Lining them up (by income) and knocking them down.
I didn’t realize how strong the income gradient is for children’s emotional and behavioral problems. This new graph from the CDC combines data from 6 years of the National Health Interview Survey, and shows a steep relationship at all ages:
The question asked was, “Overall, do you think that [child] has any difficulties in one or more of the following areas: emotions, concentration, behavior, or being able to get along with other people?” Children are included here if the parent said “yes, definite difficulties” or, “yes, severe difficulties.”
As background: I’ve posted before on the income gradient for asthma, overall health, diagnosis timing, mammography, pregnancy, and women generally. That makes me curious, but not an expert. That is probably a good description for the authors of this recent review article, Janet Currie and Wanchuan Lin, who conclude:
Low-income children are in worse health than other children are. This paper explores the extent to which insults to health and activity limitations are responsible. In the most recent National Health Interview Survey (NHIS) data, low-income children are more likely than other children to have virtually every measured chronic or acute condition and are more likely to be limited by these conditions. Mental health conditions are particularly common and limiting. But the higher incidence of measured conditions and limits does not explain all of the relationships between income and overall health status, which suggests that unmeasured illnesses and injuries are also involved.
And finally, this reminds me of a good research tip. To get started on your subject, find a review article that’s a few years old or older, and then see which articles cite it — that should help bring you up to date. In this case, you could get these, which look highly relevant:
- Impact of Income and Income Inequality on Infant Health Outcomes in the United States. Pediatrics December 2010 126:61165-1173.
- Child Health and Young Adult Outcomes. J. Human Resources July 2010 45:3517-548.
- Policy Interventions to Address Child Health Disparities: Moving Beyond Health Insurance. Pediatrics November 2009 124:Supplement_3S246-S254. [Are we really ready to move “beyond health insurance”?]
- Early Childhood Poverty and Adult Body Mass Index. AJPH March 2009 99:3527-532.
- Access to and Use of Paid Sick Leave Among Low-Income Families With Children. Pediatrics August 2008 122:2e480-486.