WITHDRAWN: Family Socioecnomic Status and Physical Health Disparities in Early Childhood: Neighborhood Matters

Introduction: Variations in neighborhood conditions are known underpinnings of childhood health disparities. However, research has primarily focused on family socioeconomic status (SES) or neighborhood poverty measures. Public health programs targeting children’s physical health necessitate a broader perspective on neighborhood influences and community-level intervention opportunities. The Childhood Opportunity Index (COI; Acevedo-Garcia et al., 2014) uses national data to create freely-available census tract-level composites of community conditions relevant to children’s health. We examined the COI as a predictor of children’s physical health in the San Francisco Bay area. We hypothesized that children from more disadvantaged neighborhoods would evidence poorer health. Given adult literature showing gender differences in the relation between SES and health, we also expected to find interactions between neighborhood disadvantage and gender on children’s health.

Methods: Data on children’s physical health impairment was collected from 17 teachers of 285 children (M age = 5.32 years, 49% male) during the fall and spring of the kindergarten year. Data on the three COI domains, Educational (e.g., proximity to high-quality early education facilities), Health and Environmental (e.g., percentage of healthy grocery stores in the area), and Social and Neighborhood (e.g., foreclosure rate) were downloaded from www.diversitydatakids.org. Multilevel models (children nested within teachers) predicted spring health impairment from each of the COI domains, gender, and COI*gender, adjusting for ethnicity, income, days absent from school, and fall health impairment.

Results: There was a significant interaction between the Social and Neighborhood COI and gender (b = -.23, p < .01) such that females reared in neighborhoods characterized by higher rates of unemployment, foreclosures, poverty, and public assistance demonstrated greater health-related impairment across the kindergarten year. This COI was not associated with health among males. There were no main or interactive effects of the Educational or Health and Environmental COIs on children’s health.

Conclusions: Results reveal an association between neighborhood context and children's physical health as early as age 5, and suggest females may be particularly susceptible to the negative consequences of adverse community conditions. Findings also support the predictive utility of multidimensional assessments of socioeconomic factors within communities, beyond the effects of family-level income. Consideration of inequities across multiple levels may provide a more comprehensive perspective of the effects of socioeconomic conditions on children’s health and inform prevention programs that address the needs of children.