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1.
PLoS One ; 18(5): e0285985, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37228090

RESUMO

OBJECTIVES: The effectiveness of early childhood education and care (ECEC) programs for children's development in various domains is well documented. Adding to existing meta-analyses on associations between the quality of ECEC services and children's developmental outcomes, the present meta-analysis synthesizes the global literature on structural characteristics and indicators of process quality to test direct and moderated effects of ECEC quality on children's outcomes across a range of domains. DESIGN: A systematic review of the literature published over a 10-year period, between January 2010 and June 2020 was conducted, using the databases PsychInfo, Eric, EbscoHost, and Pubmed. In addition, a call for unpublished research or research published in the grey literature was sent out through the authors' professional network. The search yielded 8,932 articles. After removing duplicates, 4,880 unique articles were identified. To select articles for inclusion, it was determined whether studies met eligibility criteria: (1) study assessed indicators of quality in center-based ECEC programs catering to children ages 0-6 years; and (2) study assessed child outcomes. Inclusion criteria were: (1) a copy of the full article was available in English; (2) article reported effect size measure of at least one quality indicator-child outcome association; and (3) measures of ECEC quality and child outcomes were collected within the same school year. A total of 1,044 effect sizes reported from 185 articles were included. RESULTS: The averaged effects, pooled within each of the child outcomes suggest that higher levels of ECEC quality were significantly related to higher levels of academic outcomes (literacy, n = 99: 0.08, 95% C.I. 0.02, 0.13; math, n = 56: 0.07, 95% C.I. 0.03, 0.10), behavioral skills (n = 64: 0.12, 95% C.I. 0.07, 0.17), social competence (n = 58: 0.13, 95% C.I. 0.07, 0.19), and motor skills (n = 2: 0.09, 95% C.I. 0.04, 0.13), and lower levels of behavioral (n = 60: -0.12, 95% C.I. -0.19, -0.05) and social-emotional problems (n = 26: -0.09, 95% C.I. -0.15, -0.03). When a global assessment of child outcomes was reported, the association with ECEC quality was not significant (n = 13: 0.02, 95% C.I. -0.07, 0.11). Overall, effect sizes were small. When structural and process quality indicators were tested separately, structural characteristics alone did not significantly relate to child outcomes whereas associations between process quality indicators and most child outcomes were significant, albeit small. A comparison of the indicators, however, did not yield significant differences in effect sizes for most child outcomes. Results did not provide evidence for moderated associations. We also did not find evidence that ECEC quality-child outcome associations differed by ethnic minority or socioeconomic family background. CONCLUSIONS: Despite the attempt to provide a synthesis of the global literature on ECEC quality-child outcome associations, the majority of studies included samples from the U.S. In addition, studies with large samples were also predominately from the U.S. Together, the results might have been biased towards patterns prevalent in the U.S. that might not apply to other, non-U.S. ECEC contexts. The findings align with previous meta-analyses, suggesting that ECEC quality plays an important role for children's development during the early childhood years. Implications for research and ECEC policy are discussed.


Assuntos
Etnicidade , Grupos Minoritários , Pré-Escolar , Humanos , Escolaridade , Qualidade da Assistência à Saúde , Instituições Acadêmicas
2.
J Clin Child Adolesc Psychol ; : 1-13, 2023 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-36803346

RESUMO

OBJECTIVE: Depression disparities between heterosexual youth and lesbian, gay, bisexual, queer, and other non-heterosexual (LGBQ+) youth are robust and linked to discrimination in schools. Advocacy by school-based Gender-Sexuality Alliances (GSAs) to raise awareness of LGBQ+ issues and to counteract discrimination may reduce these disparities within schools, yet has not been investigated schoolwide. We considered whether GSA advocacy over the school year moderated sexual orientation differences in depressive symptoms at the school year's end for students in the general school population (i.e., students who were not members of the GSA). METHOD: Participants were 1,362 students (Mage = 15.68; 89% heterosexual; 52.6% female; 72.2% White) in 23 Massachusetts secondary schools with GSAs. Participants reported depressive symptoms at the beginning and end of the school year. Separately, GSA members and advisors reported their GSA's advocacy activities during the school year and other GSA characteristics. RESULTS: LGBQ+ youth reported higher depressive symptoms than heterosexual youth at the school year's beginning. However, after adjusting for initial depressive symptoms and multiple covariates, sexual orientation was a weaker predictor of depressive symptoms at the school year's end for youth in schools whose GSAs engaged in more advocacy. Depression disparities were significant in schools whose GSAs reported lower advocacy, but were statistically non-significant in schools whose GSAs reported higher advocacy. CONCLUSION: Advocacy could be a means by which GSAs achieve school-wide impacts, benefiting LGBQ+ youth who are not GSA members. GSAs may therefore be a key resource for addressing the mental health needs of LGBQ+ youth.

