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The Effects of Socioeconomic Status on Child and Adolescent Physical Health: An Organization and Systematic Comparison of Measures

Abstract

Prior research has established a link between SES and early life health without providing clear theoretical or empirical evidence for using any particular conceptualization or operationalization of SES. Researchers refer to almost any combination of variables related to families’ economic, educational, or occupational circumstances as SES. This abundance of operationalizations makes it difficult to determine how exactly SES shapes early life health. Childhood and adolescence are unique periods of life delineated by extensive social, psychological, and physical transitions. Although these changes may make children and adolescents sensitive to different aspects of SES, research has yet to systematically compare an array of SES measures extensive enough to rigorously examine this possibility. To address this gap, I merge the National Longitudinal Survey of Youth 1979 (NLSY79) and the NLSY79 Children and Young Adults datasets. In analyses, I consider multiple operationalizations of SES derived from the distinct components conceptualization of SES. I find that the best model of SES and early life health includes family income, wealth, education, and occupational prestige. Family income and wealth play especially important roles in early life health but also impact child and adolescent health differently. Children’s health is more vulnerable to their families’ wealth, while adolescents’ health is more sensitive to their families’ current income. Together, the countervailing effects of family income and wealth negate one another such that the overall effect of economic conditions on health is the same for children and adolescents. My findings provide evidence that future research should carefully consider multiple measures of SES when studying the relationship between SES and early life health.

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Notes

  1. 1.

    I used two methods to search for studies. First, I explored the references of highly cited research on SES and early life health, e.g., McLeod and Shanahan (1993), Duncan et al. (1994), Case et al. (2002), West (1997), and studies that cite these articles. I also used popular search engines to find relevant studies, e.g., EBSCOhost, JSTOR, Web of Knowledge, and Google Scholar. I searched for studies that included the terms “socioeconomic status,” “health,” and “child” or “adolescent” in the title or abstract. From the lists of studies these searchers produced, I used three conditions to determine whether a study was included in the sample of studies I reviewed. First, the study’s focus had to be on the effects of a relatively common operationalization of SES on physical or mental health or explicitly state at some point in the article that the focus was on the relationship between SES and health. Second, the sample of the study had to include children between the ages 0 and 19. Third, the study had to be published after 1989 when dramatic increases in research on SES and early life health began. I did, however, make an exception for West (1988) because it is a widely cited piece arguing that the effect of SES is smaller in adolescents compared to children.

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Correspondence to Joseph D. Wolfe.

Appendix

Appendix

See Table 5.

Table 5 List of journals by discipline (total journals = 45; total studies = 110)

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Wolfe, J.D. The Effects of Socioeconomic Status on Child and Adolescent Physical Health: An Organization and Systematic Comparison of Measures. Soc Indic Res 123, 39–58 (2015). https://doi.org/10.1007/s11205-014-0733-4

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Keywords

  • Socioeconomic status (SES)
  • Physical health
  • Health inequalities
  • Childhood and adolescence
  • Health disparities