delaware survey of children’s health 2011 - march 7, 2013 zhongcui gao, co investigatorjia zhao,...

Delaware Survey of Children’s Health2011

-March 7, 2013

Zhongcui Gao, Co Investigator Jia Zhao, Co Investigator

Judith Johnson, Team Member Monica Burnett, Team Member

Tiho Enev, Principal Investigator

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The Delaware Survey of Children’s Health (DSCH), funded by Nemours, is one of the most comprehensive surveillance instruments in the field of public health for Delaware children;

The survey data is used to guide NHPS and it’s partners programmatic work and to monitor children’s health outcomes at the state level;

DSCH contains a broad range of information about health domains including healthy eating, physical activity, screen time, and emotional behavioral health.

Introduction

3Sampling Design

The DSCH features a two-stage cluster sample using random-digit-dialing (RDD).

The sample represents all Delaware households with one or more children younger than 18 years of age.

Sample size: 2006: N=3,055

2008: N=3,0812011: N=3,207

The statewide sample allows comparisons among the following demographic categories:– Geographic locations:

Kent County

New Castle County

Sussex County

City of Wilmington

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– Age groups: birth through 5 6 through 11 12 through 17

– Race and Ethnicity: Hispanic* African American White Other

* In the 2011 administration the Delaware Hispanic population was oversampled to increase the power of the analyses.

Sampling Design

5

Section 2006 2008-09 2011-12

1. Introduction & Screening Introduction & Screening Introduction & Screening

2. General Health General Health General Health

3. Schools and Child Care Schools and Child Care Schools and Child Care

4. Nutrition Nutrition Nutrition

5. Physical Activity Physical Activity Physical Activity

6. Screen Time Screen Time Screen Time

7. Neighborhood Characteristics Neighborhood Characteristics Neighborhood Characteristics

8. Family Functioning Family Functioning Family Functioning (Parent-child relationship)

9. Emotional &Behavioral Health - Emotional & Behavioral Health (age-specific scales)

10. Medical Care Medical Care Medical Care

11. 5-2-1-AN Awareness Social Marketing 5-2-1-AN Awareness

12. Demographics Demographics Demographics

13. Provider Information Provider Information Provider Information

Survey TopicsNO

T FOR DISSEM

INATION

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Demographic Characteristics: 2011 DSCH

10.90%

58.50%

24.20%

6.40%

Hispanic¹ White

African-America Other²

9.50%

23.70%

34.60%

32.20%

Birth - 1¹

2-5

6-11

12-17

Age

Race / Ethnicity

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Weight Status of Delaware Children Ages 2-17 (Based on BMI Percentile): 2006 - 2011

2006 2008 20110%

20%

40%

60%

80%

100%

7.5 7.7 7.1

55.9 52.6 52.8

17.617.3 17.1

19.0 22.4 23.0

Underweight Normal Weight Overweight Obese

Body Weight

8

Weight Status of Delaware Children Ages 2-17 (Based on BMI Percentile): 2006 - 2011

2006 2008 201110%

15%

20%

25%

30%

35%

40%

45%

50%

55%

60%

17.60% 17.30% 17.10%

19.00%22.40% 23.00%

36.60%39.70% 40.00%

55.90%52.60% 52.80%

Overweight Obese OW+OB Normal

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Percentage of Overweight and Obese Children by Age Group: 2006-2011

2006 2008 2011 20%

30%

40%

50%

27.6

35.738.8

37.1

47.5

43.141.4

35.2

37.7

2-5 6-11 12-17

Body Weight

10

Percentage of Overweight and Obese Children Ages 2-17 by Race and Ethnicity: 2006 -2011

2006 2008 201130%

40%

50%

36.5

46.2

50.0

35.2 37.0

39.1

42.5

47.4

39.4

Hispanic White Black

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Percentage of Overweight and Obese Children Ages 2-17 by Geographic Location: 2006-2011

2006 2008 201130%

35%

40%

45%

50%

37.8

46.5

40.3

34.6

39.7

39.4

40.2

38.5

44.5

38.1 38.8

37.7

City of Wilmington New Castle Sussex Kent

Body Weight

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Year 2006 Year 2008 Year 201120%

30%

40%

50%

38.3

37.5

44.2

34.7

41.7

35.7

Male Female

Percentage of Overweight and Obese Children Ages 2-17 by Gender: 2006-2011

Body Weight

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Private Health In-surance

S-CHIP Medicaid None

20%

30%

40%

50%

60%

36.3

53.4

47.446.5

Chart Title

Insurance Type

Percentage of Overweight and Obese Children Ages 2-17 by Type of Insurance: 2011

Body Weight

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Fruit and Vegetable Consumption

