Children's Health Status: Examining the Associations among Income Poverty, Material Hardship, and Parental Factors

BACKGROUND: We examined a model of multiple mediating pathways of income poverty, material hardship, parenting factors, and child health status to understand how material hardship and parental factors mediate the effects of poverty on child health. We hypothesized that: (a) poverty will be directly associated with material hardship, parental depression, and health status, and indirectly with parenting behaviors through its effects on parental depression and material hardship; (b) material hardship will be associated with parental depression, parenting behaviors, and health status; and (c) parental depression will be correlated with parenting behaviors, and that both parental depression and parenting behaviors will predict child health. METHODS AND RESULTS: We used data from the 2002 National Survey of American Families for a sample of 9,645 6-to-11 year-olds to examine a 4-step structural equation model. The baseline model included covariates and income poverty. In the hardship model, food insufficiency and medical need were added to the baseline model. The parental model included parental depression and parenting behavior and baseline model. In the full model, all the constructs were included. First, income poverty had a direct effect on health status, and an indirect effect through its association with material hardship, parental depressive affect, and parenting behaviors. Medical need and food insufficiency had negative effects on child health, and indirect effects on health through their association with parental depression and parenting behaviors. Finally, parental depression and parenting behaviors were associated with child health, and part of the effect of parental depression on health was explained by its association with parenting behaviors. CONCLUSIONS: Poverty has an independent effect on health, however, its effects are partially explained by material hardship, parental depression and parental behaviors. To improve children's health would require a multi-pronged approach involving income transfers, health insurance coverage, food and nutrition assistance, and parenting interventions

Household Food Insecurity Predictive of Health Status in Early Adolescence? A Structural Analysis Using the 2002 NSAF Data Set

We used data from the 2002 National Survey of American Families to examine a structural model of the relations among food insecurity, poor nutritional status, parental mental health problems, quality of parenting, adolescents’ emotional distress, and poor health status for a national sample of 5366 12-to-14 year-olds. The results revealed that: first, food insecurity was associated with elevated levels of parental mental health problems, diminished quality of parenting, elevated levels of adolescents’ emotional problems, and higher incidence of poor nutritional and health statuses. Second, parental mental health problems were associated with diminished quality of parenting and higher incidence of poor health status; and quality of parenting had a negative effect on emotional distress, but not on health status. Finally, poor nutritional status was associated with elevated levels of emotional distress and higher incidence of poor health status; and emotional distress was predictive of poor health status. The findings of this study highlight the mediating role of nutritional status, parenting factors and adolescents’ emotional well-being in the link between food insecurity and health; and point to the complex interaction between food insecurity and health status

A Structural Analysis of Variations in African American and Non-Hispanic White Children’s Health Care Utilization

A multi-group SEM was used to investigate the processes underlying health care use between black and white children. Data on a sample of 28,064 black and white children, ages 4-to-11 from the 2003 National Survey of Children's Health (NSCH), a computer-assisted telephone survey were used. Results showed that: the processes underlying health care use were similar for blacks and whites; however, there were some differences in factor loadings between blacks and whites. Furthermore, there were differences between blacks and whites in the effects of (a) family economic resources on health problems, (b) health problems and access to care on parental distress, (b) access to care and health problems on prevention- and curative-based use. No interaction effects were found for blacks and whites in the associations between (a) parental distress and satisfaction with physician interaction and health care usage, and (b) satisfaction with physician interactions and health care utilization

Child Social Development in Context

In his later writings, Bronfenbrenner revised his ecological theory, resulting in the bioecological model that gave prominence to proximal processes and the relationship between the context and individual characteristics. Drawing on the bioecological model, we hypothesized that (a) contextual influences will be mediated by proximal processes, (b) proximal processes will have a more powerful impact on children’s development than contextual factors, and (c) the effect of contextual and proximal processes will vary as a function of child characteristic and developmental outcome. Data used were from a sample of 28,064 six- to eleven-year-olds in the 2007 National Survey of Children’s Health. A multigroup structural equation model that employed a process-person-context research design was used to analyze the data. In general, support was found for the meditational hypothesis and the hypothesis that the impact of contextual factors and proximal processes varies as a function of person and the developmental outcome. Partial support was found for the hypothesis that proximal processes exert a more powerful effect on development than contextual factors

A Measure of Social of Globalization: Factor Analytic and Substantial Validity Assessment Using a Sample of Young Adult Kuwaitis

A sample of 146 undergraduate university students in Kuwait were used to establish the factor structure and substantive validity of a 21-item questionnaire of social globalization based on the conceptualized dimensions of personal contact, cultural proximity, and information flows. Results of the factor analysis suggested a five-factor structure that was labeled: information flows-internet; information flows-print; information flows-TV; personal contact; and cultural proximity. Furthermore, results of the substantive validity analysis suggested that although the items may be indicative of the constructs under investigation, respondents did not correlate them with their intended constructs with a higher degree of concordance. Implications for further research are discussed

Model linking Income, Material Hardship, and Parenting to Child Health Status.

<p>Model linking Income, Material Hardship, and Parenting to Child Health Status.</p

Model of Income Poverty, Material Hardship, Parenting, and Health Status.

<p>Unstandardized coefficients (SE), and standardized coefficients (bold face) are reported. Note. Covariate coefficients are reported for poverty and [health status].</p

Summary of 4-Step Structural Equation Model Building.

<p>* <i>p</i><.01; ** = <i>p</i><.001; ^a = Standardized β; SE = (standard error).</p

Unweighted Descriptive Statistics of Study Sample.

<p>Unweighted Descriptive Statistics of Study Sample.</p