1. 1 NATIONAL AND INTERNATIONAL ASPECTS OF TOBACCO CONTROL Szeged, 2011. június 18 Population dynamism related to socio-economic factors in Szabolcs-Szatmár-Bereg County in 2009 Kristie L. Foley, PhD Associate Director Medical Humanities Program Davidson College North Carolina, USA Ildiko Rakoczi University of Debrecen Faculty of Health Nyiregyháza Dr. PeterBalazs Semmelweis University Andrea Grenczer Semmelweis University Budapest

2. 2 Szabolcs-Szatmár-Bereg County Szabolcs-Szatmar-Bereg county is situated in the north-eastern corner of Hungary, bordered with three countries: Romenia, Ukraine and Slovakia Its area is 5938 km2 Its population is: 571 018 (2008) Roma population: 25 612 (2001) Number of settlements: 229: Number of county-boroughs: 1 Other towns: 26 Nyíregyháza

3. 3 PTB and LBW in Hungary 2009 PTB 9.8% LBW 8.6% Szabolcs-Szatmar-Bereg county: N. of live births = 5944 (5807 according to health visitors’ reports) N. of PTB/LBW = 652 One of the least developed regions in Hungary with a considerable ethnic Roma population living at lower socio- economic level than the non-Roma population

4. 4 Our hypotheses Tobacco smoking and alcohol drinking start at a very early age, sometimes before the age of 10 Tobbaco smoking is a considerable factor in the growing number of PTB and LWB Socio-economic level of families affects also negatively the pregnancy outcome According to the day-to-day experinece, there are significant differences between the Roma and non-Roma populations

5. 5 Material and Method Data collection about all live births in 2009 Collaboration of the Maternity and Child Health Service (MCHS) in data collection Primary information was gathered from the registry of MCHS visitors Primary information was gathered from the registry of MCHS visitors In-person survey by interviewer- administered questionnaires In-person survey by interviewer- administered questionnaires Number of questionnaires: 5806 Number of questionnaires: 5806 Response-rate 75% (n=4355) Response-rate 75% (n=4355)

6. 6 Material and Method In February 2010, MCHS visitors learned the objectives and methods of the project on meetings in the 12 districts. They were also informed about the results of the prior survey (moters of PTW / LBW babies born in 2008. Problems were discussed concerning the 2008 data collection. Visitors informed us about difficulties of data collection stressing the problem of refusing collaboration. Visitors emphasized their interest in the survey, as they expect results that may help their day-to-day activity.

7. 7 Ethnic distribution of mothers (self-determined) N:4355

8. 8 Ethnic distribution of mothers (based on the interviewer’s answers) N:4355

9. 9 Time of child births in weeks, N=4355 hét fő PTB-frequency = 8.2%

10. 10 Starting age of pregnant mothers’ smoking életkor fő

11. 11 Mothers’ ethnicity related smoking habits Variables Non-romaRoma FrequencyPercentFrequencyPercent Smoked ever only 1 cigarette 973,5322,8 Occasional smoking36913,2746,4 Regular smoking754 26,9 548 47,4 Non-smokers157956,450143,4 Total2799100,01155100,0

12. 12 Ethnicity related PTB frequency Variables RomaNon-Roma FrequencyPercentFrequencyPercent 36 weeks or less 1069,1 2007,1 37 weeks or more105590,9261092,9 Total1161100,02810100,0

13. 13 Ethnicity related LBW frequency Variables RomaNon-Roma FrequencyPercentFrequencyPercent 2499 g or less 15613.4 2087,4 2500 g or more100586.6260292.6 Total11611002810100

14. 14 Conclusions  Unfortunately, there are significant differences between the Roma and non-Roma populations.  Considering that health culture is an organic part of the whole life-style, strategies that ensure healthy life-style choices must be well-integrated in family based interventions and in schools.  Targeted programs for the young population would increase the likelihood of young girls having sufficient knowledge and social support to make decisions that positively affect their own health and that of their babies.

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