June 18 report

INRICH First Teleconference Report The International Network of Research on Inequalities in Child Health (INRICH) held its first teleconference on June 18, 2009 from 1.00pm to 3.00pm. The meeting was chaired by Professor Nick Spencer. Attendants 1. Nick Spencer 8. Richard Reading 2. Louise Séguin 9. Ingrid Schoon 3. Jennifer McGrath 10. Béatrice Nikiéma 4. Mai Thanh Tu 11. Isabelle Therien 5. Dave Gordon 12. Lucie Levesque 6. Jeff Goldhagen 13. Biessé Soura 7. Sylvia Guendelman The following members apologized for not being able to attend: Gary Evans Barbara Starfield Luis Rajmil Lise Gauvin Objectives The meeting was convened in order to meet the following objectives: To update INRICH members on progress since the Montreal Workshop To provide a forum for INRICH members to briefly present/share their current research – brief outlines/power points to be pre-circulated to participants To discuss & finalise objectives and agenda for the Second INRICH Workshop in Warwick in November 2009 To discuss students exchange possibilities Agenda The agenda of the meeting included: Introductions & apologies [5 minutes] Update on progress [10 minutes] Brief presentations of current research [5 minutes each - 90 minutes total] Objectives, agenda & financing for 2nd INRICH Workshop [30 minutes] Any other issues Minutes of the meeting Introduction and apologies Nick (Chair) started the meeting by allowing each attendant to introduce him/herself. This was followed by some clarifications on the agenda. The Chair explained that the fifth point (regarding students exchange possibilities) was dropped from the agenda and will be discussed in November during the second workshop. But he added that members should think about how this can be made possible between institutions. Update on progress Nick presented the progress made by the Network since the first workshop in Montreal. First he introduced Biessé Soura and Lucie Levesque as our two new coordinators, each working part time for the network. Then members were informed that a systematic literature review related to early childhood experience of poverty is underway. The review encompassed research from 1997 onward but will be taken back earlier, from what is available from electronic databases. He mentioned that authorship is open to anyone who wants to join the team. For the upcoming second workshop in Warwick, UK in November 6-7, 2009, rooms have been booked for participants at the University of Warwick for one night. Additional funding is needed to cover the expenses of the last day of the workshop. Therefore, we are accepting any help from members in relation to obtaining grants from funding bodies including foundations, especially from those in the US. The last point of the progress was related to the membership. The network is expanding considerably with 58 members with research interest in the field of child health inequalities. Recruitment is ongoing. We are looking to involve researchers working specifically on issues related to child health inequalities and inequities. Brief presentation of current research Researchers were given time to present their current research activities: Richard Reading (UK) is working on children’s rights with an emphasis on health for which he is collaborating with Jeff Goldhagen. He works on issues of child maltreatment and unintentional injury. He collaborates with medical geographers and has studied the effects of neighborhood characteristics on injury risk within a UK cohort. Richard also participates in surveillance studies of rare childhood conditions; in evaluation of complex interventions such as a randomized cluster trial of Breakfast Clubs among children as well as evaluation of other policy initiatives by the UK government. Dave Gordon (UK) has undertaken a lot of international collaborative work, including with UNICEF, on child poverty and health disparities in 49 developing countries. He is the principal investigator for an ESRC Large Grant in UK to improve the measurement of poverty and social exclusion.  He is working on a Gates Foundation funded project to improve water testing for microbial contamination in developing countries. Dave has been working with Nick and colleagues on child disabilities in both the UK and indeveloping countries. He is also interested in health resources allocation. Jennifer McGrath (Montreal Canada) is a child clinical psychologist and epidemiologist. She is interested in early precursors of cardiovascular diseases. She works on obesity, sleep, smoking, stress and health among children. In three longitudinal cohort studies, she is examining the link between socioeconomic status, stress, and health. Her team uses different measures of stress including biomarkers and stressful events inventories. She collaborates with Louise Seguin. Ingrid Schoon (UK) is working with the Millenium cohort, a birth cohort started in UK in the year 2000. She is actually conducting a study of the 1800 babies of the Millenium cohort on inequality and children adjustment. She is also interested on how inequality and poverty affect families. She looks especially at family environmental circumstances such as housing conditions, etc. Ingrid has already collaborated with Gary Evans another INRICH member. Sylvia Guendelman (California USA) works in the field of social epidemiology with a focus on national and international contexts. She is actually studying health insurance coverage among children of working poor in the USA who are mostly Mexican and Central American migrants. She recently conducted a study on women’s work and maternity leave and birth outcomes; women’s access to pre and after birth services. Sylvia also collaborated with Tom Boyce who is also a member of the network. Her work includes also obesity among immigrant Mexican children, maternal perception of overweight and body size perception among children. Jeff Goldhagen (Florida, USA) is interested in human and children inequities, children’s rights and poverty. He looks especially at social environment factors that create disparities. Jeff is also interested in developing indicators to define equity in a framework of children’s rights. Louise Séguin (Montreal, Canada) focuses her research