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Pediatrics. 2008 Feb;121(2):337-44. doi: 10.1542/peds.2007-0447.

Influence of multiple social risks on children's health.

Author information

1
UCLA Center for Healthier Children, Families, and Communities, 1100 Glendon Ave, Suite 850, Los Angeles, CA 90024, USA. kandyce@ucla.edu

Abstract

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.

PMID:
18245425
DOI:
10.1542/peds.2007-0447
[Indexed for MEDLINE]
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