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NATIONAL AND INTERNATIONAL ASPECTS OF TOBACCO CONTROLSzeged, 2011. június 18

Population dynamism related to socio-economic factors in

Szabolcs-Szatmár-Bereg County in 2009

Kristie L. Foley, PhDAssociate Director Medical Humanities ProgramDavidson CollegeNorth Carolina, USA

Ildiko Rakoczi University of DebrecenFaculty of Health Nyiregyháza Dr. PeterBalazs Semmelweis University Andrea Grenczer Semmelweis University Budapest

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Szabolcs-Szatmár-Bereg County

Szabolcs-Szatmar-Bereg county is situated in the north-eastern corner of Hungary, bordered with three countries: Romenia, Ukraine and Slovakia Its area is 5938 km2 Its population is: 571 018 (2008)Roma population: 25 612 (2001)Number of settlements: 229:Number of county-boroughs: 1 Other towns: 26

Nyíregyháza

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PTB and LBW in Hungary 2009PTB and LBW in Hungary 2009

PTB 9.8%PTB 9.8%LBW 8.6%LBW 8.6%

Szabolcs-Szatmar-Bereg county: N. of live births = 5944 (5807 according to health visitors’ reports)N. of PTB/LBW = 652

One of the least developedregions in Hungary with a considerable

ethnic Roma population living at lower socio-economic level than the non-Roma population

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Our hypothesesOur hypotheses

• Tobacco smoking and alcohol drinking start at a very early age, sometimes before the age of 10

• Tobbaco smoking is a considerable factor in the growing number of PTB and LWB

• Socio-economic level of families affects also negatively the pregnancy outcome

• According to the day-to-day experinece, there are significant differences between the Roma and non-Roma populations

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Material and MethodMaterial and Method

• Data collection about all live births in 2009• Collaboration of the Maternity and Child Health Service (MCHS) in data collection• Primary Primary information information was gwas gatherathereded from the from the registryregistry of of MCHS visitors MCHS visitors

• In-person survey by iIn-person survey by interviewer-nterviewer- administered questionnaireadministered questionnairess • Number of questionnaires: 5806Number of questionnaires: 5806• Response-rate 75% (n=4355)Response-rate 75% (n=4355)

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Material and MethodMaterial and Method

• In February 2010, MCHS visitors learned the objectives and methods of the project on meetings in the 12 districts. They were also informed about the results of the prior survey (moters of PTW / LBW babies born in 2008.

• Problems were discussed concerning the 2008 data collection.

• Visitors informed us about difficulties of data collection stressing the problem of refusing collaboration.

• Visitors emphasized their interest in the survey, as they expect results that may help their day-to-day activity.

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65,10%

26,80%

0,10% 8,10%

Non roma

Roma

Half roma

No answer

Ethnic distribution of mothers Ethnic distribution of mothers (self-determined)(self-determined)

N:4355

88

59,80%30,80%

0,20% 9,20%

Non roma

Roma

Half roma

No answer

Ethnic distribution of mothers Ethnic distribution of mothers (based on the interviewer’s answers)(based on the interviewer’s answers)

N:4355

99

Time of child births in weeks, Time of child births in weeks, N=4355N=4355

0

200

400

600

800

1000

1200

1400

23 24 25 26 27 28 29 30 31 32 33 34 35 35 36 37 38 39 40 41 42hét

fő

PTB-frequency = 8.2%

1010

Starting age of pregnant Starting age of pregnant mothers’ smokingmothers’ smoking

0

50

100

150

200

250

300

350

6 8 10 12 14 16 18 20 22 24 26 28 30 32 34életkor

fő

1111

Mothers’ ethnicity related Mothers’ ethnicity related smoking habitssmoking habits

Variables

Non-roma Roma

Frequency Percent Frequency Percent

Smoked ever only 1 cigarette

97 3,5 32 2,8

Occasional smoking 369 13,2 74 6,4

Regular smoking 754 26,9 548 47,4

Non-smokers 1579 56,4 501 43,4

Total 2799 100,0 1155 100,0

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Ethnicity related PTB frequencyEthnicity related PTB frequency

Variables

Roma Non-Roma

Frequency Percent Frequency Percent

3636 weeks or less weeks or less 106 9,19,1 200 7,17,1

37 weeks or more 1055 90,9 2610 92,9

Total 1161 100,0 2810 100,0

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Ethnicity related LBW frequencyEthnicity related LBW frequency

Variables

Roma Non-Roma

Frequency Percent Frequency Percent

2499 g or less2499 g or less 156 13.413.4 208 7,7,44

2500 g or more 1005 86.6 2602 92.6

Total 1161 100 2810 100

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ConclusionsConclusions

Unfortunately, there are significant differences Unfortunately, there are significant differences between the Roma and non-Roma populations. between the Roma and non-Roma populations.

Considering that health culture is an organic part of Considering that health culture is an organic part of the whole life-style, strategies that ensure healthy the whole life-style, strategies that ensure healthy life-style choices must be well-integrated in family life-style choices must be well-integrated in family based interventions and in schools.based interventions and in schools.

Targeted programs for the young population would Targeted programs for the young population would increase the likelihood of young girls having increase the likelihood of young girls having sufficient knowledge and social support to make sufficient knowledge and social support to make decisions that positively affect their own health and decisions that positively affect their own health and that of their babies.that of their babies.

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