ArticleMaternal and child health journal2012
Aligning method with theory: a comparison of two approaches to modeling the social determinants of health.
Article in Maternal and child health journal, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Impact of Ghana's fee exemption policy on maternal health service utilisation: an inverse probability of treatment weighting analysis of pooled national data.Journal of global health · 2025Article
- Risk of Low Birth Weight According to Household Composition in Brussels and Montreal: Do Income Support Policies Variations Explain the Differences Observed between Both Regions?International journal of environmental research and public health · 2021Article
- Prevalence, progress, and social inequalities of home deliveries in Ghana from 2006 to 2018: insights from the multiple indicator cluster surveys.BMC pregnancy and childbirth · 2021Article
- Building Roads Together: a peer-led, community-based walking and rolling peer support program for inclusion and mental health.Canadian journal of public health = Revue canadienne de sante publique · 2021Article
- Article
- Childhood Conditions and Multimorbidity Among Older Adults.The journals of gerontology. Series B, Psychological sciences and social sciences · 2016Article
- Patterns of social inequalities across pregnancy and birth outcomes: a comparison of individual and neighborhood socioeconomic measures.BMC pregnancy and childbirth · 2015Article
- Modeling the cumulative effects of social exposures on health: moving beyond disease-specific models.International journal of environmental research and public health · 2013Article
- Article
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Authors and funding
2 authors.
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No grant is acknowledged in the PubMed record.
Abstract
There is increasing interest in the study of the social determinants of maternal and child health. While there has been growth in the theory and empirical evidence about social determinants, less attention has been paid to the kind of modeling that should be used to understand the impact of social exposures on well-being. We analyzed data from the nationwide 2006 Canadian Maternity Experiences Survey to compare the pervasive disease-specific model to a model that captures the generalized health impact (GHI) of social exposures, namely low socioeconomic position. The GHI model uses a composite of adverse conditions that stem from low socioeconomic position: adverse birth outcomes, postpartum depression, severe abuse, stressful life events, and hospitalization during pregnancy. Adjusted prevalence ratios and 95% confidence intervals from disease-specific models for low income (<20,000/year) compared to high income (≥ 80,000/year) ranged from a low of 1.43 (1.09-1.85) for adverse birth outcomes to a high of 5.69 (3.59-8.84) for stressful life events. Estimates from the GHI model for experiencing three to five conditions yielded a prevalence ratio of 18.72 (9.29-35.77) and a total population attributable fraction of 78%. While disease-specific models are important for uncovering etiological factors for specific conditions, models that capture GHIs might be an attractive alternative when the focus of interest is on measuring and understanding the myriad consequences of adverse social determinants of health.
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