Children who grow up in lower socioeconomic households have less access to health education, putting them at risk for making poor health decisions
Thesis overview- Children who grow up in lower socioeconomic households have less access to health education, putting them at risk for making poor health decisions. This is because economic classes are the main determinants of how resources and facilities required for health education are distributed. Economic inequality has always been a common trend in most parts of the world. The poorer households often lack the exposure to conditions that would favor their efforts of trying to advance to a higher class. The life experiences, people they interact with, and the level of education for themselves as well as their parents make it (more) difficult to access proper health-related information. Being inadequately informed can also contribute as a barrier. As a result, they are more susceptible to a range of diseases, including psychological disorders due to the higher incidence of drug use and other substances which lead to deterioration of their health. A few major concerns for an epidemiologist in this context would include: Diseases (cardiovascular disease, hypertension, arthritis, diabetes, cancer, etc.) in these lower SES areas and their prevalence when compared to higher income areas, highest level of education obtained by the parents, the proportion of drug abuse in different regions, the likelihood of existing norms (which may be a major issue exposing children to more risks), and the potential implementation of cost-friendly interventions (at which stage in life might this intervention be most effective).
I. Introduction
a. Metzler, M., Merrick, M. T., Klevens, J., Ports, K. A., & Ford, D. C. (2017). Adverse childhood experiences and life opportunities: Shifting the narrative. Children and youth services review, 72, 141-149. https://doi.org/10.1016/j.childyouth.2016.10.021
i. This article explores child abuse and neglect associated with early diversities result in diminished well-being of the individual lifetime and the next generation. Research conducted in ten states and the District of Columbia shows that when a child has adverse life experiences result in a great adverse impact in education and employment resulting from socioeconomic status, thus leading to poor decision making pertaining to quality healthcare services. The evidence suggests that those in adverse childhood experiences result in a child dropping out of school, leading to living in a family below the centralized poverty level leading to poor healthcare services. The source is essential as it evaluates the structural policies and processes that may result in intergenerational continuity from poor childhood experiences resulting from child abuse, neglect, and suffering. The information therein will be important in preventing early diversity as it will widen community and professional understanding to the next generations on the correlation between early diversity and poverty.
b. Daniel, H., Bornstein, S. S., & Kane, G. C. (2018). Addressing social determinants to improve patient care and promote health equity: an American College of Physicians position paper. Annals of internal medicine, 168(8), 577-578. https://doi.org/10.7326/M17-2441
i. The article discusses the social factors of health such as conditions where a person was born, grew, and lives as the major cause of health inequalities. Over the last three decades, evidence states that the nonmedical factors have overall effects on the individuals’ physical and mental health. Studies in the United States show that numbers of deaths attributed by low social support due to poor health decisions resulted from low social and economic status, similar to the number of cases reported in lung cancer. Social determinants are key factors to health care provision and decision making involving healthcare. The source is of primary importance as it acknowledges the role social determinants play in the provision of healthcare and decision-making and examines the complexities associated with them and the recommended intervention for better integrating social determinants in healthcare service. The article’s information will be of importance in providing health equity when systemic issues concerning social determinants are addressed and curbed.
c. Braveman, P., & Barclay, C. (2009). Health disparities beginning in childhood: a life-course perspective. Pediatrics, 124 Suppl 3, S163–S175. https://doi.org/10.1542/peds.2009-1100D
i. Bravenman and Barclay (2009) contend for the value of life-long perception as a device for appreciative and addressing health differences across socioeconomic and ethnic groups, chiefly in childhood. They advocate for the life-course perception, which focuses on accepting how early-life involvements can shape health transversely an entire lifetime and potentially across cohorts. They emphasize this approach due to its relevance in understanding and addressing health differences as social and physical circumstantial factors that dominate the social and ethnic differences in health. They also focus mainly on how early-life experiences shape adult health. They also recommend improving children’s living conditions as a plan for refining health and decreasing health disparities.