3.
BMC Public Health ; 22(1): 897, 2022 05 05.
Artigo em Inglês | MEDLINE | ID: mdl-35513842

RESUMO

BACKGROUND: Policy debates over anti-poverty programs are often marked by pernicious stereotypes suggesting that direct cash transfers to people residing in poverty encourage health-risking behaviors such as smoking, drinking, and other substance use. Causal evidence on this issue is limited in the U.S. Given the prominent role of child allowances and other forms of cash assistance in the 2021 American Rescue Plan and proposed Build Back Better legislation, evidence on the extent to which a monthly unconditional cash gift changes substance use patterns among low-income mothers with infants warrants attention, particularly in the context of economic supports that can help improve early environments of children. METHOD: We employ a multi-site, parallel-group, randomized control trial in which 1,000 low-income mothers in the U.S. with newborns were recruited from hospitals shortly after the infant's birth and randomly assigned to receive either a substantial ($333) or a nominal ($20) monthly cash gift during the early years of the infant's life. We estimate the effect of the unconditional cash transfer on self-report measures of maternal substance use (i.e., alcohol, cigarette, or opioid use) and household expenditures on alcohol and cigarettes after one year of cash gifts. RESULTS: The cash gift difference of $313 per month had small and statistically nonsignificant impacts on group differences in maternal reports of substance use and household expenditures on alcohol or cigarettes. Effect sizes ranged between - 0.067 standard deviations and + 0.072 standard deviations. The estimated share of the $313 group difference spent on alcohol and tobacco was less than 1%. CONCLUSIONS: Our randomized control trial of monthly cash gifts to mothers with newborn infants finds that a cash gift difference of $313 per month did not significantly change maternal use of alcohol, cigarettes, or opioids or household expenditures on alcohol or cigarettes. Although the structure of our cash gifts differs somewhat from that of a government-provided child allowance, our null effect findings suggest that unconditional cash transfers aimed at families living in poverty are unlikely to induce large changes in substance use and expenditures by recipients. TRIAL REGISTRATION: Registered on Clinical Trials.gov NCT03593356 in July of 2018.


Assuntos
Mães , Transtornos Relacionados ao Uso de Substâncias , Criança , Características da Família , Feminino , Declarações Financeiras , Humanos , Lactente , Recém-Nascido , Pobreza , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle
4.
NPJ Sci Learn ; 6(1): 27, 2021 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-34508088

RESUMO

A recent Nature article modelled within-country inequalities in primary, secondary, and tertiary education and forecast progress towards Sustainable Development Goal (SDG) targets related to education (SDG 4). However, their paper entirely overlooks inequalities in achieving Target 4.2, which aims to achieve universal access to quality early childhood development, care and preschool education by 2030. This is an important omission because of the substantial brain, cognitive and socioemotional developments that occur in early life and because of increasing evidence of early-life learning's large impacts on subsequent education and lifetime wellbeing. We provide an overview of this evidence and use new analyses to illustrate medium- and long-term implications of early learning, first by presenting associations between pre-primary programme participation and adolescent mathematics and science test scores in 73 countries and secondly, by estimating the costs of inaction (not making pre-primary programmes universal) in terms of forgone lifetime earnings in 134 countries. We find considerable losses, comparable to or greater than current governmental expenditures on all education (as percentages of GDP), particularly in low- and lower-middle-income countries. In addition to improving primary, secondary and tertiary schooling, we conclude that to attain SDG 4 and reduce inequalities in a post-COVID era, it is essential to prioritize quality early childhood care and education, including adopting policies that support families to promote early learning and their children's education.

