøjde: indikatorer for børns sundhed og velbefindende i Grønland
2009 (Danish)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[en]
Public Health seen from Child Height : Indicators on child health and well-being in Greenland.
Abstract [da]

Formålet: Med basis i en overgribende analyse af børns sundhedstilstand i Grønland og punkt analyser indenfor specielt vigtige områder, er formålet at udvikle et samlet sæt af kerneindikatorer for børns sundhed og velbefindende på nationalt og kommunalt niveau set i et socialt perspektiv, og at præsentere data på disse indikatorer.

Metode: Delundersøgelse 1 er et litteraturstudie om grønlandske børns sundhed og velbefindende set i en social sammenhæng. Delundersøgelse 2: Undersøger udviklingen i BMI i en retrospektiv af skolebørn i Nuuk (hovedstaden) fra 1972 til 2002. Prævalens af overvægt og fedme blandt ind- og udskolings-børn blev analyseret og for den del af børnene, der var fulgt fra indskoling til udskoling analyseredes den positive og negative prædiktive værdi af tidlig erhvervet over-vægt. Delundersøgelse 3 analyserer med lav fødselsvægt som eksempel om en internationalt brugt indikatorer umiddelbart kan overføres til brug i Grønland. I delundersøgelse 4 og 5 bliver indikatorerne, deres baggrund, og deres udvælgel-se analyseret. Indikatorerne er foreslået med baggrund i FN’s børnekonvention, internationale folkesundhedsprogrammer, det grønlandske folkesundhedspro-gram og de kommunale børn og unge-politikker. Indikatorer blev søgt i litteraturen, i internationale databaser, og på hjemmesi-der. De blev sammen med materialet om børns sundhed, sundhedsydelser, sund-hedsovervågning, data tilgængelighed og datakilder samlet i en database struk-tureret på 4 områder: demografiske og socioøkonomiske forhold, sundhed og velbefindende, determinanter for sundhed, risikofaktorer og beskyttende fakto-rer, og sundhedssystemet og sundhedspolitiske faktorer. Med baggrund i opstil-lede kriterier for udvælgelsen er foreslået 28 indikatorer fra konceptionen til 18 år på nationalt niveau og 24 indikatorer på kommunalt niveau, som umiddelbart kan implementeres. De kommunale indikatorer er modificeret under hensyn til den lille befolkning og tilgængelighed af data. Yderligere 25 indikatorer til se-nere implementering blev identificeret på nationalt niveau.

Resultater: Sygdomsmønstret blandt børn domineres i dag af kroniske syg-domme, selvom alvorlige infektionssygdomme endnu ikke er under fuld kontrol og selvom dødelighed i barnealderen fortsat er høj i forhold til andre nordiske lande. Overvægt ved indskolingen steg fra 9,6 % til 22,5 % og ved 15årsalderen fra13,0 % til 19,3 % fra 1972 til 2002 og over halvdelen med tidlig erhvervet overvægtige forblev overvægtige. Lav fødselsvægt blev fundet at være en lige så god indikator her som i andre udviklede lande. En intervention overfor de mest betydningsfulde, modificerbare risikofaktorer for lav fødselsvægt må inkludere rygning under graviditeten og at sikre, at alle gravide modtager de anbe-falede antal svangerskabsundersøgelser. Data på indikatorerne viste, at en stor undergruppe af børn er sårbare på grund af sociale og demografiske forhold og at væsentlige dele af morbiditeten er højere blandt børn i yderdistrikter. Hoved-staden og byer i de større kommuner har bedre adgang til sundhedsydelser. En konsekvens er at sundhedssystemet bidrager til at øge forskellen i sundhed mel-lem mere og mindre privilegerede grupper af børn.