NHPS recommendation for children ages 2-17:– Children should have five or more servings of fruits and

vegetables each day. Measures of fruit/vegetable consumption in the 2006,

2008, and 2011 DSCH:– Thinking about yesterday, how many servings of fruit did your

child have? – Thinking about yesterday, how many servings of vegetables did

your child have?– Thinking about yesterday, how many cups of 100% fruit or

vegetable juices did your child drink? (*Note: if the number of cups reported by parents is greater than 1, only 1 cup will be

counted in the total daily fruit/vegetable consumption )

Healthy Eating

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Percentage of Children Ages 2 – 17 who Eat 5 or More Servings of Fruits and Vegetables per Day: 2006 - 2011

2006 2008 20110%

20%

40%

60%

45.7

51.8 51.3

Healthy Eating

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Percentage of Children who Eat 5 or More Servings of Fruits and Vegetables per Day by Age Group: 2006 - 2011

2006 2008 201130%

40%

50%

60%

70%

56%

64%

61%

46%

52%55%

38%

44%

40%

2-5 6-11 12-17

Healthy Eating

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Percentage of Children Ages 2-17 who Eat 5 or More Servings of Fruits and Vegetables per Day by Race and

Ethnicity: 2006 - 2011

2006 2008 201135%

40%

45%

50%

55%

60%

46.1%47.8%

55.3%

45.6%

51.4%

51.8%

41.4%

51.5%

47.2%

Hispanic White Black

Healthy Eating

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Percentage of Children Ages 2-17 who Eat 5 or More Servings of Fruits and Vegetables per Day by Gender:

2006 - 2011

2006 2008 201135%

40%

45%

50%

55%

60%

43.0%

49.3%

50.4%48.7%

54.3%

52.3%

Male Female

Healthy Eating

NOT FO

R DISSEMINATIO

N

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Average Number of Servings of Fruits and Vegetables per Day by Age Group: 2006 -2011

2006 2008 20113.5

4

4.5

5

5.5

4.72

5.26

5.12

4.39

4.67

4.76

3.89

4.2

4.05

2-5 6-11 12-17

Serv

ings

Healthy Eating

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Physical Activity

2008 Physical Activity Guidelines for Americans: – Children and adolescents ages 6-17 should have 60 minutes (1

hour) or more of physical activity each day. Measure of physical activity in the 2008 and 2011

DSCH:– “During the past seven days, on how many days was {selected

child} physically active for a total of at least 60 minutes per day? (Add up all the time he/she spends in any kind of physical activity that increases his/her heart rate and makes him/her breathe hard some of the time.)”

Physical Activity

NOT FO

R DISSEMINATIO

N

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Percentage of Children Meeting the 1-hour Physical Activity Guideline by Age, Race/Ethnicity, Gender, and Weight Status: 2011

Age 2-5

Age 6-11

Age 12-17

Hispanic

NH-White

NH-Black

Male

Female

Normal w

eight

Overweight

Obese0%

10%

20%

30%

40%

50%

60%

70%62.6%

42.4%

33.3%

44.3%

49.5%

33.5%

48.4%

41.1%

45.8%42.7%

40.5%

Physical Activity

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Comparing Physical Activity Levels: 2008 vs. 2011

The percentage of children who meet the physical activity recommendation increased significantly from 38.9% in 2008 to 44.8% in 2011.

Significant increase occurred among:– Ages 2-5 (53.2% to 62.6%) – Ages 12-17 (26.9% to 33.3%)– Non-Hispanic White (38.8% to 49.5%)– Males (41.8% to 48.4%) – Females (36.3% to 41.1%)– Children living in Sussex County (43.7% to 51.7%)– Children living in Kent County (39.7% to 46.6%)

Physical Activity

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Average Number of Days with 60+ minutes of Physical Activity per Week by Age, Race/Ethnicity, Gender and Location: 2008 & 2011

2008 2011Sig.

Mean Mean

Age groups

Age 2-5 5.31 5.84 <.05

Age 6-11 4.82 5.07

Age 12-17 4.07 4.44 <.05

Race/ethnicity

Hispanic 4.36 5.06

NH-White 4.74 5.26 <.01

NH-Black 4.65 4.58

Other 4.58 5.12

Gender

Male 4.89 5.31 <.05

Female 4.46 4.82 <.05

Location

Wilmington 4.68 4.78

New Castle 4.60 4.99

Sussex 4.80 5.28 <.05

Kent 4.74 5.21 <.05

Physical Activity

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Screen Time

NHPS recommendation for children:Children should have two hours or less of screen time a day. Measures of screen time in the 2006, 2008, and 2011

DSCH:- On an average weekday, about how many hours does your child usually watch TV, watch videos, or play video games?- On an average school day/weekday, about how many hours does your child use a computer for purposes other than school work?

