Measuring Early Childhood Health and Health Disparities: A New Approach
Efforts to improve the health of U.S. children and reduce disparities have been hampered by lack of a rigorous way to summarize the multi-dimensional nature of children’s health. This research employed a novel statistical approach to measurement to provide an integrated, comprehensive perspective on early childhood health and disparities. Nationally-representative data (n = 8,800) came from the Early Childhood Longitudinal Study, Birth Cohort. Latent class analysis was used to classify health at 48 months, incorporating health conditions, functioning, and aspects of physical, cognitive, and emotional development. Health disparities by gender, poverty, race/ethnicity, and birthweight were examined. Over half of all children were classified as healthy using multidimensional latent class methodology; others fell into one of seven less optimal health statuses. The analyses highlighted pervasive disparities in health, with poor children at increased risk of being classified into the most disadvantaged health status consisting of chronic conditions and a cluster of developmental problems including low cognitive achievement, poor social skills, and behavior problems. Children with very low birthweight had the highest rate of being in the most disadvantaged health status (25.2 %), but moderately low birthweight children were also at elevated risk (7.9 vs. 3.4 % among non-low birthweight children). Latent class analysis provides a uniquely comprehensive picture of child health and health disparities that identifies clusters of problems experienced by some groups. The findings underscore the importance of continued efforts to reduce preterm birth, and to ameliorate poverty’s effects on children’s health through access to high-quality healthcare and other services.
KeywordsChild health status Health disparities Socioeconomic status Low birth weight
Support for this research was provided by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (5P01HD062498-02) for the Mexican Children of Immigrants Program Project. It also was supported by an award from the National Institute on Drug Abuse (P50-DA010075). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Support services were provided by the Population Research Institute at The Pennsylvania State University, which is funded by the National Institute for Child Health and Human Development (R24HD041025). The authors are grateful to Steven A. Maczuga for programming assistance.
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