Self-reported hearing impairment among Greenlandic adolescents: Item development and findings from the Health Behaviour in School-aged Children study 2018.

OBJECTIVES: Ear infections are the leading cause of hearing impairment among children worldwide and a major public health problem in many indigenous populations, yet representative studies of self-reported hearing impairment are currently scarce. The purpose of the present study was therefore two-sided; first to develop an item bank for the collection of data on hearing impairment among Greenlandic adolescents, and second to report data on the child reports on hearing impairment from a national questionnaire-based survey. METHODS: The study describes the process of developing items measuring hearing impairment among schoolchildren, and reports data for their inclusion into a national questionnaire survey. The data formed part of the Health Behaviour in School-aged Children (HBSC Greenland) 2018 survey including 2,273 students, corresponding to 47.6% of all Greenlandic schoolchildren in the age range from 10 to 16 years. Data analyses performed describe the data characteristics and the frequency of self-reported hearing impairment among Greenlandic schoolchildren. Binary logistic regression examined the associations of hearing impairment on school-related (risk) factors and self-rated health. RESULTS: An average of 4% reported experiencing ear pain almost daily, and almost 10% reported ear pain at least weekly. Moreover, 3% reported having inflammation in the ear at least weekly, and 5% reported to have such impaired hearing that they were not at all able to follow what happened in school. Logistic regression showed that girls had significantly higher odds of low self-rated health, poor school environment and academic achievement below average when they had experienced impaired hearing. All ORs were statistically significant, varying from 1.85 (95% CI: 1.16-2.94) for low self-rated health, to 3.05 (95% CI 1.83-5.11) for feeling pressured by schoolwork. For boys the only significant association with impaired hearing was an academic achievement below average of 1.73 (95% CI 1.08-2.77). CONCLUSIONS: The study confirms clinical knowledge and case studies that there are a significant proportion of Greenlandic adolescents who have experienced impaired hearing. Future studies may use questionnaire data to follow up on children with hearing impairment to be able to report changes over time and associations to school-related and social factors.

Growth measures among preschool-age Inuit children living in Canada and Greenland.

AIM: The present study reports findings from a study of preschool-age Inuit children living in the Arctic regions of Canada and Greenland. METHODS: We compare stature and obesity measures using cutoffs from the Centers for Disease Control and the International Obesity Task Force references. The sample is comprised of 1121 Inuit children (554 boys and 567 girls) aged 3-5 years living in Nunavut (n=376) and Nunavik (n=87), Canada, in the capital city of Nuuk, Greenland (n=86), and in Greenland's remaining towns and villages (n=572). RESULTS: Greenland Inuit children were significantly taller than their Canadian counterparts, with greatest height and weight observed among children from Nuuk. Overall prevalence of stunting was low with the three cutoffs yielding similar values for height-for-age z-scores. Obesity prevalence was higher among Canadian Inuit children than their Greenland counterparts. CONCLUSIONS: Inuit children have stature values consistent with those of the Centers for Disease Control reference and low prevalence of stunting, though geographic variability in mean stature values between Canadian and Greenlandic samples likely reflects differences in both socioeconomic status and genetic admixture. Obesity prevalence is high among both Canadian and Greenland Inuit preschoolers, with children living in the city of Nuuk exhibiting lower obesity prevalence than children living in either Nunavut or Nunavik, Canada or Greenland's towns and villages. Varying obesity prevalence may reflect varying degrees of food security in remote locations as well as the influence of stature and sitting height which have not been well studied in young Inuit children.

Breakfast consumption and its socio-demographic and lifestyle correlates in schoolchildren in 41 countries participating in the HBSC study.

OBJECTIVE: To investigate associations of daily breakfast consumption (DBC) with demographic and lifestyle factors in 41 countries. DESIGN: Survey including nationally representative samples of 11-15 year olds (n = 204,534) (HBSC 2005-2006). STATISTICS: Multilevel logistic regression analyses. RESULTS: DBC varied from 33% (Greek girls) to 75% (Portuguese boys).In most countries, lower DBC was noticed in girls, older adolescents, those with lower family affluence and those living in single-parent families. DBC was positively associated with healthy lifestyle behaviours and negatively with unhealthy lifestyle behaviours. CONCLUSION: Breakfast skipping deserves attention in preventive programs. It is common among adolescents, especially girls, older adolescents and those from disadvantaged families.The results indicate that DBC can serve as an indicator to identify children at risk for unhealthy lifestyle behaviours.

Onset of overweight in Nuuk, Greenland: a retrospective cohort study of children from 1973 to 1992.