d. Thoits P. A. (2010). Stress and health: major findings and policy implications. Journal of health and social behavior, 51 Suppl, S41–S53. https://doi.org/10.1177/0022146510383499
i. In this article, Thoits (2010) mainly focuses on five major findings resulting from forty decades of sociological stress research. In the first finding, it is evident that when traumas, chronic strains, and negative events are measured systematically, their damaging impacts on mental and physical health are significant. The author also examines how variance in exposure to stressful involvements acts as a primary way to produce gender, marital status, and social class disparities in physical and mental health. Third, the author explores how minority groups’ members are at a higher risk of getting additional harm caused by discrimination stress. The author also elaborates on how stressors increase over the life course widening gaps between advantaged and disadvantaged group members. On the last finding, the author focuses on how the impacts of stressors on health and well-being are lowered when people have high levels of mastery, self- esteem, and social support. The author conclusively recommends that different measures be put in place to curb health inequalities that predispose people to stressors. The author stresses how policies should be formulated to target children at lifetime risks of ill health and stress because of stressful family surroundings and poverty.
e.
II. Known SES disparities
a. Pampel, F. C., Krueger, P. M., & Denney, J. T. (2010). Socioeconomic disparities in health behaviors. Annual review of sociology, 36, 349-370. https://www.annualreviews.org/doi/abs/10.1146/annurev.soc.012809.102529
i. The article highlights that social-economic factors such as wealth, incomes, and education are the fundamental causes of a wide-range health outcome. It reviews the importance of social, economic factors in shaping health and explaining their effects. The article relies on the social determinants of health (SDH) that reveal the powerful role of social and economic factors shaping general health. It also discusses the challenges related to advancing this knowledge and how they can be overcome. To solve social and economic status among children from a financially challenged background, healthcare workers should strengthen the laid out procedures of assessing and responding to social needs through referrals or legal and social services.
b. Wright, E. R., & Perry, B. L. (2010). Medical sociology and health services research: past accomplishments and future policy challenges. Journal of health and social behavior, 51 Suppl, S107–S119. https://doi.org/10.1177/0022146510383504
i. The article addresses the rising cost of quality health care in the United States in recent years. This makes it difficult for American children, especially from the social-economically challenged background, to access quality healthcare. The main concern is to address the unequal distribution of health services based on SES factors and spotlights on how proper distribution of health services may become fundamental social equality across all communities. The centralized management and coordination may be a great beginning of a better future of equalities in the United States. The study describes that healthcare organizations’ dynamics and structures can shape the outcomes, effectiveness, and qualities of health services for different groups and communities.
c. Wise, P. H. (2009). Confronting social disparities in child health: a critical appraisal of life-course science and research. Pediatrics, 124(Supplement 3), S203-S211. https://doi.org/10.1542/peds.2009-1100H
i. This article’s primary purpose is critically assessing a new life-science course and ensuring how best it can facilitate a more informed and constructive purpose in protecting against children’s health disparities. The article highlights that the existing social disparities have the involvement of either science or justice. The article acknowledges that the history of child development maps the life course framework and influences a child’s capability even beyond health. The article also recognizes the struggle for equity to a child’s health outcomes, demands coherent voice analysis, and comprehensive vision. The study teaches that if especial polices protecting child health disparities are put together, and they will best ensure that all children enjoy a life course that is socially just and optimal.
d. Chen, E., Matthews, K. A., & Boyce, W. T. (2002). Socioeconomic differences in children’s health: how and why do these relationships change with age?. Psychological bulletin, 128(2), 295. https://psycnet.apa.org/buy/2002-00947-006
i. This article explores the special effects of socioeconomic rank on health. The authors scrutinized the literature and established support for a childhood socioeconomic status effect, whereby each decline in the socioeconomic eminence was connected with an amplified health risk. The authors discovered how this relationship altered as children underwent normal developmental changes and anticipated 3 models to describe the temporal arrays. The authors found that a model’s capability to explain Socioeconomic-health relationships mottled across health outcomes. Childhood harm exhibited stronger socioeconomic status relations at younger ages, whereas smoking exhibited stronger relationships with Socioeconomic status in puberty. Finally, the authors suggest the developmental methodology to exploring appliances that link socioeconomic status and child health.
