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Cumulative hardship and wellness of low-income, young children: multisite surveillance study
Journal article

Cumulative hardship and wellness of low-income, young children: multisite surveillance study

Deborah A Frank, Patrick H Casey, Maureen M Black, Ruth Rose-Jacobs, Mariana Chilton, Diana Cutts, Elizabeth March, Timothy Heeren, Sharon Coleman, Stephanie Ettinger de Cuba, …
Pediatrics (Evanston), v 125(5), pp e1115-e1123
May 2010
DOI: https://doi.org/10.1542/peds.2009-1078
PMID: 20385641
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Academic Medical Centers - statistics & numerical data Cross-Sectional Studies Primary Health Care - statistics & numerical data Psychosocial Deprivation Anthropometry Humans Life Change Events Child, Preschool Infant Logistic Models Male Poverty - psychology Emergency Service, Hospital - statistics & numerical data Health Surveys Medically Uninsured - statistics & numerical data Female Medically Uninsured - psychology Quality of Life - psychology Health Status Population Surveillance Poverty - statistics & numerical data
The goals were to generate a cumulative hardship index and to evaluate its association with the well-being of children 4 to 36 months of age without private health insurance. Cross-sectional surveys were linked to anthropometric measures and medical record review at 5 urban medical centers (July 1, 2004, to December 31, 2007). Cumulative hardship index scores ranged from 0 to 6, with food, housing, and energy each contributing a possible score of 0 (secure), 1 (moderately insecure), or 2 (severely insecure) to generate scores indicating no hardship (score of 0), moderate hardship (scores of 1-3), or severe hardship (scores of 4-6). The outcome was a composite indicator of child wellness, including caregivers' reports of children's good/excellent heath, no hospitalizations, not being developmentally at risk, and anthropometric measurements within normal limits. Covariates were selected a priori and through association with predictors and outcomes. Of 7141 participants, 37% reported no material hardship, 57% moderate hardship, and 6% severe hardship. Multivariate logistic regression analyses showed ordinal association between the cumulative hardship index and children's adjusted odds of wellness (severe versus no hardship, adjusted odds ratio [AOR]: 0.65 [95% confidence interval [CI]: 0.51-0.83]; severe versus moderate hardship, AOR: 0.73 [95% CI: 0.58-0.92]; moderate versus no hardship, AOR: 0.89 [95% CI: 0.79-0.99]). Increasing levels of a composite measure of remediable adverse material conditions correlated with decreasing adjusted odds of wellness among young US children.

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128 citations in Web of Science
131 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#10 Reduced Inequalities
#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Pediatrics
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