Disability as a "family affair": parental disability and childhood immunization

The relationship between parental disability and child outcomes: Evidence from veteran Families

We examine the relationship between parental disability and child outcomes in the American Community Survey. We focus on families with veteran parents, for whom parental disability is a direct result of service-related activities and thus is more plausibly exogenous to child outcomes than other forms of parental disability. Using the service connected disability rating (SCDR) as a measure of the severity of veteran disability, we document a gradient in child outcomes with respect to parental disability (even conditional on having a disabled parent). Children with more severely disabled parents are more likely to be late for grade, less likely to be in private school, and more likely to have disabilities themselves. These results lend meaningful insight to broader populations; we find similar associations between parental disability and child outcomes in non-veteran families. We provide evidence consistent with two broad mechanisms: first, parental disability reduces parental labor supply and thus household income (even net of transfers) and second, children—especially older children—allocate time away from work and schooling to provide care for disabled parents.

Children of chronically ill parents: Relationship between parental multiple sclerosis and childhood developmental health

Background:

Exposure to parental chronic illness is associated with adverse developmental outcomes.

Objective:

We examined the association between parental multiple sclerosis (MS) and parental MS-related clinical factors on developmental health.

Methods:

We conducted a population-based cohort study in British Columbia, Canada, using linked health databases. The outcome was childhood development at 5 years of age, expressed as vulnerability on the Early Development Instrument (EDI). Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated using conditional logistic regression.

Results:

MS-affected parents (n = 783) were older, more likely to be English speakers, and had higher rates of mental health morbidity (39.6% vs 22.2%, p < 0.001) than unaffected parents (n = 2988). In the adjusted models, children of mothers with MS (aOR = 0.62, 95% CI = 0.44–0.87), but not children of the fathers with MS, had a lower risk of vulnerability on the social development domain of the EDI. However, mental health comorbidity (aOR = 1.62, 95% CI = 1.05–2.50) and physical comorbidity (aOR = 1.67, 95% CI = 1.05–2.64) among mothers with MS were associated with increased vulnerability on the EDI.

Conclusion:

Maternal MS, but not paternal MS, was associated with lower rates of developmental vulnerability on the social development domain. However, mental and physical comorbidity among MS-affected mothers were associated with increased developmental vulnerability in children.

Impact of parents' wartime military deployment and injury on young children's safety and mental health

OBJECTIVE

Children are at risk for adverse outcomes during parental military deployments. We aim to determine the impact of parental deployment and combat injury on young children's postdeployment mental health, injuries, and maltreatment.

METHOD

This is a population-based, retrospective cohort study of young children of active duty military parents during fiscal years (FY) 2006 to 2007, a high deployment period. A total of 487,460 children, 3 to 8 years of age, who received Military Health System care, were included. The relative rates of mental health, injury, and child maltreatment visits of children whose parents deployed and children of combat-injured parents were compared to children unexposed to parental deployment.

RESULTS

Of the included children, 58,479 (12%) had a parent deploy, and 5,405 (1%) had a parent injured during deployment. Relative to children whose parents did not deploy, children of deployed and combat-injured parents, respectively, had additional visits for mental health diagnoses (incidence rate ratio [IRR] = 1.09 [95% CI = 1.02-1.17], IRR = 1.67 [95% CI = 1.47-1.89]), injuries (IRR = 1.07 [95% CI = 1.04-1.09], IRR = 1.24 [95% CI = 1.17-1.32]), and child maltreatment (IRR = 1.21 [95% CI = 1.11-1.32], IRR 2.30 = [95% CI 2.02-2.61]) postdeployment.

CONCLUSION

Young children of deployed and combat-injured military parents have more postdeployment visits for mental health, injuries, and child maltreatment. Mental health problems, injuries, and maltreatment after a parent's return from deployment are amplified in children of combat-injured parents. Increased preventive and intervention services are needed for young children as parents return from deployments. Child health and mental health providers are crucial to effective identification of these at-risk children to ensure effective care provision.