activities on poverty and child health. She is actually mostly working on data from the Quebec Longitudinal Study of Child Development, a representative birth cohort in which children are followed annually. She is conducting analysis on the links between poverty and diverse health outcomes taking advantage of the longitudinal data which include much information on child and family living conditions since birth. For some analysis she looked at the impact of early poverty as well as biological vulnerability at birth, exposure to environmental adversities on the child health. Her team will soon begin the analysis of biomarkers they just finished collecting among children of the cohort. They are especially interested with the role of stress in the pathway between the poverty environment and child health. Louise is also involved with Michael Kramer, another member of the INRICH network, on a study on socioeconomic status and preterm birth. Nick Spencer (UK) has a long record on the issue of inequalities and child health. He is interested in how to ensure better health for children in our communities. He has written on the subject of pre term birth and birth weight. Nick is currently involved in a study on quality of health for children, seeking to understand conditions that limit children during daily activities. Nick and Clare Blackburn, a member of the network, are working on the issue of disability, which remains a neglected area. They are expanding their work on WHO’s living conditions of disabilities. The study is being conducted with a UK perspective. With Louise and other INRICH members, Nick is also involved in the systematic literature review on child poverty and health that is underway. After the presentation of research interests and current work the participants raised the issues related to: Impact of stress on health; stress and poverty; distinction between chronic stress and traumatic stress; stress measurement instruments; good (normal) and deleterious stress; stress management; stress in children and adults. Development of medical tools for child health diagnosis. Although the discussion was interesting, we could not reach a final conclusion due to time constraints. Nick proposed that these questions be discussed thoroughly during the workshop in November. Objectives, Agenda and financing of the 2nd INRICH workshop The draft version of the objectives of the workshop was: To update INRICH members on progress since the Montreal Workshop & the June conference with particular reference to the appointment of new coordinators, the systematic review and collaborative work To provide a forum for those INRICH members who did not participate in the June conference to briefly present their current research – brief outlines/power points to be pre-circulated to participants To build on discussions at the 1st Workshop and further examine research into pathways to child inequalities with a view to informing future collaborative projects To agree the outline and main research questions for a collaborative project To agree a strategy for involvement of post-doctoral and doctoral students in the Network and prepare a framework for student exchanges To discuss health and social policies necessary for the promotion of child health equity To agree a strategy for building links with policy-makers To identify further potential network members To discuss plans for INRICH programme over the next year Concerns and suggestions: During this session, the objectives of the 2nd workshop were accepted by the attendants. However some participants raised the following concerns: What is the rationale to include policy-makers at this level of the network’s development? What do we mean by the term “policy-makers”? How do we translate our research results into policy? One of the objectives should mention clinical tools to transform child health practices. Clarifications: For Nick, the idea of including the point about policy-makers in the agenda is to raise this issue during the workshop in order to take it forward. We need to move to an evidence-based approach. Louise added that policy-makers could be people who are decision-makers and who can help translate our results into policy. According to Nick, as for now, our focus is not on clinical practices but this question can be considered by the network. The agenda for the workshop was also discussed. The concerns and suggestions raised include: Rearrangement of the agenda to accommodate presentations of collaborative works by participants; Will the workshop attendants come with ideas on collaborative research? Synthesis of 2 or 3 research pathways that participants will be willing to collaborate on; Is there any plan for publication and dissemination of the results of the workshop? Will the network integrate researchers from developing countries and how can these researchers participate in the coming workshop? It was suggested that, instead of participants report on their current work all being presented in the first session, it might be better to try and match presentations by participants to the main themes of the sessions so that they contribute to the discussion during the most appropriate session. It was agreed that Nick and Louise would work on this suggestion. Clarifications: One of the deliverables of the workshop is to arrive at collaborative research agreements among the participants. The agenda will be revised to reflect on this issue; We will think of giving responsibility to people to take some ideas forward in terms of collaborative works; An outline of the results of the workshop will be prepared for publication and dissemination. It depends on whether we have people willing to write on the issue; Participation of researchers from developing countries is important. We will broaden the network to include them. Any other issues Jeff reported a successful video-conference on climate change with the University of Florida. The technology is simple and can be implemented by INRICH. He volunteers to provide assistance to make this possible. For Nick, this will be helpful next year for the 2nd teleconference. The summary of the meeting will be circulated for input and suggestions prior to its dissemination on INRICH’s web page. 1