The relationship of household assets and amenities with child health outcomes: An exploratory cross-sectional study in India 2015-2016
The relationship of household assets and amenities with child health outcomes: An exploratory cross-sectional study in India 2015-2016
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DOI：
10.1016/j.ssmph.2019.100513
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发表时间：
2020-04-01
影响因子：
4.7
通讯作者：
Subramanian, S., V
中科院分区：
文献类型：
--
作者：
Karlsson, Omar;Kim, Rockli;Subramanian, S., V
印度儿童的健康发展远未得到保障。儿童健康状况不佳的直接决定因素是传染病和营养不良，这与社会经济地位有关。在低收入和中等收入国家，研究人员依靠根据家庭资产所有权和设施信息构建的财富指数来研究儿童健康方面的社会经济差异。然而，其中一些财富指数项目可以直接影响儿童健康的直接决定因素。本文探讨了用于构建人口与健康调查财富指数的每个项目与不同儿童健康结果的独立关联。这项横断面研究使用了2015-16年进行的印度全国家庭健康调查中的245，866名0-59个月儿童的全国代表性样本。该研究使用了条件泊松回归模型以及一系列敏感性规范。在控制了社会经济地位、医疗保健使用、孕产妇因素、社区因素和所有财富指数项目后，以下财富指数项目与儿童健康最相关：厕所设施类型、水源、冰箱、高压锅、烹饪燃料类型、农业用地、家庭建筑材料、移动的电话和摩托车/踏板车。厕所设施和水源的类型与死亡率的关系特别强，分别显示死亡率降低16-35%和14-28%。用于构建人口与健康调查财富指数的大多数项目仅表明家庭的社会经济地位，而少数项目可能直接影响儿童健康，可以作为政策干预的有用目标。
Healthy development of children in India is far from ensured. Proximate determinants of poor child health outcomes are infectious diseases and undernutrition, which are linked to socioeconomic status. In low- and middle-income countries, researchers rely on wealth indices, constructed from information on households' asset ownership and amenities, to study socioeconomic disparities in child health. Some of these wealth index items can, however, directly affect the proximate determinants of child health. This paper explores the independent association of each item used to construct the Demographic and Health Surveys' wealth index with diverse child health outcomes. This cross-sectional study used nationally representative sample of 245,866 children, age 0-59 months, from the Indian National Family Health Surveys conducted in 2015-16. The study used conditional Poisson regression models as well as a range of sensitivity specifications. After controlling for socioeconomic status, health care use, maternal factors, community-level factors, and all wealth index items, the following wealth index items were the most consistently associated with child health; type of toilet facilities, water source, refrigerator, pressure cooker, type of cooking fuel, land usable for agriculture, household building material, mobile phone, and motorcycle/scooter. The association with type of toilet facilities and water source was particularly strong for mortality, showing a 16-35% and 14-28% lower mortality, respectively. Most items used to construct the Demographic and Health Surveys' wealth index only indicate household socioeconomic status, while a few items may affect child health directly, and can be useful targets for policy intervention.