Neighborhood socioeconomic deprivation characteristics in child (0–18 years) health studies: A review

doi:10.1016/j.healthplace.2014.05.010

Health & Place

Volume 29, September 2014, Pages 34-42

https://doi.org/10.1016/j.healthplace.2014.05.010 Get rights and content

Abstract

Background

Growing up in socioeconomically deprived neighborhoods has been shown to have negative health effects on children. However, the most recent review on which measures are used to investigate the association between neighborhood characteristics and child (0–18 year) health included studies only until 2004. Insight into more recent research is needed for the further development of these measures.

Objectives

To review neighborhood socioeconomic deprivation characteristics used in recent studies investigating the relationship between neighborhood socioeconomic deprivation and child health.

Methods

Sensitive search in MEDLINE, Embase, PsycINFO, Sociological Abstracts databases (2004–2013).

Results

Ultimately, 19 studies were included. We found ten neighborhood socioeconomic deprivation constructs, of which income/wealth, employment, and education were most frequently used. The choice for neighborhood characteristics seemed independent of the health outcome and in most cases was not based on a specific theoretical background or earlier work.

Conclusion

Studies vary regarding study designs, measures and outcomes. Researchers should clearly specify their choice of neighborhood socioeconomic deprivation characteristics; preferably, these should be theory-based and used consistently.

Introduction

Because children and adolescents are influenced by the neighborhoods they live in, interest in the effects of neighborhood socioeconomic deprivation on child health (0–18 years) has increased in recent years. Neighborhood socioeconomic deprivation is the relatively low physical (e.g. houses for sale, graffiti), social (e.g. unemployment, non-voter) and economical position (income, education level) of a neighborhood (Galobardes et al., 2006, Galobardes et al., 2007; Krieger et al., 1997). Evidence shows that growing up in socioeconomically deprived neighborhoods has negative health effects on children and adolescents. For example, the risks of low birth weight, childhood injury, and abuse are twice as high in deprived areas compared to non-deprived areas (Earls and Carlson, 2001, Leventhal and Brooks-Gunn, 2000, Messer et al., 2006, Pickett and Pearl, 2001, Sampson et al., 2002, Sellstrom and Bremberg, 2006). According to Leventhal and Brooks-Gunn (2000), neighborhood factors explain 5% to 10% of the variation in children׳s development, well-being, and health. However, the validity of the studies on neighborhood effects on health (including child health) has been questioned. Studies vary with regard to outcomes, study designs, and measures of neighborhood socioeconomic deprivation (Diez Roux, 2001, Sellstrom and Bremberg, 2006, Veugelers et al., 2008). The latter in particular may seriously affect any findings on differences in child health according to neighborhood socioeconomic deprivation, because an invalid measurement of socioeconomic deprivation may lead to spurious associations (Leventhal and Brooks-Gunn, 2000).

We previously showed that the age-composition of neighborhoods may affect the validity of the measurement of neighborhood socioeconomic deprivation. Having only primary education occurs much more frequently among elderly than among young adults. That leads to an increase of the proportion of low educated people in neighborhoods with a larger share of elderly. This may bias findings and at least affects the accuracy of the measurement of this association (Reijneveld and Gunning-Schepers, 1994).

Unfortunately, there is still no consensus on how to define and operationalize neighborhood socioeconomic deprivation. No recent review is available on neighborhood socioeconomic deprivation characteristics in child health research. Although Pickett and Pearl (2001), Leventhal and Brooks-Gunn (2000) and Sellstrom and Bremberg (2006) summarized the evidence on the effects of neighborhood context on health outcomes, they provided neither overviews nor full discussions of the neighborhood socioeconomic deprivation measures used. The only review on this topic, that of Rajaratnam et al. (2006) is rather outdated, as it included no studies published after March 2004, and did not focus specially on socioeconomic characteristics of neighborhoods. Their review concerned neighborhood effects with regard to maternal and child health, and provided an overview of the types of neighborhood constructs explored and the measures used. They found that a wide diversity of approaches was used to measure neighborhood deprivation characteristics and that the most widely utilized source of data was that of administrative records from the census or local government authorities. Few authors of their selected studies were explicit about why certain indicators were selected to measure these constructs. In addition, the authors (Rajaratnam et al., 2006) did not address individual or family-level factors that were used to adjust for possible aggregation effects, while they reviewed and summarized the studies with regard to choice and operationalization of neighborhood factors.

An overview of the neighborhood socioeconomic deprivation constructs and measures that have been used recently and which try to address the above mentioned limitation may serve as a guideline for future studies on neighborhood socioeconomic deprivation and child health. Therefore, the aim of this study was to summarize 1) the neighborhood socioeconomic deprivation constructs and measures and 2) family level deprivation characteristics that were used in studies published after March 2004 investigating the relationship between neighborhood socioeconomic deprivation and child health.

Section snippets

Search strategies and procedures

We identified relevant quantitative studies that examined the relationship between neighborhood characteristics and child health through searches conducted in the MEDLINE, Embase, PsycINFO, and Sociological Abstracts databases. The search was limited to studies published from March 2004 through January 2013 to include all studies not covered in the previous review on this topic (Rajaratnam et al., 2006). Studies were identified by key word searches using MeSH terms. Manual reference checking

General characteristics of the studies

After reading the titles and abstracts, we initially selected 41 studies (Fig. 1). After reading the full text, 14 of these papers met all of the criteria. We also included 5 articles which were identified by manual reference search. The main reason (n=14) for excluding papers was that they did not use a hierarchical model with clear descriptions of neighborhood and/or family-level socioeconomic factors. Furthermore, nine papers were excluded because they did not study the direct relationship

Discussion

This review describes the current state of research on neighborhood socioeconomic deprivation effects on child (0–18 years) health. We reported on our review descriptively because of the aim of our study was to summarize both the neighborhood and family level socioeconomic characteristics. The 19 included studies dealt with mental health and quality of life, behavior and delinquency and physical health and life style. To define neighborhood socioeconomic deprivation, most studies used measures

Acknowledgments

The authors would like to thank librarian Jan Vlierhuis at the Department of Epidemiology and Health Promotion, Public Health Service of Amsterdam, the Netherlands for his careful and insightful contributions to the literature search.

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Review EssayNeighborhood socioeconomic deprivation characteristics in child (0–18 years) health studies: A review

Abstract

Background

Objectives

Methods

Results

Conclusion

Introduction

Section snippets

Search strategies and procedures

General characteristics of the studies

Discussion

Acknowledgments

Health Place

Soc. Sci. Med.

Am. J. Clin. Nutr.

Soc. Sci. Med.

Soc. Sci. Med.

Health Place

J. Adolesc. Health

Neighborhood disadvantage and changes in condom use among African American adolescents

J. Urban Health

Socioeconomic status and child development

Annu. Rev. Psychol.

Socioeconomic status in health research: one size does not fit all

JAMA

Neighborhood, family, and subjective socioeconomic status: how do they relate to adolescent health?

Health Psychol.

Investigating neighborhood and area effects on health

Am. J. Public Health

The wider social environment and changes in self-reported quality of life in the transition from late childhood to early adolescence: a cohort study

BMC Public Health

Delinquency in context; neighbourhood and gender interactions among adolescents

Epidemiol. Psichiatr. Soc.

The social ecology of child health and well-being

Annu. Rev. Public Health

Some practical guidelines for measuring youth׳s race/ethnicity and socioeconomic status

Child Dev.

Discovering how urban poverty and violence affect health: development and validation of a neighborhood stress index

Health Psychol.

Measuring socioeconomic position in health research

Br. Med. Bull.

Indicators of socioeconomic position part 1

J. Epidemiol. Community Health

Child obesity associated with social disadvantage of children׳s neighborhoods

Soc. Sci. Med.

Review Essay
Neighborhood socioeconomic deprivation characteristics in child (0–18 years) health studies: A review