Konklusion: De foreslåede indikatorer er et vigtigt værktøj i monitorering af kerneområder for børns sundhed og faktorer, der influerer denne. Data viste, at hvis alle børn i Grønland skal sikres lige mulighed for sundhed vil det nødven-diggøre en strategi, der er mere vidtrækkende end det nuværende folkesund-hedsprogram, og som indebærer en koordineret indsats fra alle strukturelle ni-veauer og sektorer i samfundet. Værdifuldt for det videre arbejde, er at de få veldokumenterede indikatorer er foreslået ud fra systematisk indsamlet viden og set ud fra et folkesundhedsperspektiv; og at de bygger dels på allerede indsam-lede registerbaserede data og dels på spørgeskemabaserede data, fra en lands-dækkende og internationalt baseret undersøgelse af skolebørn, der gennemføres hvert 4. år. Det giver mulighed for at analysere udviklingen over tid. Indikato-rerne sikrer mulighed for enintegreret tilgang til viden om børns sundhed med mulighed for internationale, nationale, og kommunale sammenligninger og for nogle ned til de enkelte skoler. Dog er videreudvikling påkrævet indenfor data, datakvalitet, og dataindsamling

Abstract [en]

Aim: Based on a broad examination of child health in Greenland and in depth analyses in fields of special relevance, the aim is to identify a set of core indica-tors of children’s health and well-being seen in a social context at the national and municipal level, and present empirical data about them.

Methods: Investigation I is a literature review on child health in its social con-text in Greenland. Investigation II analyzes the development in BMI in a retro-spective cohort of schoolchildren in Nuuk (the capital) from 1972 to 2002. The prevalence of overweight and obesity among children at school start and at graduation age was analysed, and for children followed from school start to graduation age the positive and negative predictive value of early-acquired overweight were analyzed. Investigation III analyzes with low birth weight as an example if an internationally used indicator can be used in Greenland. In Investigation IV and V indicators, their background, and their selection are ana-lyzed. The indicators were proposed based on the UN Convention on the Rights of the Child, international and national public health programmes, and Greenland’s municipal child policies. Indicators were searched for in the litera-ture, databases, and international homepages. They were together with material on child health, health care delivery, present surveillance, data sources, and data availability collected in a database structured in four domains: demographic and socio-economic conditions; health status and well-being; determinants of health, risk, and protective factors; and health systems and health policy. Based on proposed criteria, 28 indicators from conception to age 18 at the national level were identified for immediate use, and 25 indicators for later implementation. At the municipal level, 24 indicators modified according to the small popula-tions and lack of data in the municipalities was proposed.

Results: Today, chronic diseases dominate in children, even if serious infec-tious diseases are not fully controlled and mortality during childhood is still high compared to the other Nordic countries. Overweight at school entry in-creased from 9.6% to 22.5% and at age 15 from 13.0% to 19.3% during the 30 years from 1972 to 2002. In more than half of the children the early-acquired overweight remained. Low birth weight was found to be as good an indicator as in other developed countries. The most important modifiable determinants of low birth weight, are smoking and antenatal care. Large subgroups of children are vulnerable because of their socio-economic and demographic conditions. Important part of the morbidity was higher among children in remote municipalities, while the capital and municipalities with lar-ger cities had better access to health care facilities. A consequence is that the health care system contributes to the health gap between privileged and less privileged children.

Conclusion: The selected indicators are a powerful tool in monitoring core issues in children’s health and the factors influencing it. If equal opportunities for health are to be given to all children in Greenland, a strategy is needed, which goes beyond the proposals of the present public health program, and which includes a coordinated effort from all structural levels and sectors in so-ciety. Of value for the future work is that the few, well documented indicators that are proposed are based on systematic evidence and are seen from a public health perspective, and adapted to Greenlandic conditions. They also build on routinely collected data as well as on data from a nationwide and internationally based survey on schoolchildren health and well-being that is repeated every four years. Trend analyses are therefore possible. The indicators make it possible to gain easy and inexpensive access essential knowledge on child health, including potentials to make comparisons over time and between countries and munici-palities.Nevertheless, further development was found necessary regarding data access, data quality, and data collection.

Place, publisher, year, edition, pages
Nordic School of Public Health NHV Göteborg, Sweden, 2009. 86 p.
Series
NHV Reports and Doctor of Public Health-Theses, ISSN 0283-1961 ; NHV Reprot 2009:4
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:norden:org:diva-3679 (URN)978-91-85721-62-7 (ISBN)
Public defence
2009-06-15, Nordic School of Public Health NHV, Göteborg, Sweden, 13:00 (Danish)
Opponent
Supervisors
Available from: 2015-02-03 Created: 2015-02-03 Last updated: 2015-02-03Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed
By organisation
Nordic School of Public Health NHV
In the same journal
Scandinavian Journal of Public Health
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

Altmetric score

Total: 117 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf