Understanding child disadvantage from a social determinants perspective
Understanding child disadvantage from a social determinants perspective
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DOI：
10.1136/jech-2017-209036
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发表时间：
2018-03-01
影响因子：
6.3
通讯作者：
Kochanoff, Anita T.
中科院分区：
文献类型：
--
作者：
Goldfeld, Sharon;O'Connor, Meredith;Kochanoff, Anita T.
背景儿童健康和发育不平等存在于所有国家。全面且强大的劣势概念是发展可以揭示童年不平等程度的证据基础的基础，并确定可修改的变化利用点。我们概念化和测试一个与社会决定因素和生物生物学观点一致的儿童劣势的框架。方法是对澳大利亚儿童的纵向研究，是两个澳大利亚儿童的全国代表性样本2004年。分析的重点是在4-5岁时收集的劣势指标。验证性因素分析用于测试理论上知情的劣势模型。通过与8 - 9年的学业表现的关联来检查并发有效性。归因于包括社会人口统计学的四个潜在因素（10个指标），地理环境（三个指标），健康状况（三个指标）和风险因素（14个指标）是发现比替代模型更适合数据。每个因素都与学习成绩相关，提供了并发有效性的证据。判断该研究提供了一个理论上知情且经验测试的框架，用于操作相对儿童劣势。通过捕获儿童在发展发展的多种环境中，理解和解决不平等的理解和解决不平等。
Background Child health and developmental inequities exist in all countries. Comprehensive and robust concepts of disadvantage are fundamental to growing an evidence base that can reveal the extent of inequities in childhood, and identify modifiable leverage points for change. We conceptualise and test a multidimensional framework of child disadvantage aligned to a social determinants and bioecological perspective.Methods The Longitudinal Study of Australian Children is a nationally representative sample of two cohorts of Australian children, including the birth cohort of 5107 infants, which commenced in May 2004. The analysis focused on disadvantage indicators collected at age 4-5 years. Confirmatory factor analysis was used to test a theoretically informed model of disadvantage. Concurrent validity was examined through associations with academic performance at 8-9 years.Results The model comprising four latent factors of sociodemographic (10 indicators), geographical environments (three indicators), health conditions (three indicators) and risk factors (14 indicators) was found to provide a better fit for the data than alternative models. Each factor was associated with academic performance, providing evidence of concurrent validity.Conclusion The study provides a theoretically informed and empirically tested framework for operationalising relative child disadvantage. Understanding and addressing inequities will be facilitated by capturing the complexity of children's experiences of disadvantage across the multiple environments in which their development unfolds.