Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Nov-Dec:37:42-50.
doi: 10.1016/j.pedn.2017.06.018. Epub 2017 Jul 10.

How Early do Social Determinants of Health Begin to Operate? Results From the Fragile Families and Child Wellbeing Study

Anao Zhang  1 , Yolanda C Padilla  2 , Yeonwoo Kim  2
Affiliations

How Early do Social Determinants of Health Begin to Operate? Results From the Fragile Families and Child Wellbeing Study

Anao Zhang et al. J Pediatr Nurs. 2017 Nov-Dec.

Abstract

Purpose: From a life course perspective, important insights about how social determinants of health operate can be gained by analyzing the various forms that social climate can take in different life periods. For children, a critical aspect of social climate is exposure to bullying. Bullying can serve as a proxy for power imbalance and social exclusion analogous to adult social climate of discrimination and racism.

Design and methods: We used the Year 9 follow-up data of the Fragile Families and Child Wellbeing Study (N=3301) that, for the first time included interviews with the children. We drew on a national sample of children and their families, which allowed us to account for broader contextual variables and represented a broad range of geographic areas and schools. Multinomial logistic regression was used to estimate the effects of exposure to bullying on self-rated health among primarily 9- to 10-year-old children while controlling for socio-demographic and diagnosed health-conditions.

Results: Both frequency and forms of bullying were positively associated with lower odds of reporting excellent, very good or good health. The effect of forms of bullying on children's self-rated health fell on a gradient. Subgroup analysis indicated a significant effect on self-rated health for children who experienced peer rejection but not for those who experienced physical aggression.

Conclusions: The results of the study provide new evidence that the harmful health consequences of power imbalance and discriminatory practices may extend to children in early development. It also accentuates the need to study social determinants of health from both an ecological/contextual and a developmental angle.

Practice implications: Echoing a plethora of nursing literature on the critical role of psycho-social pediatric care, this study further encourages pediatric nurses to expand their assessment and intervention priorities beyond a familial and developmental perspective, and to consider the evident physical health consequence of a child's overall social climate determinants.

Keywords: Bullying; Children; Self-rated health; Social climate; Social determinants of health.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. Allison S, Roeger L, & Reinfeld-Kirkman N (2009). Does school bullying affect adult health? Population survey of health-related quality of life and past victimization. Australian and NewZealand Journal of Psychiatry, 43(12), 1163–1170. - PubMed
    1. Bekman NM, Goldman MS, Worley MJ, & Anderson KG (2011). Pre-adolescent alcohol expectancies: Critical shifts and associated maturational processes. Experimental and Clinical Psychopharmacology, 19(6), 420–432. - PMC - PubMed
    1. Benedict FT, Vivier PM, & Gjelsvik A (2015). Mental health and bullying in the United States among children aged 6 to 17 years. Journal of Interpersonal Violence, 30(5), 782–795. - PubMed
    1. Boulton MJ (2013). The effects of victim of bullying reputation on adolescents’ choice of friends: Mediation by fear of becoming a victim of bullying, moderation by victim status, and implications for befriending interventions. Journal of Experimental Child Psychology, 114(1), 146–160. - PubMed
    1. Braveman P, Egerter S, & Williams DR (2011). The social determinants of health Coming of age.: Annual Review of Public Health, 32,381–389. - PubMed

MeSH terms