Understanding health disparities: the role of race and socioeconomic status in children's health

Abstract

Objectives: We sought to determine whether childhood health disparities are best understood as effects of race, socioeconomic status (SES), or synergistic effects of the two.

Methods: Data from the National Health Interview Survey 1994 of US children aged 0 to 18 years (n=33911) were used. SES was measured as parental education. Child health measures included overall health, limitations, and chronic and acute childhood conditions.

Results: For overall health, activity and school limitations, and chronic circulatory conditions, the likelihood of poor outcomes increased as parental education decreased. These relationships were stronger among White and Black children, and weaker or nonexistent among Hispanic and Asian children. However, Hispanic and Asian children exhibited an opposite relationship for acute respiratory illness, whereby children with more educated parents had higher rates of illness.

Conclusions: The traditional finding of fewer years of parent education being associated with poorer health in offspring is most prominent among White and Black children and least evident among Hispanic and Asian children. These findings suggest that lifestyle characteristics (e.g., cultural norms for health behaviors) of low-SES Hispanic and Asian children may buffer them from health problems. Future interventions that seek to bolster these characteristics among other low-SES children may be important for reducing childhood health disparities.

FIGURE 1—

Parental education × race interaction for activity limitations. Note. The education line was significant among White and Black children (P’s were <.001) but not for Hispanic and Asian children.

FIGURE 2—

Parental education × race interaction for chronic circulatory conditions. Note. The education line was significant and negative among Black children (P < .05) but significant and positive among Hispanic and Asian children (P’s were <.05).

FIGURE 3—

Parental education × race interaction for acute respiratory illnesses. Note. The education line was not significant among White and Black children but was significant for Hispanic and Asian children (P’s were <.05)