Gradients in low birthweight by maternal education: A comparative perspective.

Background: Longstanding research has shown strong inequalities in low birthweight by household income. However, most such research has focused on Anglophone countries, while evidence emerging from other developed countries suggest a stronger role of education rather than incomes in creating inequalities at birth. This paper compares gradients in low birthweight by maternal education, as well as explores underlying mechanisms contributing to these gradients, in France, the United States, and the United Kingdom. Methods: Analyses are based on harmonized data from large, nationally-representative samples from France, UK and US. We use regression models and decomposition methods to explore the relative role of several possible mechanisms in producing birthweight inequalities. Results: Inequalities in low birth weight across maternal education groups were relatively similar in the United States, the United Kingdom and France. However, the individual-level mechanisms producing such inequalities varied substantially across the three countries, with income being most important in the US, pregnancy smoking being most evident in France, and the UK occupying an intermediate position. Differences in the mechanisms producing birth health inequalities mirror differences in the policy environment in the three countries. Conclusion: While inequalities in health appear from the earliest moments in many countries, our results suggest research on birth health inequalities, and therefore policies, is not easily generalizable across national contexts, and call for more scholarship in uncovering the "whys" of health inequalities in a variety of contexts.

Inequalities in Resources for Preschool-Age Children by Parental Education: Evidence from Six Advanced Industrialized Countries.

This paper provides new evidence on inequalities in resources for children age 3-4 by parental education using harmonized data from six advanced industrialized countries-United States, United Kingdom, France, Germany, Netherlands, and Japan-that represent different social welfare regime types. We analyze inequalities in two types of resources for young children-family income, and center-based child care-applying two alternative measures of parental education-highest parental education, and maternal education. We hypothesize that inequalities in resources by parental education will be less pronounced in countries where social policies are designed to be more equalizing. The results provide partial support for this hypothesis: the influence of parental education on resources for children does vary by the social policy context, although not in all cases. We also find that the measurement of parental education matters: income disparities are smaller under a maternal-only definition whereas child care disparities are larger. Moreover, the degree of divergence between the two sets of estimates differs across countries. We provide some of the first systematic evidence about how resources for young children vary depending on parents' education and the extent to which such inequalities are buffered by social policies. We find that while early inequalities are a fact of life in all six countries, the extent of those inequalities varies considerably. Moreover, the results suggest that social policy plays a role in moderating the influence of parental education on resources for children.

International differences in gradients in early childhood overweight and obesity: the role of maternal employment and formal childcare attendance.

BACKGROUND: There are significant cross-country differences in socio-economic gradients in later childhood and adulthood overweight/obesity; few studies assess whether this cross-national variation is evident from early childhood. Furthermore, the role of childcare in explaining overweight/obesity gradients might vary across countries, given differences in access, quality and heterogeneity within. Additionally, childcare is linked to parental characteristics such as maternal employment. The interplay between childcare and employment in producing early overweight/obesity gradients has received little attention, and might vary cross-nationally. METHODS: Using harmonized data from six high-quality, large datasets, we explore the variation in gradients in early overweight/obesity (at age 3-4 years old) by parental education across several high-income countries (USA, UK, France, the Netherlands, Germany and Japan). We then assess whether differential formal group care use attenuates some of these gradients, and whether this varies across maternal employment. RESULTS: Gradients in early childhood overweight/obesity by parental education are evident across several developed countries. Countries with higher overall prevalence of early overweight/obesity did not have the largest inequalities across education groups. The contribution of formal group care to producing these gradients varied across countries and across maternal employment status. CONCLUSION: Early childhood inequalities in overweight/obesity are pervasive across developed countries, as noted for older children and adults. However, mechanisms producing these gradients vary across national contexts. Our study shows that, given the right context, quality childcare and maternal employment can successfully support healthy weight trajectories and not contribute (or even reduce) social inequalities in early overweight/obesity.

Differences in birth weight between immigrants' and natives' children in Europe and Australia: a LifeCycle comparative observational cohort study.

OBJECTIVE: Research on adults has identified an immigrant health advantage, known as the 'immigrant health paradox', by which migrants exhibit better health outcomes than natives. Is this health advantage transferred from parents to children in the form of higher birth weight relative to children of natives? SETTING: Western Europe and Australia. PARTICIPANTS: We use data from nine birth cohorts participating in the LifeCycle Project, including five studies with large samples of immigrants' children: Etude Longitudinale Française depuis l'Enfance-France (N=12 494), the Raine Study-Australia (N=2283), Born in Bradford-UK (N=4132), Amsterdam Born Children and their Development study-Netherlands (N=4030) and the Generation R study-Netherlands (N=4877). We include male and female babies born to immigrant and native parents. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome is birth weight measured in grams. Different specifications were tested: birth weight as a continuous variable including all births (DV1), the same variable but excluding babies born with over 4500 g (DV2), low birth weight as a 0-1 binary variable (1=birth weight below 2500 g) (DV3). Results using these three measures were similar, only results using DV1 are presented. Parental migration status is measured in four categories: both parents natives, both born abroad, only mother born abroad and only father born abroad. RESULTS: Two patterns in children's birth weight by parental migration status emerged: higher birth weight among children of immigrants in France (+12 g, p<0.10) and Australia (+40 g, p<0.10) and lower birth weight among children of immigrants in the UK (-82 g, p<0.05) and the Netherlands (-80 g and -73 g, p<0.001) compared with natives' children. Smoking during pregnancy emerged as a mechanism explaining some of the birth weight gaps between children of immigrants and natives. CONCLUSION: The immigrant health advantage is not universally transferred to children in the form of higher birth weight in all host countries. Further research should investigate whether this cross-national variation is due to differences in immigrant communities, social and healthcare contexts across host countries.

Parental migrant status and health inequalities at birth: The role of immigrant educational selectivity.

Immigrants tend to exhibit better health than natives despite immigrants' more disadvantaged socioeconomic status. This paradox has often been attributed to immigrants' pre-migration selectivity. However, most empirical studies investigating the role of selectivity have focused on adult health; less attention has been paid to children's birth outcomes outside the U.S. context. Using data from the Etude Longitudinale Française depuis l'Enfance (ELFE), a nationally representative sample of over 18000 births in France in 2011, we investigate the role of immigrant parents' educational selectivity in shaping four birth outcomes: birthweight, low birthweight, prematurity, and being born small for gestational age. Results from linear and logistic regressions confirm a health advantage for children of immigrants compared to natives despite lower parental socioeconomic status, mainly among children of Middle Eastern and North African parents. Immigrant parents' positive pre-migration educational selectivity explains most of this health advantage, predominantly among children with two immigrant parents. Further, mediation analyses indicate that the effect of educational selectivity is partially mediated by parental health behaviors, particularly smoking during pregnancy. Furthermore, analyses suggest that selectivity improves birth outcomes only for children of recent arrivals, with less than five years of residence in France. The beneficial effect of selectivity declines with length of residence, suggesting that a process of "unhealthy assimilation," coupled with the cumulative exposure to health risks and disadvantaged living conditions, may lead to the erosion of the protective effect of immigrant selectivity.

The Impact of Center-Based Childcare Attendance on Early Child Development: Evidence From the French Elfe Cohort.

Proponents of early childhood education and care programs cite evidence that high-quality center-based childcare has positive impacts on child development, particularly for disadvantaged children. However, much of this evidence stems from randomized evaluations of small-scale intensive programs based in the United States and other Anglo/English-speaking countries. Evidence is more mixed with respect to widespread or universal center-based childcare provision. In addition, most evidence is based on childcare experiences of 3- to 5-year-old children; less is known about the impact of center-based care in earlier childhood. The French context is particularly suited to such interrogation because the majority of French children who attend center-based care do so in high-quality, state-funded, state-regulated centers, known as crèches, and before age 3. We use data from a large, nationally representative French birth cohort, the Étude Longitudinale Français depuis l'Enfance (Elfe), and an instrumental variables strategy that leverages exogenous variation in both birth quarter and local crèche supply to estimate whether crèche attendance at age 1 has an impact on language, motor skills, and child behavior at age 2. Results indicate that crèche attendance has a positive impact on language skills, no impact on motor skills, and a negative impact on behavior. Moreover, the positive impact on language skills is particularly concentrated among disadvantaged children. This implies that facilitating increased crèche access among disadvantaged families may hold potential for decreasing early socioeconomic disparities in language development and, given the importance of early development for later-life outcomes, thereby have an impact on long-term population inequalities.

COVID-19 lockdowns and demographically-relevant Google Trends: A cross-national analysis.

The spread of COVID-19 and resulting local and national lockdowns have a host of potential consequences for demographic trends. While impacts on mortality and, to some extent, short-term migration flows are beginning to be documented, it is too early to measure actual consequences for family demography. To gain insight into potential future consequences of the lockdown for family demography, we use cross-national Google Trends search data to explore whether trends in searches for words related to fertility, relationship formation, and relationship dissolution changed following lockdowns compared to average, pre-lockdown levels in Europe and the United States. Because lockdowns were not widely anticipated or simultaneous in timing or intensity, we exploit variability over time and between countries (and U.S. states). We use a panel event-study design and difference-in-differences methods, and account for seasonal trends and average country-level (or state-level) differences in searches. We find statistically significant impacts of lockdown timing on changes in searches for terms such as wedding and those related to condom use, emergency contraception, pregnancy tests, and abortion, but little evidence of changes in searches related to fertility. Impacts for union formation and dissolution tended to only be statistically significant at the start of a lockdown with a return to average-levels about 2 to 3 months after lockdown initiation, particularly in Europe. Compared to Europe, returns to average search levels were less evident for the U.S., even 2 to 3 months after lockdowns were introduced. This may be due to the fact, in the U.S., health and social policy responses were less demarcated than in Europe, such that economic uncertainty was likely of larger magnitude. Such pandemic-related economic uncertainty may therefore have the potential to slightly increase already existing polarization in family formation behaviours in the U.S. Alongside contributing to the wider literature on economic uncertainty and family behaviors, this paper also proposes strategies for efficient use of Google Trends data, such as making relative comparisons and testing sensitivity to outliers, and provides a template and cautions for their use in demographic research when actual demographic trends data are not yet available.

Many Kinds of Poverty: Three Dimensions of Economic Hardship, Their Combinations, and Children's Behavior Problems.

Income poverty, material deprivation, and subjective financial stress are three distinct dimensions of economic hardship. The majority of the theoretical and empirical literature on the effects of economic hardship on children has treated material deprivation and subjective financial stress as only mediators of the effects of income poverty, not considering the independent effects of each dimension or the effects of their combinations. Using nationally representative, longitudinal data from the Millennium Cohort Study on more than 18,000 families in the United Kingdom, we propose seven distinct experiences of economic hardship, based on the possible combinations of income poverty, material deprivation, and subjective financial stress. We use mixed- and fixed-effects linear regression models to identify whether these different economic hardship combinations are differentially associated with children's behavior problems between ages 3 and 7. We find that all economic hardship combinations, including those without income poverty, are associated with higher levels of children's behavior problems. The combination of material deprivation and subjective financial stress and the combination of all three dimensions of economic hardship are associated with the highest levels of behavior problems. Based on these findings, we argue that income poverty is an important but insufficient measure of economic hardship for children and that theory and research on the effects of economic hardship on children should consider the multidimensional nature of economic stressors for families.

Family structure trajectories and early child health in the UK: Pathways to health.

A large body of literature has shown marked differences in the average levels of resources and child well-being across different family structures. Studies have examined cognitive, educational and behavioural outcomes; less is known about differentials in physical health, and about dynamics in early childhood. Furthermore, up to the present time, less emphasis has been placed on describing the underlying mechanisms relating childhood experiences of family structure to health. In this paper, we hypothesize that socio-economic characteristics and family structure trajectories will affect every-day, more proximal processes (material, behavioural and family stress pathways) directly experienced by the child, which will in turn affect child health. Using the UK Millennium Cohort Study, a nationally representative cohort of over 19 000 children born in 2001 and living in the UK shortly thereafter, we employ Graphical Chain Models to map the processes linking family structure trajectories to three physical health outcomes at age 5: overweight/obesity, respiratory health, and accidental injury. We construct family trajectories to highlight two components: status (distinguishing between married, cohabiting and single parents), and (in)stability. We show that both status, the (in)stability of that status, and their interplay, are important components of family structure trajectories which correlate to children's early physical health. Analyses highlight the relative importance of distinct pathways across different health outcomes. As well as some outcome-specific paths, we find that "family stress" variables appeared to underscore the relationship between family structure and child physical health, pointing to the importance of such variables in understanding how family structure relates to early child health.

The perinatal health of immigrant women in France: a nationally representative study.

