[Social inequalities in child health. SESPAS report 2010]

Abstract

There is considerable evidence of the impact of poverty and social exclusion on child health. In the last few years, interest has grown in the concept of social gradients in health, according to social position, family educational level, gender, and ethnic background. Several cohort studies have demonstrated an association between maternal socioeconomic position during the prenatal period and adult health. The Commission on Social Determinants of Health of the World Health Organization proposed closing the health gap in a generation by giving a major role to early child development. Family educational level and academic achievement are fundamental determinants of health inequalities. There is scarce empirical evidence on the effectiveness of interventions to reduce child health inequalities. Most of the interventions in children and adolescents aim to change individual behavior, and very few have been critically evaluated. The present manuscript provides a review of initiatives and recent interventions aimed at reducing social inequalities, as well as a checklist to be taken into account in interventions on health promotion and disease prevention in schools from the perspective of social and gender inequalities. Strategies for data collection, research and health and educational policies are proposed.