e. Kaplan, S. A., Madden, V. P., Mijanovich, T., & Purcaro, E. (2013). The perception of stress and its impact on health in poor communities. Journal of community health, 38(1), 142–149. https://doi.org/10.1007/s10900-012-9593-5.
i. This article examines the role of stress in explaining persistent differences in health outcomes in poor communities. It also strives to illuminate the relation amid the stress and health behaviors. The author focuses on a group of participants from low in-come communities from SouthBronx, New York, and Highbridge. The majority of the focus group participants directly related stress to poor health. In contrast, others indirectly related the two, citing sleep deprivation, uncontrolled eating, substance abuse, smoking, aggression, and violence, among others as the main causes. The participants also explained why stress leads to unhealthy behavior, which included; adaptive behavior, disregarding the future, competing priorities, and diminution of willpower. Their understanding of the relation between the two elaborates how stress may create a difference in health outcomes and generate challenges in altering poor communities’ health behaviors.
f. Victora, C. G., Wagstaff, A., Schellenberg, J. A., Gwatkin, D., Claeson, M., & Habicht, J. P. (2003). Applying an equity lens to child health and mortality: more of the same is not enough. The Lancet, 362(9379), 233-241. https://www.sciencedirect.com/science/article/pii/S0140673603139177
i. Victoria et al. 2003 address the widening gap in exposure to health risks between poor children and wealthy children. The article discloses that this may be brought about by being less resistant to diseases because of under nutrition, sanitation, and hazards normally from poor communities. The research findings have shown that the disparities were compounded by a lack of curative and preventive interventions. To solve this problem, universal health coverage can be a great solution for improving equality in a healthcare setting. The article recommends that prioritizing health equity in child health interventions will ensure that accountability in health care is achieved and the child mortality rate is minimized.
g.
III. Availability and affordability
a. Patrick, H., & Nicklas, T. A. (2005). A review of family and social determinants of children’s eating patterns and diet quality. Journal of the American college of nutrition, 24(2), 83-92. https://www.tandfonline.com/doi/abs/10.1080/07315724.2005.10719448
i. The article relates the childhood’s feeding habits related outcomes such as obesity and nutrition disorders. The research proved the children’s eating pattern was greatly influenced by the accessibility of food and other social environments. The children from wealthy families ate much a where some had healthy body others suffered obesity while in low-income families some suffered malnutrition and other nutrition disorders. The research shows that parents have to control the eating pattern of their children to prevent feeding-related disorders. Such roles include scheduled mealtime, ensuring the child has eaten enough, not more than enough, and having a balanced diet. The article recommends addressing interventions intended at improving children’s nutrition to be put in place.
b. Dammann, K. W., & Smith, C. (2009). Factors affecting low-income women’s food choices and the perceived impact of dietary intake and socioeconomic status on their health and weight. Journal of nutrition education and behavior, 41(4), 242-253. https://www.sciencedirect.com/science/article/pii/S1499404608007586
i. The article investigated the factor that affects the choice of food and beliefs in health among low-income families in relation to birth weight and social, economic status. The research involved 92 low-income women aged between 18-65 years and at least one child aged nine months to13 years in their families. The findings showed that over 75 percent of the women were overweight and had health concerns such as diabetes and hypertension. Although many would like to eat healthy food, they perceived it as unaffordable. The study shows that the disconnect between diet and health among women from low income calls for nutrition intervention to educate these families on the importance of eating quality food despite the challenge of cost and how helpful the food may be in the fight for diseases and protection of future generation.
c. Inglis, V., Ball, K., & Crawford, D. (2005). Why do women of low socioeconomic status have poorer dietary behaviors than women of higher socioeconomic status? A qualitative exploration. Appetite, 45(3), 334-343. https://doi.org/10.1016/j.appet.2005.05.003
i. Crawford and Inglis (2005) examine the reasons as to why women of truncated socioeconomic status have shoddier dietary behaviors compared to other women of sophisticated socioeconomic status. Their focus is mainly in developing countries where people of low socioeconomic rank are less expected to consume diets reliable with dietary rules. Their focus groups included women from all levels, including high and mid women, consisting of 19 and 18 from low socioeconomic status. An ecological framework was used to develop questions that they used in their interview questions and interpret the data. Several key influencers varied by socioeconomic status. These comprised food-related values such as health awareness and lack of time due to family obligations and the perceived great cost of healthy eating and absence of time due to other work obligations. The author proposes that public health approaches aimed at dropping socioeconomic dissimilarities in diet might center on encouraging healthy nourishments that are low and promoting time-efficient diet preparation approaches for most women.
d.