OBJECTIVES: Despite the healthy migrant effect, immigrants and descendants of immigrants face health challenges and socio-economic difficulties. The objective of this study is to examine the perinatal health of women of migrant origin. METHODS: The nationwide French ELFE (Etude Longitudinale Française Depuis l'Enfance) birth cohort study recruited approximately 18,000 women. We studied pre-pregnancy BMI, gestational diabetes mellitus (GDM), as well as tobacco, and alcohol consumption during pregnancy according to migrant status and region of origin. RESULTS: Women from North Africa and Turkey had a higher risk of pre-pregnancy overweight and GDM, while women from Eastern Europe and Asia had a lower risk of pre-pregnancy overweight and obesity, but a higher risk of GDM compared to non-immigrants. Women from Sub-Saharan Africa had a higher risk of being overweight or obese pre-pregnancy. Compared to non-immigrants, immigrants-but not descendants of immigrants-had lower levels of tobacco smoking, while descendants of immigrants were less likely to drink alcohol during pregnancy. CONCLUSIONS: Pregnant women of migrant origin have particular health needs and should benefit from a medical follow-up which addresses those needs.

Maternal Repartnering: Does Father Involvement Matter? Evidence from United Kingdom.

Maternal repartnering may have benefits for mothers and children. Yet, mothers with coresident children face more difficulty repartnering than other adults. Despite that shared physical custody and father involvement have increased over time, few studies have examined whether nonresidential father involvement and financial support are associated with subsequent maternal repartnering. Using data from the UK Millennium Cohort Study, we found a negative relationship between nonresident father involvement and subsequent maternal repartnering among mothers who were neither married nor cohabiting at childbirth. A potential explanation is that these parents may be engaged in fluid and uncertain relationships, and that the ambiguity thereof may discourage maternal repartnering. We found no association between father involvement and maternal repartnering for mothers who were cohabiting with or married to the father at the time of birth. Finally, we found no association between child support (maintenance) receipt and maternal repartnering, regardless of parental relationship status at the birth.

Socioemotional wellbeing of mixed race/ethnicity children in the UK and US: Patterns and mechanisms.

Existing literature suggests that mixed race/ethnicity children are more likely to experience poor socioemotional wellbeing in both the US and the UK, although the evidence is stronger in the US. It is suggested that this inequality may be a consequence of struggles with identity formation, more limited connections with racial/ethnic/cultural heritage, and increased risk of exposure to racism. Using data from the UK Millennium Cohort Study (n = 13,734) and the US Early Childhood Longitudinal Study-Birth Cohort (n ~ 6250), we examine differences in the socioemotional wellbeing of mixed and non-mixed 5/6 year old children in the UK and US and explore heterogeneity in outcomes across different mixed groups in both locations. We estimate a series of linear regressions to examine the contribution of factors that may explain any observed differences, including socio-economic and cultural factors, and examine the extent to which these processes vary across the two nations. We find no evidence of greater risk for poor socioemotional wellbeing for mixed race/ethnicity children in both national contexts. We find that mixed race/ethnicity children experience socio-economic advantage compared to their non-mixed minority counterparts and that socio-economic advantage is protective for socioemotional wellbeing. Cultural factors do not contribute to differences in socioemotional wellbeing across mixed and non-mixed groups. Our evidence suggests then that at age 5/6 there is no evidence of poorer socioemotional wellbeing for mixed race/ethnicity children in either the UK or the US. The contrast between our findings and some previous literature, which reports that mixed race/ethnicity children have poorer socioemotional wellbeing, may reflect changes in the meaning of mixed identities across periods and/or the developmental stage of the children we studied.

Women's mental health in the perinatal period according to migrant status: the French representative ELFE birth cohort.

Background: Mental health problems in the perinatal period are common. We examined associations between different categories of migrant status and region of origin in relation to mental health during pregnancy and at 2 months post-partum. Methods: We analyzed data from the French nationally representative Etude Longitudinale Française depuis l'Enfance birth cohort (n = 17 988). Migrant status was divided into five categories: 'majority population', 'descendants with one migrant parent', 'descendants with two migrant parents', 'naturalized migrant' and 'non-naturalized migrant women'. Multivariate logistic regression models were implemented to examine associations between migrant status and mental health outcomes: persistent psychological difficulties during pregnancy as well as mother's depression and poor self-reported health at 2 months post-partum. Results: After adjusting for covariates, migrant status was not associated with psychological difficulties during pregnancy. Descendants of migrants had comparable mental health to the majority population. Non-naturalized migrant women were more likely to experience depression (odd's ratio (OR)= 1.66, 95%confidence interval (CI): 1.27, 2.20) and poor self-reported health (OR = 1.45, 95%CI: 1.06, 1.98) during the post-partum period. The region of origin was associated with post-partum health independently of migrant status, such that women from Africa and Turkey were most likely to have depression or poor self-rated health. Conclusion: First, but not second, generation migrant women appear to have high levels of mental health difficulties during the post-partum period. Women from North Africa, Sub-Saharan Africa, and Turkey have higher levels of distress than those from other regions. In particular, non-naturalized migrant appear to be a vulnerable group; they may disproportionately face stressors that increase their risk for post-partum depressive symptoms.