The purpose of the study was to examine the age at onset of overweight and obesity of 2-15-year-old children in Nuuk, Greenland, born between 1973 and 1992. The study was a retrospective cohort study. The data were retrieved from the children's individual health files containing information on height and weight, and the database contained a total of 12,002 measurements of BMI in 3,094 children (1,522 boys and 1,572 girls). The main outcome measure was age at onset of overweight-the age at which BMI was above an internationally recommended cutoff point for overweight. The study showed that an increasing proportion of children reached the overweight state and did so at an earlier age for later cohorts. This was seen for both boys and girls. Overweight was less prevalent among boys in all cohorts. For the 1973-1992 cohorts of children from Nuuk, Greenland, the age at onset of overweight was significantly decreased.

Child health in Greenland.

AIM: To review the knowledge on child health and child health problems in Greenland. METHOD: The review was based on theses, national statistics, national and international reports, and a search in Pub Med, PsycINFO, Web of Science, and WHOLIB databases from 1985 to 2005. The resulting articles were sorted by topic, type, quality of study, and relevance for child health today, providing 47 articles. RESULTS: Children in Greenland have become taller and have improved their general health. The morbidity found in Greenlandic children is similar to that found elsewhere even though the magnitude of problems might differ. The child mortality is relatively high and unevenly distributed. The acute disease pattern is dominated by infections, mostly airway infections. Otitis and its sequelae is a problem. An increase in chronic conditions such as atopy, asthma, obesity, and disabilities has taken place. Overweight and obesity have tripled in 20 years and are a health threat as well as constituting negative health behaviour. Social ill health, socioeconomic inequity, and sociocultural changes also influence health but their consequences are not well investigated in children. CONCLUSIONS: A relatively high child mortality but the same morbidity pattern as in other Western societies was found. Negative health behaviour is frequent in schoolchildren. The influence of rapid cultural changes, and familial and societal factors related to social ill health, together with socioeconomic inequity, are of major importance to the health of children in Greenland. More accurate data on child health are necessary in the future to secure better prioritization. It is suggested to construct a set of reliable indicators of child health in Greenland to monitor the health of children on a national and regional basis.

Overweight and obesity at school entry as predictor of overweight in adolescence in an Arctic child population.

BACKGROUND: The aim of this study was to analyse the changes in the prevalence of overweight, obesity, and in mean body mass index (BMI) among school children, and to analyse the predictive value of overweight and obesity at school entry to overweight and obesity in adolescence in an Arctic child population. METHODS: Retrospective cohort study. A database was created on the basis of files from health examinations. Data on children aged 5-7 years and 13-17 years and the subsample of children followed from school entry to adolescence was analysed. RESULTS: During the years 1972-2002 the prevalence of overweight and obesity increased significantly, and mean BMI rose by 5.6% at school entry and by 4.7% in adolescence. Sensitivity and specificity: Of the children being obese in adolescence, 56.3% were already obese at school entry; for the overweight children, 50.6% were also overweight or obese at school entry. Of the children with normal weight in adolescence, 91.9% were also normal weight at school entry. The positive predictive value of being overweight or obese combined at school entry was 59.5%, i.e. more than every second retained their overweight or obesity in adolescence. Only 10% of the obese school entry children had gained normal weight in adolescence. The negative predictive value for normal weight children at school entry was 91.3%. CONCLUSION: The study showed that during 30 years from 1972, overweight and obesity among school children in Greenland have increased dramatically. Overweight and obesity at school entry were shown to be a good predictor of overweight or obesity in adolescence.

Changes in drug prescription over a decade in an Arctic child population.

AIM: To describe the changes in drug prescription to 0-14-y-old outpatient children from 1991 to 2001. METHODS: ATC codes on prescriptions were compared. MAIN RESULTS: Prescriptions rose from 2.00 to 2.18 drugs/child/year, and the proportion of prescribed drugs rose from 60.7% to 70.4% of the child population (p<0.001). The 10 most prescribed subgroups accounted for 92.7% of all drugs in 0-1-y-olds and 75.9% in the schoolchildren. The individual prescription of anti-asthmatics increased by 155% (p<0.001), the use of nasal preparations and drugs against cough decreased, and more of the antibiotics were penicillin V. In 0-1-y-olds, prescriptions halved, while they nearly doubled in schoolchildren (p<0.001). CONCLUSION: In Nuuk, a unique possibility exists: to be able to study changes in drug use and prescriptions to individual children over time from one health clinic. In the last decade, major changes have occurred regarding the number of drugs, the distribution of therapeutic subgroups, and prescriptions to all age groups. If interpreting from the magnitude of prescriptions, the prevalence of asthma doubled in this period. In summary, this study has revealed changes in prescription that can hardly be explained by changes in disease patterns. Even if unrecognized, this might also be found elsewhere.