Socioeconomic Predictors of Health and Development in Middle Childhood: Variations by SES measure and race

BACKGROUND: Socioeconomically disadvantaged children have poorer health and developmental outcomes compared to higher socioeconomic status (SES) children. These associations may vary by child's age, choice of SES indicator, child race/ethnicity, and health/developmental outcome. We examine these issues in a multiracial sample of middle-age children given evidence that middle-childhood represents a distinct and potentially critical developmental period. METHODS: We recruited sixty families with a child between 8-12 years of age from the San Francisco Bay area September 2005-June 2006. The MacArthur Health/Behavior Questionnaire was used to assess health/adaptive functioning across four developmental domains: physical health, mental health, social functioning, and school/academic functioning. We examined a wide range of SES measures including continuous and categorical assessments of poverty, income, wealth, maternal and overall family educational attainment, subjective social status, and cumulative social risk. A series of multivariate ordinary least squares regressions was performed on the total sample and within race-specific groups. RESULTS: Although the long-recognized, graded relations among SES and outcomes were present, associations employing categorical representations of SES were far more pervasive; and stronger in magnitude. Health/functioning was more strongly associated with educational attainment among Whites and financial resources among Blacks. Moreover, among Whites more wealth was associated with worse outcomes. Physical health was more strongly associated income across the spectrum of family incomes, whereas mental health was more related to poverty. CONCLUSIONS: Improvements in health/functioning in middle childhood may require more significant status transitions; racial differences suggest more targeted social interventions; and need to intervene on adversities facing affluent youth.