Parenting with a disability and child mental health: a propensity score analysis

Little research has examined the impact of having a parent with a disability on child mental health. This study used data from 7,116 families of children who participated in the 2006 National Health Interview Survey and propensity score matching (PSM) to investigate this question. Prior to PSM, differences in Child Mental Health Brief scores were significant with a moderate effect size. After PSM, differences in Child Mental Health Brief scores were still significant, but the effect size was small. Results indicate that much of the mental health risk for children of parents with disabilities is connected to related issues.

Effects of prenatal care on child health at age 5

The broad goal of contemporary prenatal care is to promote the health of the mother, child, and family through the pregnancy, delivery, and the child's development. Although the vast majority of mothers giving birth in developed countries receive prenatal care, past research has not found compelling evidence that early or adequate prenatal care has favorable effects on birth outcomes. It is possible that prenatal care confers health benefits to the child that do not become apparent until after the perinatal period. Using data from a national urban birth cohort study in the US, we estimate the effects of prenatal care on four markers of child health at age 5-maternal-reported health status, asthma diagnosis, overweight, and height. Prenatal care, defined a number of different ways, does not appear to have any effect on the outcomes examined. The findings are robust and suggest that routine health care encounters during the prenatal period could potentially be used more effectively to enhance children's health trajectories. However, future research is needed to explore the effects of prenatal care on additional child health and developmental outcomes as well as the effects of preconceptional and maternal lifetime healthcare on child health.

Parental combat injury and early child development: a conceptual model for differentiating effects of visible and invisible injuries

The injuries (physical and emotional) sustained by service members during combat influence all members of a family system. This review used a systemic framework to conceptualize the direct and indirect effects of a service member's injury on family functioning, with a specific focus on young children. Using a meta-ethnographic approach to synthesize the health research literature from a variety of disciplines, this review makes relevant linkages to health care professionals working with injured veterans. Studies were included that examined how family functioning (psychological and physical) is impacted by parental illness; parental injury; and posttraumatic stress disorder. The synthesis of literature led to the development of a heuristic model that illustrates both direct and indirect effects of parental injury on family functioning and the development of young children. It further illustrates the contextual factors or moderating variables that buffer detrimental effects and promote family resilience. This model can be a foundation for future research, intervention, and policy.

Intimate partner violence and death among infants and children in India

OBJECTIVE

The goal was to test the association between maternal intimate partner violence (IPV) victimization and child death.

METHODS

Information was collected regarding 39096 children <60 months of age in the nationally representative 2005-2006 National Family Health Survey of India. The exposures were maternal reports of physical, sexual, psychological, and any IPV. Outcomes included infant (0 to <12 months), older child (12 to <60 months), and any child (0 to <60 months) deaths.

RESULTS

Maternal experience of physical IPV was associated with increased mortality rates among all children (risk ratio [RR]: 1.21 [95% confidence interval [CI]: 1.13-1.30]), infants (RR: 1.24 [95% CI: 1.01-1.53]), and older children (RR: 1.25 [95% CI: 1.00-1.56]). Sexual and psychological IPV were less strongly associated with child death. The associations between maternal IPV and death did not differ according to the child's gender.

CONCLUSION

The robust association between exposure to household IPV and infant and child death could be attributable to the mother's inability to care for her child, psychological stress associated with witnessing violence, and the use of maternal violence victimization as a proxy for child violence victimization.

Special topics in international adoption

As international adoption has become more "mainstream," the issues recently addressed in domestic adoption have become more important in adoptions involving children originating in other countries. Certain groups of prospective adoptive parents, such as gay or lesbian couples, single parents, and parents with disabilities, have begun to apply to adopt in ever increasing numbers. Children who may have been considered unadoptable in the past are now routinely being offered to prospective adoptive parents. The numbers and ages of the children placed and the spacing between adoptions have come under scrutiny. The rates of adoption dissolutions and disruptions are being examined carefully by the receiving and sending countries. There is a pressing need for research into numerous social aspects of adoption.