IV. Epidemiology
a. Mackenbach, J. P., Kulhánová, I., Bopp, M., Deboosere, P., Eikemo, T. A., Hoffmann, R., Kulik, M. C., Leinsalu, M., Martikainen, P., Menvielle, G., Regidor, E., Wojtyniak, B., Östergren, O., Lundberg, O., & EURO-GBD-SE Consortium (2015). Variations in the relation between education and cause-specific mortality in 19 European populations: a test of the “fundamental causes” theory of social inequalities in health. Social science & medicine (1982), 127, 51–62. https://doi.org/10.1016/j.socscimed.2014.05.021
i. The article reviews the Link and Phelan 1995 theory of “fundamental cause,” which addresses the persistence of inequalities lead by social, economic status. The authors conducted the study by comparing the magnitude of disparities in mortality between preventable and unpreventable deaths. The research involved 19 Europeans, and it measured whether the disparities in mortality from avertible causes are greater in countries with greater resource inequalities. The research finding shows that inequalities in mortality are relatively high for preventable causes that to that of unpreventable causes due to lower education and SES factors. The study highlights that the difference between preventable and non-preventable are greater for causes that open to change of behavior and are not open to injury prevention among women and children.
b. de Gelder, R., Menvielle, G., Costa, G., Kovács, K., Martikainen, P., Strand, B. H., & Mackenbach, J. P. (2017). Long-term trends of inequalities in mortality in 6 European countries. International journal of public health, 62(1), 127–141. https://doi.org/10.1007/s00038-016-0922-9
i. Gelder et al. (2017) assess the changing tendencies in inequalities in mortality throughout the 1970-2010 periods and how it differed between certain countries, including Norway, England, Finland, France, and Hungary. During their research, the total mortality data by educational level were composed and synchronized and both relative and absolute measures of inequality in mortality calculated. A cross-examination of their findings reveals that it is only over several decades that one can see the very vigorous nature of mortality disparities trends. This is evident in the article as some of the countries that initially had small mortality inequalities rose to the highest. In contrast, others made significant progress in reducing variations in mortality. The article indicates that disparities in mortality are not incontrovertible in that while certain countries are experiencing dramatic obstructions, others have made extensive progress in decreasing inequalities in mortality.
c. Tienda, M., & Haskins, R. (2011). Immigrant children: Introducing the issue. The future of children, 3-18. https://www.jstor.org/stable/41229009
i. Tienda, M., & Haskins, R. 2011 expressed their concern on how many immigrants’ children are exposed to high health risks due to poverty and mental health-related disorders. The article’s main aim was to examine immigrant children’s well-being and what can be done to minimize the risks facing them. The research indicates that for every 100 immigrants, 15 of them are exposed to high risks of SES related health problems such as improper medication, malnutrition, and starvation. The article recommends a free education and universal health coverage to be the best solution for the problems faced by American immigrants.
V. Interventions/ policy changes –
a. Thoits P. A. (2010). Stress and health: major findings and policy implications. Journal of health and social behavior, 51 Suppl, S41–S53. https://doi.org/10.1177/0022146510383499
i. In this article, Thoits (2010) mainly focuses on five major findings resulting from forty decades of sociological stress research. In the first finding, it is evident that when traumas, chronic strains, and negative events are measured systematically, their damaging impacts on mental and physical health are significant. The author also examines how variance in exposure to stressful involvements acts as a primary way to produce gender, marital status, and social class disparities in physical and mental health. Third, the author explores how minority groups’ members are at a higher risk of getting additional harm caused by discrimination stress. The author also elaborates on how stressors increase over the life course widening gaps between advantaged and disadvantaged group members. On the last finding, the author focuses on how the impacts of stressors on health and well-being are lowered when people have high levels of mastery, self- esteem, and social support. The author conclusively recommends that different measures be put in place to curb health inequalities that predispose people to stressors. The author stresses how policies should be formulated to target children at lifetime risks of ill health and stress because of stressful family surroundings and poverty.
