Social class gradients and health in childhood.
OBJECTIVE
To determine if there are social class gradients in health in children aged 6 to 11 years.


METHODS
Self and parent reports of health of children in 5 sites across the United States were assessed using the Child Health and Illness Profile-Child Edition. Distribution of scores in 4 domains: satisfaction (with health); comfort; resilience; and risk avoidance were used to create profiles of health. Social class was defined as a composite of parental education and work participation.


RESULTS
Social class gradients were found for all but the satisfaction domain and for most subdomains in the parent version; the most notable gradient was in the risk avoidance domain, with better health the higher the social class. Apparent gradients did not reach statistical significance in the child reports. Children from a higher social class were more likely to be in excellent/average health and less likely to be in poor health profiles than were lower class children.


CONCLUSIONS
The findings generally mirror those from a prior study of adolescents, using the same conceptual framework for health and the same measure of social class, and are consistent with a cumulative effect for most aspects of health, and with a critical-period effect for risky behaviors.
Department of Health Policy and Management, Johns Hopkins University, Baltimore, Md 21205, USA. bstarfie@jhsph.edu
Barbara
B
Starfield
Judy
J
Robertson
Anne W
AW
Riley
D002648:Child; D002669:Child Welfare; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D012923:Social Class; D014481:United States