The Great Recession and the Health of Young Children: A Fixed-Effects Analysis in Ireland.

Economic recessions have been linked to adult health, but few studies have examined how recessions influence the health of young children. This study examined the impact of life transitions linked to the recent financial crisis on the health of young children in Ireland. Data came from the Growing Up in Ireland Infant Cohort Study (n = 11,134), which assessed children before (2008), during (2011), and after (2013) the Great Recession that followed the financial crisis of 2008 and incorporated questions on the impacts of the financial crisis on families. Using fixed-effects models to control for confounding, we found that a reduction in welfare benefits during the recession was associated with a significant increase in the risks of asthma (ß = 0.014, 95% confidence interval (95% CI): 0.004, 0.023) and atopy (ß = 0.014, 95% CI: 0.001, 0.027). While parental job loss was not associated with child health, a reduction in working hours was associated with increased reports of child health problems (ß = 0.024, 95% CI: 0.004, 0.043), as were difficulties affording basic necessities (ß = 0.019, 95% CI: 0.001, 0.038). Results suggest that failing to protect vulnerable families and children during economic recessions may have long-lasting implications for child health.

Do flexible work policies improve parents' health? A natural experiment based on the UK Millennium Cohort Study.

BACKGROUND: There is limited evidence of the impact of policies to promote work-family balance on family health. Exploiting the introduction of the UK Flexible Working Act (2003), we examined whether a policy that grants parents the right to request flexible work influences their health and well-being. METHODS: Using the UK Millennium Cohort Study, we focus on 6424 mothers employed in 2001-2002, when the cohort child was 9 months old, until their child's seventh birthday. We used a difference-in-differences (DiD) approach to compare changes in outcomes before and after the policy among mothers most likely to benefit and mothers unlikely to benefit from the policy. RESULTS: Flexible working increased in a small group of mothers (n=548) whose employer did not offer work flexibility before the reform (treatment group). By contrast, among mothers whose employer already offered flexible work before the reform (control group, n=5810), there was little change or a slight decline in flexible working. DiD estimates suggest that the policy was associated with an increase in flexible working (37.5 percentage points, 95% CI 32.9 to 41.6), but it had no impact on self-rated health (-1.6 percentage points, 95% CI -4.4 to 1.1), long-term illness (-1.87 percentage points, 95% CI -4.3 to 0.5) or life satisfaction scores (ß=0.04, 95% CI -0.08 to 0.16). CONCLUSION: The Flexible Working Act increased flexible working only among a small group of mothers who had not yet the right to request work flexibility, but it had no impact on their health and well-being. Policies promoting work flexibility may require stronger incentives for both parents and employers.

The Inter-relationship of Adolescent Unhappiness and Parental Mental Distress.

PURPOSE: Substantial evidence supports the hypothesis that parental well-being impacts upon child well-being and that this relationship is bidirectional. Here we explore how, in a large, nationally representative sample, both parents' mental distress relates over time to each other's mental distress and to their adolescent child's unhappiness, and vice versa. METHODS: Analyses were conducted using data from waves one to five (2009/10-2014/15) of Understanding Society, the UK Household Longitudinal Study. Understanding Society collects data on adults' mental distress (General Health Questionnaire), and on youths' (age: 10-15 years) unhappiness in relation to their school work, appearance, family, friends, school, and life as a whole. We use repeated-measures structural equation models to investigate the reciprocal relationships between both parents' distress and their child's unhappiness, using both longitudinal cross-lagged and nonrecursive contemporaneous specifications. The analytic sample is 1,883 triads (adolescent child, mother, and father) with data at two or more consecutive time points. Analyses are stratified by adolescent gender. RESULTS: Our results show that parental mental distress predicts unhappiness of girls but not that of boys. Reciprocal associations of maternal and paternal mental distress are evident in families with an adolescent daughter. Unhappiness of adolescents does not predict their parents' mental distress. Results are similar whether examined contemporaneously or over time. CONCLUSIONS: Our findings support the suggestion that the family should be considered as a dynamic system, for instance when planning clinical interventions. This is particularly pertinent in families with an adolescent daughter present.