5.
Pediatrics ; 148(4)2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34475270

RESUMO

Childhood economic disadvantage is associated with lower cognitive and social-emotional skills, reduced educational attainment, and lower earnings in adulthood. Despite these robust correlations, it is unclear whether family income is the cause of differences observed between children growing up in poverty and their more fortunate peers or whether these differences are merely due to the many other aspects of family life that co-occur with poverty. Baby's First Years is the first randomized controlled trial in the United States designed to identify the causal impact of poverty reduction on children's early development. A total of 1000 low-income mothers of newborns were enrolled in the study and began receiving a monthly unconditional cash gift for the first several years of their children's lives. Mothers were randomly assigned to receive either a large monthly cash gift or a nominal monthly cash gift. All monthly gifts are administered via debit card and can be freely spent with no restrictions. Baby's First Years aims to answer whether poverty reduction in early childhood (1) improves children's developmental outcomes and promotes healthier brain functioning, and (2) improves family functioning and better enables parents to support child development. Here we present the rationale and design of the study as well as potential implications for science and policy.


Assuntos
Desenvolvimento Infantil , Apoio Financeiro , Pobreza , Instituições de Caridade , Feminino , Apoio Financeiro/ética , Disparidades nos Níveis de Saúde , Humanos , Renda , Imposto de Renda , Lactente , Mães , Estados Unidos
6.
BMJ Glob Health ; 6(4)2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33875519

RESUMO

A comprehensive evidence-based framework is needed to guide policies and programmes that enable children and adolescents to accrue the human capital required to meet the Sustainable Development Goals (SDGs). This paper proposes a comprehensive, multisectoral, multilevel life-course conceptualisation of human capital development by building on the Nurturing Care Framework (NCF), originally developed for the foundational period of growth and development through the age 3 years. Nurturing care (NC) comprises stable environments that promote children's health and nutrition, protect from threats, and provide opportunities for learning and responsive, emotionally supportive and developmentally enriching relationships. NC is fostered by families, communities, services, national policies and beyond. The principles apply across the life course, endorse equity and human rights, and promote long-term human capital. This paper presents an evidence-based argument for the extension of the NCF from preconception through adolescence (0-20 years), organised into six developmental periods: preconception/prenatal, newborn/birth, infancy/toddlerhood, preschool, middle childhood and adolescence. The proposed framework advances human capital within each developmental period by promoting resilience and adaptive developmental trajectories while mitigating negative consequences of adversities.Attaining the SDGs depends on strengthening human capital formation, extending throughout childhood and adolescence and supported by NC. Embedded in enabling laws, policies and services, the dynamic NCF components can mitigate adversities, enhance resilience and promote the well-being of marginalised groups. The life-course extension of the NCF is strategically positioned to enhance human capital, to attain the SDGs and to ensure that children or adolescents are not left behind in reaching their developmental potential.


Assuntos
Desenvolvimento Infantil , Saúde da Criança , Adolescente , Criança , Pré-Escolar , Humanos , Recém-Nascido
7.
PLoS One ; 15(7): e0236107, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32649702

RESUMO

BACKGROUND AND OBJECTIVES: Globally, studies have shown associations between maternal stimulation and early child development. Yet, little is known about the prevalence of paternal and other caregivers' stimulation practices, particularly in low- and- middle-income countries (LMICs). METHODS: Data from the Multiple Indicators Cluster Survey (MICS) and the Demographic and Health Survey (DHS) were combined across 62 LMICs (2010-2018). The sample included 205,150 mothers of children aged 3 and 4 years. High levels of stimulation were defined as caregiver engagement in at least 4 out of 6 possible activities with the child. The proportion of mothers, fathers, and other caregivers providing high levels of stimulation was calculated by country, region, and for the whole sample. Socioeconomic disparities within and between countries were estimated. RESULTS: On average, 39.8% (95% CI 37.4 to 42.2) of mothers, 11.9% (95% CI 10.1 to 13.8) of fathers, and 20.7% (95% CI 18.4 to 23.0) of other adult caregivers provided high levels of stimulation. Stimulation varied by region, country income group, and Human Development Index (HDI), with higher levels of maternal and paternal-but not other caregivers'-stimulation in high-income and high-HDI countries. Within countries, stimulation levels were, on average, lower in the poorest relative to the richest households, and some but not all countries exhibited differences by child sex (i.e., boys vs. girls) or area (i.e., urban vs. rural). CONCLUSIONS: Results suggest a need for intervention efforts that focus on increasing caregiver stimulation in LMICs, particularly for fathers and in low-income contexts.


