Dianna Pickett, Kristen Becker, Kathleen Anger, Ken Rosenberg, Bobbie Weber Oregon Public Health Division, Office of Public Health; Oregon State University Presented to the Oregon Public Health Association Annual Meeting October 19 th, 2010
2 Monday October 26 10:45 am
3 Among preschoolers in general, there is a higher proportion of 3-4 year olds in child care centers than 1-2 year olds. Families in poverty with employed mothers and preschoolers use relative care more often than centers care. CENSUS REPORT ON CHILD CARE (data from 2002, published 2005)
1/3 of children in care are in paid care: 32.9% 2/3 unpaid care… Think “unregulated” care: 67.1% 4 Child Care and Education in Oregon and Its Counties: 2008 Oregon Child Care Research Partnership June 2009
Using PRAMS and PRAMS 2 data we looked at breast feeding initiation and duration related to child care arrangements.
Oregon PRAMS : ◦ Stratified random sample of live births to Oregon resident women ◦ Women participate by mail or phone when their infant is 2-3 months old ◦ Approximately 75% weighted response rate in 2004 and 2005 ◦ Results are weighted Oregon PRAMS-2 ◦ Follow-up survey for PRAMS respondents when their child is 2 years old ◦ Women participate by mail or phone ◦ Approximately 57% response rate for 2004 and 2005 births (weighted back to original PRAMS sample) ◦ Results are weighted 7
What are your childcare arrangements?% Childcare center15.2% Child’s grandparent14.6% Childcare in non-relative’s home13.0% Other7.2% Paid care in your home6.8% Other relative3.5% Babysitter/friend/neighbor3.4% Chose more than one response36.2% Do you have regular childcare arrangements for your two-year–old now? % YES51.1% NO48.9%
We grouped respondents based on age, race, education, and breastfeeding duration. LEAST likely to have risk factors used FORMAL care settings: -Childcare center -Paid in-home care -Non-relative’s home MOST likely to have risk factors used INFORMAL care settings: -Other relatives -Grandparents -Babysitter/Friend Neighbor -Other
Average age * % High school or less* % Non- white % Not Married* % <100% FPL* Women using FORMAL care %18.5%18.9%11.0% Women using INFORMAL care %24.6%33.3%27.4% ALL PRAMS-2 respondents** %28.3%27.7%28.3% *At birth of index child **Includes women with multiple types of child care and no regular child care PRAMS and PRAMS-2, births
*Includes women with multiple types of child care and no regular child care
Health Care Differences by Child Care Type PRAMS-2, births *Includes women with multiple types of child care and no regular child care
Dental Care Differences by Child Care Type PRAMS-2, births *Includes women with multiple types of child care and no regular child care
We are not claiming that childcare type causes differences in breastfeeding rates. There are differences in the characteristics of women using different types of child care. Women using informal care appear to be more vulnerable than other groups in the areas of: ◦ Breastfeeding ◦ Having a regular health care provider for their child ◦ Dental care for their child
Prevention and health promotion for informal child care providers Offer training on breast feeding Consult on breast feeding-friendly practices. Promote child health insurance programs Encourage child health record-keeping and immunization up-dating processes Share what PRAMS data has revealed with others.
Full report available at: admin/site/publications/ files/homevisitingkinshipffn.pdf
Dianna Pickett, Healthy Child Care Oregon Office of Family Health Kristen Becker, Research Analyst Office of Family Health