Maternal educational inequalities in child’s birth weight: ONS Longitudinal Study

Abstract Background Studies found that maternal education is the most frequently assessed predictor of child’s birth weight. Lower level of education was consistently found as indicator of lower child’s birthweight. In turn, inequalities in child’s birthweight have been repeatedly shown to be closely related to inequalities in later adult health. The aim of this project is to evaluate the association between the highest achieved level of maternal education and birthweight of single born babies in large English and Welsh population sample, taking into account factors such as child’s gender, parity, maternal age, partnership status, ethnicity, and household socioeconomic characteristics. Methods Using Office for National Statistics Longitudinal Study (ONS LS) based on English and Welsh Census data, information from almost quarter of a million children born since 1981 to ONS LS sample mothers were used. Maternal education was categorised in 3 categories (below secondary, completed secondary education, degree and higher), and its association with child’s birth weight was analysed by logistic regression accounting for range of available covariates. Results Significant association between the level of education and birth weight was found in crude analysis (p < 0.001). When adjusted, the magnitude of the association with education gradient declined but remained highly significant and was found to considerably increase over the years. The birth weight difference between those born to mothers with below secondary education and those born to mothers with degree increased by more than 60 grams (p for change <0.001) between 1981 and 2016. Conclusions These findings support previous evidence based on different population samples. According to our results, children of mothers with below secondary education tend to have lower birth weight. Our results suggest that the inequalities in birth weight by the highest education level achieved by mother significantly increased since 1981. Key messages • Lower levels of maternal education predict low birth weight in children. • The differences in birth weight by maternal educational demonstrate increase in inequalities over the years.


Background:
To investigate contextual factors that influence the implementation of obesity prevention interventions in school addressing children with low socioeconomic status (SES) is very important.Evidence about these factors helps to improve the implementation, which can promote the health of children with low SES and therefore reduce health inequity.We aimed to systematically identify, critically appraise and summarize the evidence on implementation of school-based interventions promoting obesity prevention for children with low SES.Methods: A systematic search in seven databases was conducted with the main inclusion criteria 1) school-based interventions and 2) age group 5-14 years.The Consolidated Framework for Implementation Research and its five domains and 39 categories was used to analyze the data deductively.If necessary, inductive sub-categories were defined within the categories.Contextual factors are assessed in the domain Outer Setting with four categories (A-D).Results: 6.446 studies were screened and 16 studies fulfilled all inclusion criteria.Seven studies reported contextual factors in the four categories A. Needs & resources of parents (N = 4), B. Cosmopolitanism (N = 4), C. Peer pressure (N = 2), and D. External policy (N = 4) with seven sub-categories in total.In the following are examples for reported aspects in the subcategories.In the sub-category D.2 Existing policy, policy in line with the intervention was a facilitator for implementation (N = 2), whereas lack of control over administrative changes and food served in cafeteria due to policy were reported as barriers (N = 2).

Conclusions:
Intervention research as well as applied health promotion should consider the complexity and interdependency of influencing factors for successful implementation.Albeit contextual factors are hardly changeable, they should be considered and addressed to reduce health inequity.

Key messages:
More research is needed with detailed reporting of influencing factors, as detailed information is those of relevance for practice.
Contributing to standardized analysis and reporting in implementation research by using a comprehensive framework. Abstract

Background:
The countries with paid sick leave (PSL) and sickness benefits (SB) mostly provide the benefit coverage to specific categories of workers, which results in health inequalities among employees in COVID-19.The PSL and SB are key factors to achieve universal health coverage (UHC) in that they protect access to healthcare and improve population health.This study attempted to investigate whether the policies helped achieve the UHC when they were expanded.Methods: This review followed the scoping review protocol of PRISMA-ScR.On April 6, 2021, we extracted the literature using the keywords 'paid sick leave', 'sickness benefits', 'paid sick day', and 'earned sick leave' from PubMed and Web of Science and added two studies through hand-search.All articles were written in English.We did not limit the publication date.

Results:
Forty-four selected studies were based in four single countries and the European Union.Most of the studies were published after 2010 (84.1%) and were conducted as cross-sectional (72.7%) studies.Not only workers who use PSL and SB but also children whose parents use PSL and SB increased their use of healthcare services and getting flu shots.Also, using PSL and SB decreased their unmet healthcare needs and emergency use.
The various health status factors, such as infectious disease incidence, mortality, and presenteeism, also decreased.

Conclusions:
The provisions of PSL and SB offer individual and public health benefits by allowing employees and their families to use healthcare services.Group of employees, we can expect similar public health impacts on newly covered groups, thus contributing to achieving the UHC.Since more than 90% of articles are published from the United States, future studies need to evaluate the outcomes of health effects in various European or Asian countries.

Key messages:
The provision of PSL and SB positively affects employees and their families by allowing them to use healthcare services.
The expansion of PSL and SB contributes to the UHC by guaranteeing indirect medical costs that enable universal access to essential healthcare services.

Background:
In the area of the Local Health Authority Toscana Sud-Est (LHA) 13,5% of residents are foreigners.We aim to assess the impact of our intervention to COVID-19 vaccination coverage.Methods: Since summer 2021, LHA has promoted vaccination sessions dedicated to foreign residents with free walk-in access, multilingual forms, flyers and TV interventions, cultural mediators and trained healthcare workers.We collected data about vaccination status of residents (28 December 2020-31 January 2022) and we analysed them using the software STATA to assess vaccine coverage by nationality and the effectiveness of our intervention.The results were adjusted for age and sex.We set significance level at p < 0.05.

Results:
On 31 July 2021, 78% of Italian residents (N = 685289) had received the first dose of vaccine, compared to only 43% of foreign residents (N = 106370).There was a 35% gap.On 31 January 2022, after our intervention, 89% of Italian residents and 71% of foreign residents had received the first dose of the vaccine.The gap was 18%.On 31 January 2022, 50% of residents of all nationalities had received two doses of the vaccine.A significant difference between Italian and foreign residents is still observed after adjustment for age and sex (OR 0.41 95% IC 0.40-0.41).Vaccination adherence is lower in females than males, for both Italian (OR 0.90 0.89-0.91)and foreign residents (OR 0.82 0.79-0.84).This is accentuated within some ethnic groups: Macedonians, Kosovars, Pakistanis.

Conclusions:
The creation of dedicated service guaranteed to reach a high vaccination coverage in all the nationalities and to reduce the gap between host and foreign residents.In foreigners it is lower than in the hosts, so it is necessary to investigate possible 15th European Public Health Conference 2022 These findings support previous evidence based on different population samples.According to our results, children of mothers with below secondary education tend to have lower birth weight.Our results suggest that the inequalities in birth weight by the highest education level achieved by mother significantly increased since 1981.Key messages:Lower levels of maternal education predict low birth weight in children.The differences in birth weight by maternal educational demonstrate increase in inequalities over the years.
2 RECETOX, Masaryk University, Brno, Czechia Contact: j.pikhartova@ucl.ac.ukBackground:Studies found that maternal education is the most frequently assessed predictor of child's birth weight.Lower level of education was consistently found as indicator of lower child's birthweight.In turn, inequalities in child's birthweight have been repeatedly shown to be closely related to inequalities in later adult health.The aim of this project is to evaluate the association between the highest achieved level of maternal education and birthweight of single born babies in large English and Welsh population sample, taking into account factors such as child's gender, parity, maternal age, partnership status, ethnicity, and household socioeconomic characteristics.