The missing link between poverty and child maltreatment: Parental burnout.

BACKGROUND: Child maltreatment remains a major social welfare and public health issue. The relationship between SES and child maltreatment has been intensively studied. And syntheses of meta-analyses have identified low SES as one of the five major antecedents of child maltreatment. OBJECTIVE: The underlying mechanism that explains the association between low SES and child maltreatment, has however not been clearly demonstrated. PARTICIPANTS AND SETTING: In a sample of 3429 parents (51.53 % low SES), we postulated a double mediation to explain this relationship, namely that low SES increased the imbalance between the parent's risk and resource factors, and that this imbalance in turn increased parental burnout, which itself increased parental neglect and violence. METHODS: We estimated three successive models encompassing the direct and indirect effects of low SES on the imbalance between risk and resource factors, parental burnout, parental neglect and parental violence. RESULTS: The results provide little support for the direct effect of poverty on parental burnout, parental neglect and parental violence. They rather confirm the mediating role of the imbalance between risk and resource factors and parental burnout. CONCLUSIONS: Parental burnout could be the missing link between poverty and child maltreatment. The results are discussed for research and clinical purposes.

Health literacy and the use of healthcare services in Belgium.

BACKGROUND: Most of the existing studies demonstrating the relationships between health literacy and health service use have been conducted outside Europe and cannot be generalised to European healthcare systems. Moreover, the majority of studies measure healthcare use via self-reports. This study investigated whether health literacy is related to the use of health services measured objectively via patient records in a European country. METHODS: 9617 members of a Belgian health insurance fund (59% females, ages 18-88 years, mean age 55.8 years) completed an online questionnaire including the 16-item European Health Literacy Survey Questionnaire (HLS-EU-Q) and agreed to have their responses linked to the insurance fund's health service use records. A two-part model approach was used to assess the association between health literacy and the use of healthcare services and the costs related, adjusting for personal and behavioural characteristics. RESULTS: Low health literacy is associated with more admissions to 1-day clinics, general practitioner (GP) home consultations, psychiatrist consultations and ambulance transports, and with longer stays in general hospitals. Associations with psychiatric hospitalisations and specialist consultations are also found but are not significant when correction for multiple comparisons is applied. In contrast, health literacy is not significantly related to the number of GP consultations, admissions to 1-day surgical clinics or emergency consultations. The relationship between health literacy and medication use is inconsistent. CONCLUSION: The results partly confirm that low health literacy is associated with greater use of healthcare services, and especially of more specialised services. Improving the health literacy of the population can be an effective strategy to promote a more (cost)-effective use of the healthcare services and thus contribute to population health.

A nationally representative study of emotional competence and health.

Emotional competence (EC; also called "emotional intelligence"), which refers to individual differences in the identification, understanding, expression, regulation, and use of one's emotions and those of others, has been found to be an important predictor of individuals' adaptation to their environment. Higher EC is associated with greater happiness, better mental health, more satisfying social and marital relationships, and greater occupational success. Whereas a considerable amount of research has documented the significance of EC, 1 domain has been crucially under investigated: the relationship between EC and physical health. We examined the relationship between EC and objective health indicators in 2 studies (N1 = 1,310; N2 = 9,616) conducted in collaboration with the largest Mutual Benefit Society in Belgium. These studies allowed us (a) to compare the predictive power of EC with other well-known predictors of health such as age, sex, Body Mass Index, education level, health behaviors (diet, physical activity, smoking and drinking habits), positive and negative affect, and social support; (b) to clarify the relative weight of the various EC dimensions in predicting health; and (c) to determine to what extent EC moderates the effect of already known predictors on health. Results show that EC is a significant predictor of health that has incremental predictive power over and above other predictors. Findings also show that high EC significantly attenuates (and sometimes compensates for) the impact of other risk factors. Therefore, we argue that EC deserves greater interest and attention from health professionals and governments.