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
Review
. 2019 Oct;104(10):998-1003.
doi: 10.1136/archdischild-2018-314808. Epub 2019 Feb 23.

Pathways to inequalities in child health

Anna Pearce  1 , Ruth Dundas  1 , Margaret Whitehead  2 , David Taylor-Robinson  2
Affiliations
Review

Pathways to inequalities in child health

Anna Pearce et al. Arch Dis Child. 2019 Oct.

Abstract

From birth, children living in disadvantaged socioeconomic circumstances (SECs) suffer from worse health than their more advantaged peers. The pathways through which SECs influence children's health are complex and inter-related, but in general are driven by differences in the distribution of power and resources that determine the economic, material and psychosocial conditions in which children grow up. A better understanding of why children from more disadvantaged backgrounds have worse health and how interventions work, for whom and in what contexts, will help to reduce these unfair differences. Macro-level change is also required, including the reduction of child poverty through improved social security systems and employment opportunities, and continued investment in high-quality and accessible services (eg, childcare, key workers, children's centres and healthy school environments). Child health professionals can play a crucial role by being mindful of the social determinants of health in their daily practice, and through advocating for more equitable and child-focussed resource allocation.

Keywords: child health; health inequalities; life course; policy; social determinants of health.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Child health inequalities, UK Millennium Cohort Study (http://doi.org/10.5255/UKDA-SN-6411-7) (age 7 years, 2008). 1Borderline—abnormal total difficulties score, using the parent-reported Strengths and Difficulties Questionnaire. 2Including obese, applying International Obesity Task Force cut-offs to measured body mass index. 3Parent report of conditions that have troubled or are likely to trouble the child for a period of time. 4Medical opinion sought for one or more unintentional injuries occuring since the last survey (∼5 years). 5Parent report of the child having ever had asthma. *Quintiles, based on OECD equivalised household income.
Figure 2
Figure 2
Social determinants of child health. Adapted from Bronfenbrenner and Dahlgren and Whitehead.
Figure 3
Figure 3
Conceptual model demonstrating the pathways to child health inequalities. Adapted from Diderichsen et al. SECs, socioeconomic circumstances.
See this image and copyright information in PMC

References

    1. Rougeaux E, Hope S, Law C, et al. . Have health inequalities changed during childhood in the New Labour generation? Findings from the UK Millennium Cohort Study. BMJ Open 2017;7:e012868 10.1136/bmjopen-2016-012868 - DOI - PMC - PubMed
    1. Viner RM, Hargreaves D, Cheung C. State of Child Health Report. London: Royal College of Paediatrics and Child Health, 2017.
    1. Law C, Parkin C, Lewis H. Policies to tackle inequalities in child health: why haven’t they worked (better)? Arch Dis Child 2012;97:301–3. 10.1136/archdischild-2011-300827 - DOI - PubMed
    1. Weightman AL, Morgan HE, Shepherd MA, et al. . Social inequality and infant health in the UK: systematic review and meta-analyses. BMJ Open 20122:e000964 10.1136/bmjopen-2012-000964 - DOI - PMC - PubMed
    1. Graham H, Power C. Childhood disadvantage and adult health: a lifecourse framework. London: Health Development Agency, 2004. - PubMed

Publication types