Healthy Use of Media

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Average TV Time by Age Group 2006 - 2011

2006 2008 20111.00

1.50

2.00

2.50

3.00

1.87

1.57

2.10

1.571.40

2.05

1.82

1.83

2.56

2 to 5 6 to 11 12 to 17

Hour

s

Healthy Use of Media

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Average Computer Time by Age Group 2006 -2011

2006 2008 20110.0

0.2

0.4

0.6

0.8

1.0

1.2

1.4

1.6

0.44 0.43 0.330000000000001

0.68

0.740000000000001

0.620000000000001

1.2 1.15

1.42

2 to 5 6 to 11 12 to 17

Hour

s

Healthy Use of Media

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Average TV Time for Children Ages 2-17 by Race and Ethnicity: 2006 - 2011

2006 2008 20111

1.5

2

2.5

3

3.5

1.75

1.91

2.27

1.62 1.53

1.96

2.26

1.78

2.89

Hispanic White Black

Hour

s

Healthy Use of Media

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Average Computer Time for Children Ages 2-17 by Race and Ethnicity: 2006 -2011

2006 2008 20110

0.2

0.4

0.6

0.8

1

1.2

1.4

0.42

0.640000000000001

0.89

0.790.760000000000001

0.840000000000001

0.92 1.06

Hispanic White Black

Hou

rs

Healthy Use of Media

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Average TV Time per Day by Level of Physical Activity and Age Group : 2011

0 days 1-2 days 3-4 days 5 -7 days1

1.5

2

2.5

3

3.5

2.582.46

2.84

1.95

3.3

2.56

2.1

1.89

3.06

2.81

2.5 2.37

2-5 6-11 12-17

Days Physically Active per Week

Hour

s TV

time

Healthy Use of Media

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Sugar-Sweetened Beverage Consumption

NHPS Recommendation: – Children and youth should not consume more than two servings

of sugar-sweetened beverages (SSB), specifically soft drinks, fruit drinks, and sports drinks per week.

DSCH measure of SSB consumption (2006, 2008, 2011)– Thinking about the last 7 days, how many cups of regular soda or

other drinks containing sugar such as fruit-flavored drinks did [your child] drink?

SSB Consumption

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Percentage of Children who Drank Less than Two Cups of Sugar-Sweetened Beverages per Week: 2011

Age 2-5Age 6-11

Age 12-17Hispanic

White NHBlack NH

Other NHMale

Female0%

20%

40%

60%

80%

75.6

54.8

46

57.2 58.852.5

62.1

56.3 58.3

SSB Consumption

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Percentage of Children who Drank Less than 2 Cups of Sugar- Sweetened Beverages per Week by Age Group:

2006 - 2011

2006 2008 201120%

30%

40%

50%

60%

70%

80%

67.9

69.575.6

45.9

55.9

54.8

34.7

43.9 46

2-5 year olds 6-11 year olds 12-17 year olds*

SSB Consumption

NOT FO

R DISSEMINATIO

N

33

Percentage of Children Ages 2-17 who Drank Less than 2 Cups of Sugar- Sweetened Beverages per Week by Gender:

2006 - 2011

2006 2008 201140%

45%

50%

55%

60%

65%

44.20

50.90

56.30

51.5

59.2

58.3

Male Female*

SSB Consumption

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Percentage of Children Ages 2-17 who Drank Less than 2 Cups of Sugar- Sweetened Beverages per Week by Race and Ethnicity:

2006 - 2011

2006 2008 201130%

35%

40%

45%

50%

55%

60%

65%

47.40

52.6057.20

49.7

56.658.8

37.3

49.4

52.5

Hispanic White, non-Hispanic Black, non-Hispanic*

SSB Consumption

NOT FO

R DISSEMINATIO

N

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Parental Perception of Child’s Weight Status

Consistently, across all DSCH administrations, close to 80 percent of the parents consider their overweight children (between the 85th and the 95th BMI percentile) to be in the normal weight zone…

… and over 55 percent of the parents consider their obese children (above the 95th BMI percentile) to be in the normal weight category.

Perception of Body Weight

36Perception of Body Weight

2006 2008 20110%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

87.2%

80.0%83.5%

67.6%

80.3%76.2%

Boys Girls

Percentage of Parents who Consider Their Overweight Children Ages 2-17 to be ‘Normal Weight' by Gender: 2006 -2011

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2006 2008 20110%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

65.5% 65.0% 66.1%

52.9%55.3%

48.4%

Boys Girls

Percentage of Parents who Consider Their Obese Children Ages 2-17 to be ‘Normal Weight' by Gender: 2006-2011

Perception of Body Weight

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Dissemination

Press releases Publications Presentations Electronic access – Nemours website Availability of data for analysis to external parties

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Electronic Access To create an interactive data website, connected to and

aligned in a seamless manner to the Nemours website, that will provide the opportunity for the community at-large to view and interact with the data and obtain information.

The website would provide access to measures of various health-related behaviors and domains and help inform a broad audience:– Partners– Communities– Researchers– Policy and Decision Makers– Providers and Caregivers

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Questions?

Contact Information:

Tiho Enev

tenev@nemours.org

(302) 444-9246