Features of children’s health conditions in large families: experience of cohort study

One of Russia’s national development goals until 2030 is preserving the population, health and well-being of people. Overcoming the natural population decline in the country is impossible without increasing the number of large families. At the same time, researchers are interested in assessing the conditions for children’s health formation in large families, which is the purpose of the study. The authors used general scientific (literature analysis, study and generalization of information, comparison, synthesis, induction, deduction, classification) and empirical methods (measurements, questionnaires, observation, comparison). The information base is sample data of prospective cohort monitoring of 308 families in 2022, 65 of which are the control group of large families. Scientific novelty of the work consists in comparing the conditions of children’s health in families with a different number of children. It is revealed that parents of three and more children more often than others have secondary education, they have lower medical activity, which leads to the omission of scheduled examinations and immunizations of their children. Marriages of parents with many children are somewhat stronger, but relations between spouses are more tense. Average per capita income and, accordingly, purchasing power is much lower than in families with one or two children. The largest part of the family budget is spent on food and compulsory payments. The living conditions of large families are more often unsatisfactory: cramped, poorly furnished and exposed to unfavorable environmental factors. As a consequence, large families more often experience material problems related to children’s upbringing and care; in addition, they often experience the problem of lack of time. The impact of unfavorable conditions is confirmed by the analysis of children’s health status. Children from large families show lower indicators of physical and neuropsychological development. Therefore, large families should be the main target groups in the course of preventive measures to improve children’s health through socio-economic and medical support programs.