Assuntos
Cuidadores/psicologia , Desenvolvimento Infantil , Países em Desenvolvimento/estatística & dados numéricos , Pai/psicologia , Mães/psicologia , Pré-Escolar , Relações Pai-Filho , Feminino , Humanos , Masculino , Relações Mãe-Filho , Inquéritos e Questionários
9.
Child Dev ; 91(5): 1509-1528, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-31762010

RESUMO

Extracurricular groups can promote healthy development, yet the literature has given limited attention to indirect associations between extracurricular involvement and mental health or to sexual and gender minority youth. Among 580 youth (Mage  = 15.59, range = 10-20 years) and adult advisors in 38 Gender-Sexuality Alliances (GSAs), multilevel structural equation models showed that greater engagement in GSAs over the school year predicted increased perceived peer validation, self-efficacy to promote social justice, and hope (baseline adjusted). Through increased hope, greater engagement indirectly predicted reduced depressive and anxiety symptoms at the year's end (baseline adjusted). GSAs whose members had more mental health discussions and more meetings reported reduced mental health concerns. Findings suggest how groups addressing issues of equity and justice improve members' health.


Assuntos
Empoderamento , Transtornos Mentais/prevenção & controle , Sistemas de Apoio Psicossocial , Minorias Sexuais e de Gênero/psicologia , Participação Social , Adolescente , Adulto , Criança , Feminino , Esperança/fisiologia , Humanos , Masculino , Massachusetts , Transtornos Mentais/epidemiologia , Transtornos Mentais/etiologia , Transtornos Mentais/psicologia , Saúde Mental , Transtornos do Neurodesenvolvimento/epidemiologia , Transtornos do Neurodesenvolvimento/etiologia , Transtornos do Neurodesenvolvimento/prevenção & controle , Transtornos do Neurodesenvolvimento/psicologia , Grupo Associado , Fatores de Risco , Serviços de Saúde Mental Escolar/organização & administração , Serviços de Saúde Mental Escolar/provisão & distribuição , Autoeficácia , Meio Social , Justiça Social/psicologia , Participação Social/psicologia , Inquéritos e Questionários , Adulto Jovem
10.
J Fam Psychol ; 33(4): 433-443, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30843706

RESUMO

Two-generation human capital programs for families provide education and workforce training for parents simultaneously with education for children. This study uses a quasi-experimental design to examine the effects of a model two-generation program, CareerAdvance, which recruits parents of children enrolled in Head Start into a health care workforce training program. After 1 year, CareerAdvance parents demonstrated higher rates of certification and employment in the health care sector than did matched-comparison parents whose children were also in Head Start. More important, there was no effect on parents' short-term levels of income or employment across all sectors. CareerAdvance parents also experienced psychological benefits, reporting higher levels of self-efficacy and optimism, in addition to stronger career identity compared with the matched-comparison group. Notably, even as CareerAdvance parents juggled the demands of school, family, and employment, they did not report higher levels of material hardship or stress compared with the matched-comparison group. These findings are discussed in terms of the implications of a family perspective for human capital programs. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Educação/organização & administração , Emprego/estatística & dados numéricos , Pais/educação , Orientação Vocacional/organização & administração , Adulto , Criança , Intervenção Educacional Precoce , Feminino , Humanos , Renda , Masculino , Pobreza , Desenvolvimento de Programas , Seguridade Social
11.
Am Educ Res J ; 56(6): 2262-2294, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34385714

RESUMO

School-based extracurricular settings could promote dialogue on sociopolitical crises. We considered immigration discussions within Gender-Sexuality Alliances (GSAs), which address multiple systems of oppression. Among 361 youth and 58 advisors in 38 GSAs (19 in 2016-2017/Year 1; 19 in 2017-2018/Year 2), youth in Year 1 reported increased discussions from baseline throughout the remaining school year; differences were non-significant in Year 2. In both years, youth reporting greater self-efficacy to promote social justice, and GSAs with advisors reporting greater self-efficacy to address culture, race, and immigration discussed immigration more over the year (adjusting for baseline). In interviews, 38 youth described circumstances promoting or inhibiting discussions: demographic representation, open climates, critical reflection, fear or consequences of misspeaking, discomfort, agenda restrictions, and advisor roles.

