title: Community socioeconomic context and its influence on intermediary determinants of child health: evidence from Colombia.
abstract: Intermediary determinants are the most immediate mechanisms through which socioeconomic position shapes health inequities. This study examines the effect of community socioeconomic context on different indicators representing intermediary determinants of child health. In the context of Colombia, a developing country with a clear economic expansion, but one of the most unequal countries in the world, two categories of intermediary determinants, namely behavioural and psychosocial factors and the health system, are analysed. Using data from the 2010 Colombian Demographic and Health Survey (DHS), the results suggest that whilst the community context can exert a greater influence on factors linked directly to health, in the case of psychosocial factors and parent's behaviours, the family context can be more important. In addition, the results from multilevel analysis indicate that a significant percentage of the variability in the overall index of intermediary determinants of child health is explained by the community context, even after controlling for individual, family and community characteristics. These findings underline the importance of distinguishing between community and family intervention programmes in order to reduce place-based health inequities in Colombia.
authors.affiliation: *Department of Econometrics,University of Barcelona,Barcelona,Spain.
authors.forename: Ana María
authors.initials: AM
authors.lastname: Osorio
authors.affiliation: *Department of Econometrics,University of Barcelona,Barcelona,Spain.
authors.forename: Catalina
authors.initials: C
authors.lastname: Bolancé
authors.affiliation: ‡Division of Social Statistics and Centre for Global Health, Population, Poverty and Policy,University of Southampton,Southampton,UK.
authors.forename: Nyovani
authors.initials: N
authors.lastname: Madise
mesh_terms: D001519:Behavior; D002648:Child; D002669:Child Welfare; D003105:Colombia; D003710:Demography; D003906:Developing Countries / Q000706:statistics & numerical data; D005191:Family Characteristics; D005260:Female; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D008297:Male; D011584:Psychology; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012959:Socioeconomic Factors