Asthma trajectories in early childhood: identifying modifiable factors.

BACKGROUND: There are conflicting views as to whether childhood wheezing represents several discreet entities or a single but variable disease. Classification has centered on phenotypes often derived using subjective criteria, small samples, and/or with little data for young children. This is particularly problematic as asthmatic features appear to be entrenched by age 6/7. In this paper we aim to: identify longitudinal trajectories of wheeze and other atopic symptoms in early childhood; characterize the resulting trajectories by the socio-economic background of children; and identify potentially modifiable processes in infancy correlated with these trajectories. DATA AND METHODS: The Millennium Cohort Study is a large, representative birth cohort of British children born in 2000-2002. Our analytical sample includes 11,632 children with data on key variables (wheeze in the last year; ever hay-fever and/or eczema) reported by the main carers at age 3, 5 and 7 using a validated tool, the International Study of Asthma and Allergies in Childhood module. We employ longitudinal Latent Class Analysis, a clustering methodology which identifies classes underlying the observed population heterogeneity. RESULTS: Our model distinguished four latent trajectories: a trajectory with both low levels of wheeze and other atopic symptoms (54% of the sample); a trajectory with low levels of wheeze but high prevalence of other atopic symptoms (29%); a trajectory with high prevalence of both wheeze and other atopic symptoms (9%); and a trajectory with high levels of wheeze but low levels of other atopic symptoms (8%). These groups differed in terms of socio-economic markers and potential intervenable factors, including household damp and breastfeeding initiation. CONCLUSION: Using data-driven techniques, we derived four trajectories of asthmatic symptoms in early childhood in a large, population based sample. These groups differ in terms of their socio-economic profiles. We identified correlated intervenable pathways in infancy, including household damp and breastfeeding initiation.

Changes in family structure in early childhood in the Millennium Cohort Study.

This article develops a typology of family change over the first five years of children's lives using data from the Millennium Cohort Study. It examines the changes over time of parental living arrangements and describes a range of social, economic and well-being indicators. It shows that nearly three quarters of this sample of young children have not experienced changes in family structures. The most advantaged group appears to be children living with continuously married parents, followed by those who live with cohabiting parents who marry. Children who experienced changes in family structure are a diverse group. Coupled parents who separate suffer the largest drop in income over five years. Lone parents who partner gain the most income. However, their incomes are still much lower than continuously partnered parents. This article suggests that using static or overly simplified measures of family structure hides important variations in the experiences of children.

Ethnic variation in childhood asthma and wheezing illnesses: findings from the Millennium Cohort Study.

BACKGROUND: It is not clear how respiratory morbidity during early childhood varies across ethnic groups in the UK. This article seeks to determine whether asthma and wheeze illnesses during early childhood differ across ethnic groups and what factors explain observed differences. METHODS: Data from the UK Millennium Cohort Study on 14,630 children were analyzed from the second sweep of interviews. Parental interviews were conducted when the cohort member was aged approximately 3(1/2) years. Data collected included the occurrence of asthma and wheezing symptoms, biological and socio-economic factors and markers of cultural tradition. RESULTS: At age 3, 12.3% (n = 1,902) of children had ever had asthma and 20.0% (n = 3,030) had wheezed in the last 12 months. 18.2% of Black Caribbean children and 5.0% of Bangladeshi children reported ever asthma compared with 11.6% of White children. 25.5% of Black Caribbean children and 8.7% of Bangladeshi reported recent wheeze compared with 19.4% of White children. After adjustments, the disadvantage in asthma and recent wheeze for Black Caribbeans was mostly explained by socio-economic factors (adjusted odds ratios (OR) for asthma 1.42, 95% confidence interval (CI) 0.96-2.09; recent wheeze 1.18, 0.85-1.64). The Bangladeshi advantage lost statistical significance, mostly due to adjustment for markers of cultural tradition (adjusted OR for asthma 0.40, 95% CI 0.15-1.09; recent wheeze 0.44, 0.18-1.19). CONCLUSION: Our results point to the need to locate child health within the unique context of each ethnic group and to recognize that potential explanations for observed differences do not necessarily hold for all groups.