12.
RSF ; 4(2): 22-42, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30246143

RESUMO

To reduce child poverty and income instability, and eliminate extreme poverty among families with children in the United States, we propose converting the Child Tax Credit and child tax exemption into a universal, monthly child allowance. Our proposal is based on principles we argue should undergird the design of such policies: universality, accessibility, adequate payment levels, and more generous support for young children. Whether benefits should decline with additional children to reflect economies of scale is a question policymakers should consider. Analyzing 2015 Current Population Survey data, we estimate our proposed child allowance would reduce child poverty by about 40 percent, deep child poverty by nearly half, and would effectively eliminate extreme child poverty. Annual net cost estimates range from $66 billion to $105 billion.

14.
J Res Adolesc ; 27(1): 4-19, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-28498536

RESUMO

In the United States, 5.3 million children and adolescents are growing up either with unauthorized status or with at least one parent who has that status. Until recently, little in the way of research has informed federal, state, and local policy debates related to unauthorized status (e.g., border enforcement, deportation, and a pathway to citizenship) although these issues have important implications for youth development. This statement is a brief summary of the research evidence on multiple domains of development that may be affected by the child or parent's unauthorized status. We also describe the contextual and psychological mechanisms that may link this status to developmental outcomes. We summarize a range of policies and practices that could reduce the developmental harm to children, youth, and their families stemming from this status. Finally, we conclude with recommendations for policy, practice, and research that are based on the evidence reviewed.


Assuntos
Desenvolvimento do Adolescente , Consenso , Emigração e Imigração/legislação & jurisprudência , Imigrantes Indocumentados/estatística & dados numéricos , Adolescente , Feminino , Humanos , Masculino , Formulação de Políticas , Política Pública , Pesquisa , Imigrantes Indocumentados/psicologia , Estados Unidos/etnologia
15.
Lancet ; 389(10064): 91-102, 2017 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-27717615

RESUMO

The UN Sustainable Development Goals provide a historic opportunity to implement interventions, at scale, to promote early childhood development. Although the evidence base for the importance of early childhood development has grown, the research is distributed across sectors, populations, and settings, with diversity noted in both scope and focus. We provide a comprehensive updated analysis of early childhood development interventions across the five sectors of health, nutrition, education, child protection, and social protection. Our review concludes that to make interventions successful, smart, and sustainable, they need to be implemented as multi-sectoral intervention packages anchored in nurturing care. The recommendations emphasise that intervention packages should be applied at developmentally appropriate times during the life course, target multiple risks, and build on existing delivery platforms for feasibility of scale-up. While interventions will continue to improve with the growth of developmental science, the evidence now strongly suggests that parents, caregivers, and families need to be supported in providing nurturing care and protection in order for young children to achieve their developmental potential.


Assuntos
Desenvolvimento Infantil , Comportamento Social , Cuidadores , Pré-Escolar , Humanos , Pais , Política Pública
16.
Educ Res ; 46(9): 508-516, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38550966

RESUMO

Outside the immediate classroom setting, efforts within other school spaces also can shape school climate, address inequality, and affect student performance. Nevertheless, in this respect there has been little research on school-based extracurricular groups focused on issues of social inclusion and justice. An exception to this lack of focus has been Gay-Straight Alliances (GSAs), which promote social inclusion and justice for sexual and gender minority youth (e.g., lesbian, gay, bisexual, transgender, or questioning youth; LGBTQ) through support, socializing, education, and advocacy. As this literature has matured, we detail and provide examples of the following conceptual and methodological recommendations to address emerging research needs for GSAs: (1) Move from a monolithic to contextualized treatment of GSAs, (2) attend to heterogeneity among members, (3) utilize multiple data sources for triangulation, (4) apply a range of methodological approaches to capitalize on strengths of different designs, (5) collect longitudinal data over short-term and extended time periods, and (6) consider GSAs within a broader umbrella of youth settings. Further, we note ways in which these recommendations apply to other student groups organized around specific sociocultural identities. These advances could produce more comprehensive empirically supported models to guide GSAs and similar groups on how to promote resilience among their diverse members and address broader social issues within their schools.

