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Mediating pathways in the socio-economic gradient of child development: Evidence from children 6-42 months in Bogota.

ABSTRACT: Research has previously shown a gap of near 0.5 of a standard deviation (SD) in cognition and language development between the top and bottom household wealth quartile in children aged 6-42 months in a large representative sample of low- and middle-income families in Bogota, using the Bayley Scales of Infant and Toddler Development. The gaps in fine motor and socio-emotional development were about half that size. Developmental deficits increased with age. The current study explored the associations amongst child development, household socio-economic status (SES), and a set of potential mediating variables-parental characteristics, child biomedical factors, and the quality of the home environment-in this sample. We ran mediation tests to quantify the contribution of these variables to the SES gap, and explored the role of age as a moderator. Parental education, particularly maternal education, and the quality of the home environment mediated the SES gap in all outcomes examined. Height-for-age mediated a small amount of the deficit in language scales only. More educated mothers provided better home stimulation than less educated mothers and the home environment partly mediated the effect of maternal education. These results suggested that in interventions aimed at promoting child development, those focusing on the quality of the home environment should be effective.

SUBMITTER: Rubio-Codina M

PROVIDER: S-EPMC5102093 | biostudies-literature | 2016 Nov

REPOSITORIES: biostudies-literature

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Mediating pathways in the socio-economic gradient of child development: Evidence from children 6-42 months in Bogota.

Rubio-Codina Marta M Attanasio Orazio O Grantham-McGregor Sally S

International journal of behavioral development 20160617 6

Research has previously shown a gap of near 0.5 of a standard deviation (SD) in cognition and language development between the top and bottom household wealth quartile in children aged 6-42 months in a large representative sample of low- and middle-income families in Bogota, using the Bayley Scales of Infant and Toddler Development. The gaps in fine motor and socio-emotional development were about half that size. Developmental deficits increased with age. The current study explored the associati ...[more]

PMID: 27885311

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Project description:BackgroundHealth-seeking behaviour lies on the direct pathway between socio-economic position (SEP) and health outcomes. The objective of this systematic review is to identify and synthesise evidence of socio-economic gradients in health-seeking behaviours related to maternal and child health in Egypt.MethodsFour databases (Medline, Embase, Global Health and Web of Science) were searched in September 2013 for material published in English from 1992 to 2013 for a combination of terms describing health-seeking behaviours, indicators of socio-economic position and geographical limitation to Egypt. Findings of studies were described and synthesised in a narrative format as meta-analysis was not possible.FindingsAmong the 786 references identified, 10 articles met the inclusion criteria. Six studies examined maternal and five studies child health-seeking behaviours (one study examined both). For maternal health, three dimensions of health-seeking behaviour (receipt of any care, type of care and intensity of care) were covered by studies of ante-natal and one dimension (type of care) by analyses of delivery care. For child health, two dimensions of preventive care (coverage of and intensity of immunisation) and three dimensions of curative care (receipt of any care, type and cost of care) were analysed.ConclusionsBased on two studies of time trends in nationally-representative surveys, socio-economic inequalities in seeking care for basic preventive and curative interventions in maternal and child health appear to have narrowed. Limited evidence of gradients in intensity of maternal preventive and provider selection in child curative care showed that inequalities may have widened. In studies of more geographically and socially homogeneous samples, fewer gradients were identified. Current body of evidence contains numerous limitations and gaps and is insufficient to draw a conclusive summary of such gradients. Improved understanding of SEP gradients is crucial in designing and prioritising interventions to equitably improve maternal and child health outcomes.

Project description:PurposeTo examine the impacts of socio-economic status (SES) on visual impairment (VI), and the mediating role of lifestyles in developed rural areas of China.MethodsA cross-sectional study was conducted among people living in rural districts of Tianjin, a developed municipality in China. An interviewer-administered survey along with free eye screenings was conducted with participants. The questionnaire included questions about demographic characteristics, SES, medical histories and lifestyles. Presenting visual acuity (PVA) and main causes of VI were identified by ophthalmologists. χ2 test was undertaken to determine whether significant differences (p<0.05) exist between VI and demographic, SES, medical history and lifestyle factors. A stepwise regression method was conducted to investigate whether lifestyles play mediating roles between SES and VI. Multivariable logistic and ordinal logistic regression were used contingent on different types of dependent variables in each regression, and adjusted odds ratio (OR) values were estimated.ResultsOf the 12,233 participants, 6,233 were male (50.59%); the mean age was 34.61 years; 310 (2.54%) had VI. Hypertension, diabetes and cardiopathy were main medical histories, with 1,640 had hypertension (13.41%), 854 had diabetes (6.98%) and 483 had cardiopathy (3.95%). About SES factors, higher education level (Adjusted OR, 0.84; 95% CI, 0.75-0.95) and higher income level (Adjusted OR, 0.54; 95% CI, 0.39-0.76), were significantly associated with VI in a gradient across severity of VI. Lifestyles including smoking (Adjusted OR, 1.55; 95% CI, 1.31-1.83) and drinking (Adjusted OR, 1.36; 95% CI, 1.06-1.74) played mediating roles between SES and VI when considering the full sample. Besides smoking and drinking, reading every week (Adjusted OR, 2.07; 95% CI, 1.53-2.82) and exercising more than 2h every day (Adjusted OR, 0.39; 95% CI, 0.15-1.00) also played mediating roles between SES and VI when considering the subsample (age≥16).ConclusionThis study revealed the crucial impacts of SES factors on VI, and the mediating role played by several lifestyles. Targeted public health interventions for reducing VI should thus be proposed in developed rural areas of China.

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Mediating pathways in the socio-economic gradient of child development: Evidence from children 6-42 months in Bogota.

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Mediating pathways in the socio-economic gradient of child development: Evidence from children 6-42 months in Bogota.

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