The Environment and Children's Health Care in Northwest China

• Published in: BMC pediatrics 2014-03, Vol.14 (1), p.82-82, Article 82
• Main Authors: Trasande, Leonardo, Niu, Jingping, Li, Juansheng, Liu, Xingrong, Zhang, Benzhong, Li, Zhilan, Ding, Guowu, Sun, Yingbiao, Chen, Meichi, Hu, Xiaobin, Chen, Lung-Chi, Mendelsohn, Alan, Chen, Yu, Qu, Qingshan
• Format: Article
• Language: English
• Subjects: Adult; Air pollution; Attitude of Health Personnel; Child; Child Health Services; Child Welfare; Children & youth; Childrens health; China; Data Collection; Environmental Exposure; Environmental health; Female; Health care; Health Knowledge, Attitudes, Practice; Human subjects; Humans; Lead content; Likert scale; Male; Medicine; Outdoor air quality; PCB; Polls & surveys; Polychlorinated biphenyls; Public health; Studies; Surveys and Questionnaires
• ISSN: 1471-2431; 1471-2431
• DOI: 10.1186/1471-2431-14-82

Industrialization in the northwest provinces of the People's Republic of China is accelerating rapid increases in early life environmental exposures, yet no publications have assessed health care provider capacity to manage common hazards. To assess provider attitudes and beliefs regarding the environment in children's health, determine self-efficacy in managing concerns, and identify common approaches to managing patients with significant exposures or environmentally-mediated conditions, a two-page survey was administered to pediatricians, child care specialists, and nurses in five provinces (Gansu, Shaanxi, Xinjiang, Qinghai, and Ningxia). Descriptive and multivariable analyses assessed predictors of strong self-efficacy, beliefs or attitudes. 960 surveys were completed with 20 affected patients. Only 12.0% reported specific training in environmental history taking, and 12.0% reported owning a text on children's environmental health. Geographic disparities were most prominent in multivariable analyses, with stronger beliefs in environmental causation yet lower self-efficacy in managing exposures in the northwestern-most province. Health care providers in Northwest China have strong beliefs regarding the role of environment in children's health, and frequently identify affected children. Few are trained in environmental history taking or rate self-efficacy highly in managing common hazards. Enhancing provider capacity has promise for improving children's health in the region.