17.
Adv Child Dev Behav ; 51: 231-55, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27474428

RESUMO

More than 4 million unauthorized parents of legal status children currently reside in the United States (Capps, Fix, & Zong, 2016). Developmental scientists and intervention researchers hoping to work with these mixed-status families face a myriad of challenges, largely generated from the population's policy-driven social exclusion. Despite the challenges, there is a moral imperative to work with and support parents and children currently living in mixed-status households. This chapter applies a social justice perspective, largely stemming from Prilleltensky's critical community psychological framework, to improve the relevance and usefulness of research on mixed-status families (Prilleltensky & Nelson, 1997). We discuss the utility of this social justice perspective in theory building, study design and implementation, and dissemination of findings regarding mixed-status families, with exemplars from recent research.


Assuntos
Emigração e Imigração , Família , Distância Psicológica , Justiça Social , Imigrantes Indocumentados , Adolescente , Criança , Pesquisa Participativa Baseada na Comunidade , Emigrantes e Imigrantes , Humanos , Disseminação de Informação , Pais , Política Pública , Estados Unidos
18.
J Youth Adolesc ; 45(7): 1438-51, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26781740

RESUMO

Gay-Straight Alliances (GSAs) may promote wellbeing for sexual minority youth (e.g., lesbian, gay, bisexual, or questioning youth) and heterosexual youth. We considered this potential benefit of GSAs in the current study by examining whether three GSA functions-support/socializing, information/resource provision, and advocacy-contributed to sense of agency among GSA members while controlling for two major covariates, family support and the broader school LGBT climate. The sample included 295 youth in 33 Massachusetts GSAs (69 % LGBQ, 68 % cisgender female, 68 % white; M age = 16.06 years). Based on multilevel models, as hypothesized, youth who received more support/socializing, information/resources, and did more advocacy in their GSA reported greater agency. Support/socializing and advocacy distinctly contributed to agency even while accounting for the contribution of family support and positive LGBT school climate. Further, advocacy was associated with agency for sexual minority youth but not heterosexual youth. Greater organizational structure enhanced the association between support/socializing and agency; it also enhanced the association between advocacy and agency for sexual minority youth. These findings begin to provide empirical support for specific functions of GSAs that could promote wellbeing and suggest conditions under which their effects may be enhanced.


Assuntos
Heterossexualidade/psicologia , Relações Interpessoais , Minorias Sexuais e de Gênero/psicologia , Apoio Social , Adolescente , Feminino , Humanos , Controle Interno-Externo , Masculino , Massachusetts , Modelos Psicológicos , Preconceito/psicologia , Qualidade de Vida/psicologia , Ajustamento Social , Percepção Social , Socialização
19.
Am J Prev Med ; 50(1): 47-56, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26342634

RESUMO

INTRODUCTION: Childhood adversity is an under-addressed dimension of primary prevention of disease in children and adults. Evidence shows racial/ethnic and socioeconomic patterning of childhood adversity in the U.S., yet data on the interaction of race/ethnicity and SES for exposure risk is limited, particularly with consideration of immigration history. This study examined racial/ethnic differences in nine adversities among children (from birth to age 17 years) in the National Survey of Child Health (2011-2012) and determined how differences vary by immigration history and income (N=84,837). METHODS: We estimated cumulative adversity and individual adversity prevalences among white, black, and Hispanic children of U.S.-born and immigrant parents. We examined whether family income mediated the relationship between race/ethnicity and exposure to adversities, and tested interactions (analyses conducted in 2014-2015). RESULTS: Across all groups, black and Hispanic children were exposed to more adversities compared with white children, and income disparities in exposure were larger than racial/ethnic disparities. For children of U.S.-born parents, these patterns of racial/ethnic and income differences were present for most individual adversities. Among children of immigrant parents, there were few racial/ethnic differences for individual adversities and income gradients were inconsistent. Among children of U.S.-born parents, the Hispanic-white disparity in exposure to adversities persisted after adjustment for income, and racial/ethnic disparities in adversity were largest among children from high-income families. CONCLUSIONS: Simultaneous consideration of multiple social statuses offers promising frameworks for fresh thinking about the distribution of disease and the design of targeted interventions to reduce preventable health disparities.


Assuntos
Proteção da Criança/etnologia , Emigrantes e Imigrantes/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Renda/estatística & dados numéricos , Grupos Raciais , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Emigrantes e Imigrantes/psicologia , Etnicidade/estatística & dados numéricos , Feminino , Inquéritos Epidemiológicos , Humanos , Lactente , Recém-Nascido , Masculino , Prevalência , Fatores de Risco , Estados Unidos
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