b. Wise, P. H. (2009). Confronting social disparities in child health: a critical appraisal of life-course science and research. Pediatrics, 124(Supplement 3), S203-S211. https://doi.org/10.1542/peds.2009-1100H
i. This article’s primary purpose is critically assessing a new life-science course and ensuring how best it can facilitate a more informed and constructive purpose in protecting against children’s health disparities. The article highlights that the existing social disparities have the involvement of either science or justice. The article acknowledges that the history of child development maps the life course framework and influences a child’s capability even beyond health. The article also recognizes the struggle for equity to a child’s health outcomes, demands coherent voice analysis, and comprehensive vision. The study teaches that if especial polices protecting child health disparities are put together, and they will best ensure that all children enjoy a life course that is socially just and optimal.
c. Ochoa, E. R., & Nash, C. (2009). Community engagement and its impact on child health disparities: building blocks, examples, and resources. Pediatrics, 124(Supplement 3), S237-S245.https://doi.org/10.1542/peds.2009-1100L
i. The article examines the impacts of interventions that communities can apply to minimize minor health disparities. This article’s findings show that health interventions and interdisciplinary collaborations for child health improvements have much to offer primary care. The care providers should properly cultivate the history of the patient’s family relationships and background to learn to work fit in the related community. By understanding of the significance of minor health inequalities, pediatrics must make a transition from “one on one” clinical care to community-based partnerships. This will build long-term strategic initiatives to fight disparities and give them open doors to work easily in the communities. The article teaches that effective partnerships between the clinical care providers and the communities can be essential in fighting a child’s health disparities.
d. Chamberlin, L. A., Sherman, S. N., Jain, A., Powers, S. W., & Whitaker, R. C. (2002). The challenge of preventing and treating obesity in low-income preschool children: perceptions of WIC health care professionals. Archives of pediatrics & adolescent medicine, 156(7), 662–668. https://doi.org/10.1001/archpedi.156.7.662.
i. In this article, Chamberlin et al. (2002) examine the challenges of preventing and treating obesity in preschool children from low-income backgrounds. They suggest new strategies that are needed to address the altered perceptions that are alleged by customers and health care experts. Their research focuses on women, infants, and children from Kentucky. Of the 19 health care professionals partaking, all had provided nutrition counseling in WIC. They also noted that many were still at nutritional risk despite the exceptional supplemental nutrition program for women, infants, and children (WIC). The WIC was motivated by the fact that many low-income children were inadequately nourished and would not achieve optimal growth and development. Despite this move, the obesity was still a great problem facing children enrolled in WIC. They recommended that there was an essence of increasing awareness among mothers about obesity in their children. The researchers choose to use qualitative research methods as obesity was a complex topic.
1. This was showing a change that was already implemented but another problem arose. What can we take from this study to help change the current rising obesity rates
e. Victora, C. G., Wagstaff, A., Schellenberg, J. A., Gwatkin, D., Claeson, M., & Habicht, J. P. (2003). Applying an equity lens to child health and mortality: more of the same is not enough. The Lancet, 362(9379), 233-241. https://www.sciencedirect.com/science/article/pii/S0140673603139177
i. Victoria et al. 2003 address the widening gap in exposure to health risks between poor children and wealthy children. The article discloses that this may be brought about by being less resistant to diseases because of under nutrition, sanitation, and hazards normally from poor communities. The research findings have shown that the disparities were compounded by a lack of curative and preventive interventions. To solve this problem, universal health coverage can be a great solution for improving equality in a healthcare setting. The article recommends that prioritizing health equity in child health interventions will ensure that accountability in health care is achieved and the child mortality rate is minimized.
f.
