Socioeconomic gradients in child development in very young children: Evidence from India, Indonesia, Peru, and Senegal
- 8 October 2012
- journal article
- Published by Proceedings of the National Academy of Sciences in Proceedings of the National Academy of Sciences
- Vol. 109 (supplement), 17273-17280
- https://doi.org/10.1073/pnas.1121241109
Abstract
Gradients across socio-economic position exist for many measures of children's health and development in higher-income countries. These associations may not be consistent, however, among the millions of children living in lower- and middle-income countries. Our objective was to examine child development and growth in young children across socio-economic position in four developing countries. We used cross-sectional surveys, child development assessments, measures of length (LAZ), and home stimulation (Family Care Index) of children in India, Indonesia, Peru, and Senegal. The Extended Ages and Stages Questionnaire (EASQ) was administered to parents of all children ages 3-23 mo in the household (n =8,727), and length measurements were taken for all children 0-23 mo (n = 11,102). Household wealth and maternal education contributed significantly and independently to the variance in EASQ and LAZ scores in all countries, while controlling for child's age and sex, mother's age and marital status, and household size. Being in the fifth wealth quintile in comparison with the first quintile was associated with significantly higher EASQ scores (0.27 to 0.48 of a standardized score) and higher LAZ scores (0.37 to 0.65 of a standardized score) in each country, while controlling for maternal education and covariates. Wealth and education gradients increased over the first two years in most countries for both EASQ and LAZ scores, with larger gradients seen in 16-23-mo-olds than in 0-7 mo-olds. Mediation analyses revealed that parental home stimulation activities and LAZ were significant mediating variables and explained up to 50% of the wealth effects on the EASQ.Keywords
This publication has 64 references indexed in Scilit:
- Socioeconomic status and the brain: mechanistic insights from human and animal researchNature Reviews Neuroscience, 2010
- Cross-national comparison of the link between socioeconomic status and emotional and behavioral problems in youthsSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2010
- Socio-economic inequalities in childhood mortality in low- and middle-income countries: a review of the international evidenceBritish Medical Bulletin, 2009
- The social determinants of child health: variations across health outcomes – a population-based cross-sectional analysisBMC Pediatrics, 2009
- Family Income Gradients in the Health and Health Care Access of US ChildrenMaternal and Child Health Journal, 2009
- Is the relationship between socioeconomic status and health stronger for older children in developing countries?Demography, 2009
- Investing in early human development: Timing and economic efficiencyEconomics & Human Biology, 2009
- Multi-country analysis of the effects of diarrhoea on childhood stuntingInternational Journal of Epidemiology, 2008
- Maternal and child undernutrition: global and regional exposures and health consequencesThe Lancet, 2008
- Developmental potential in the first 5 years for children in developing countriesThe Lancet, 2007