Health-related quality of life in urban elementary schoolchildren.
BACKGROUND
Health disparities between children from urban minority backgrounds and children from more affluent backgrounds are well-recognized. Few studies specifically address urban children's perceptions of their health-related quality of life (HRQOL) or the factors that contribute to these perceptions. Since schools are pivotal to children's intellectual, social, and emotional development, school connectedness may be a factor that contributes to their perception of HRQOL.


OBJECTIVE
To examine children's perceptions of HRQOL in an elementary school-based population of urban children.


METHODS
The study population consisted of 2nd, 3rd, and 5th graders from 6 urban kindergarten to 8th grade schools and their parents. Children completed a survey that included questions on HRQOL and school connectedness. Parents completed a telephone survey that assessed demographics, the child's health, health care usage, and parental health status. Data on school absences and mobility from the computerized school database were linked to survey data. Bivariate analyses were used to evaluate the association between child report of HRQOL and collected variables, including school connectedness. Multivariable linear regression was conducted to identify the factors best predicting HRQOL in these urban children.


RESULTS
Of the 1150 eligible students, parent and child survey data were available for 525 (45.6%). Fifty-one percent of students were male and 89% were black. Ninety-four percent of parents were female, 29% were married, and 62% had family incomes below 20,000 dollars per year. The mean total score for HRQOL was 67.2, with a possible range of 0 to 100 (higher scores reflecting better HRQOL). In the multivariable analysis, child grade, the relationship of the " parent" to the child, employment, family income, type/presence of insurance, and school connectedness were significantly associated with the HRQOL total score.


CONCLUSIONS
Young urban children self-report low HRQOL scores and do so as early as the 2nd grade. These low scores, which reflect children's own perceptions of impaired psychological and physical health, have potential implications for the success of urban children in their learning environments. The association between HRQOL and school connectedness might suggest that health and educational programs that improve a child's attachment to school could result in improved perceptions of health by urban children.
Mansour
Mona E
ME
Division of General and Community Pediatrics, Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA. Mona.mansour@chmcc.org
Kotagal
Uma
U
Rose
Barbara
B
Ho
Mona
M
Brewer
David
D
Roy-Chaudhury
Ashwini
A
Hornung
Richard W
RW
Wade
Terrance J
TJ
DeWitt
Thomas G
TG
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D002648:Child; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data; D008875:Middle Aged; D015999:Multivariate Analysis; D009820:Ohio; D010290:Parents; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014504:Urban Health / Q000706:statistics & numerical data / Q000639:trends*