OBJECTIVE: Social risk factors such as growing up in poverty, racial/ethnic minority status, and maternal depression have been associated with poorer health outcomes for children. This study examined the strength of association of 8 social risk factors, both individually and as part of a cumulative social risk index, on parent-reported child health status. METHODS: We performed an analysis of cross-sectional data from the 2003 National Survey of Children's Health, a telephone survey of 102,353 parents of children aged 0 to 17 years. In bivariate and multivariate logistic regression models, 8 social risk factors were tested as independent predictors of 4 parent-reported child health outcomes: global health status, dental health, socioemotional health, and overweight. These risk factors were combined into a categorical "social risk index" ranging from low risk (0 risk factors) to very high risk (> or = 6 risk factors), and risk gradients were examined using linear polynomial testing and multivariate logistic regression. RESULTS: The percentage of children in poorer health increased with the number of social risk factors across all health outcomes. More than half of children had > or = 2 risk factors, and 24% had > or = 4. Low maternal mental health, black or Hispanic race/ethnicity, < 200% of the federal poverty level, low household education, unsafe neighborhoods, and lack of health insurance increased the odds for less than very good child health in adjusted models. CONCLUSIONS: Multiple social risk factors have a cumulative effect on parent-reported child health status across physical and socioemotional domains, demonstrating a very strong risk gradient effect. These findings emphasize the importance of addressing multiple levels of social risk to achieve improvements in child health.
OBJECTIVE: Social risk factors such as growing up in poverty, racial/ethnic minority status, and maternal depression have been associated with poorer health outcomes for children. This study examined the strength of association of 8 social risk factors, both individually and as part of a cumulative social risk index, on parent-reported child health status. METHODS: We performed an analysis of cross-sectional data from the 2003 National Survey of Children's Health, a telephone survey of 102,353 parents of children aged 0 to 17 years. In bivariate and multivariate logistic regression models, 8 social risk factors were tested as independent predictors of 4 parent-reported child health outcomes: global health status, dental health, socioemotional health, and overweight. These risk factors were combined into a categorical "social risk index" ranging from low risk (0 risk factors) to very high risk (> or = 6 risk factors), and risk gradients were examined using linear polynomial testing and multivariate logistic regression. RESULTS: The percentage of children in poorer health increased with the number of social risk factors across all health outcomes. More than half of children had > or = 2 risk factors, and 24% had > or = 4. Low maternal mental health, black or Hispanic race/ethnicity, < 200% of the federal poverty level, low household education, unsafe neighborhoods, and lack of health insurance increased the odds for less than very good child health in adjusted models. CONCLUSIONS: Multiple social risk factors have a cumulative effect on parent-reported child health status across physical and socioemotional domains, demonstrating a very strong risk gradient effect. These findings emphasize the importance of addressing multiple levels of social risk to achieve improvements in child health.
Authors: Marjorie Beeghly; Ty Partridge; Ed Tronick; Maria Muzik; Mahya Rahimian Mashhadi; Jordan L Boeve; Jessica L Irwin Journal: Infant Ment Health J Date: 2017-01-02
Authors: Katherine Yun; Arina Chesnokova; Justine Shults; Andres Pinto; David M Rubin Journal: Am J Public Health Date: 2014-10-16 Impact factor: 9.308