264866 SES from birth to 10 years and the odds of child behavior problems in a cohort of low- to middle-SES Chilean children

Tuesday, October 30, 2012

D. Eastern kang Sim, MPH , Pediatrics, Division of Child Development and Community Health, University of California San Diego, La Jolla, CA
Estela Blanco, MPH, MA , Pediatrics, Division of Child Development and Community Health, University of CA, San Diego, La Jolla, CA
Suzanna M. Martinez, PhD, MS , Pediatrics, Division of Child Development and Community Health, University of California, San Diego, La Jolla, CA
Marcela Castillo, PhD , Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
Besty Lozoff, MD , Center for Human Growth and Development, University of Michigan, Ann Arbor, MI
Sheila Gahagan, MD, MPH , Department of Pediatrics, Division of Child Development and Community Health, University of California, San Diego, La Jolla, CA
Introduction: Little is known about how SES relates to children's behavior in developing countries. We hypothesized that low and unstable SES over the first 10 years would relate to more child behavior problems (CBP) at 10 years.

Methods: Participants (n = 888) were enrolled as infants in an iron deficiency anemia preventive trial and follow-up. CBP (internalizing and externalizing) were based on Achenbach's Child Behavior Check List at 10 years. SES at infancy, 5 and 10 years was assessed with a modified Graffar index. Groups (middle and low) were determined using latent class analysis and group-based trajectory modeling determined SES trajectory. Covariates included gender and the Home Observation for Measurement of the Environment. Logistic regression tested the association between SES trajectories and CBP.

Results: We identified 3 SES trajectory groups: 1) changing (middle-low-middle) (10%); 2) persistent middle (78%); and 3) persistent low (12%). Compared to the persistent middle group, the persistent low group had greater odds of internalizing, but not externalizing, behaviors at 10 years (OR=1.82 [1.13, 2.94]), controlling for gender and home environment. Boys had higher odds of internalizing behaviors compared to girls (OR= 2.29, [1.66, 3.15]). We did not find higher risk for internalizing behaviors in the changing SES group, however, we found lower risk for externalizing behaviors (OR=0.13, [0.03,0.55]).

Conclusion: Children of families with low SES during their first 10 years had higher odds of having internalizing behaviors at 10 years, compared to those with middle SES. Those with changing SES had lower risk of externalizing behaviors.

Learning Areas:
Epidemiology
Public health or related research
Social and behavioral sciences

Learning Objectives:
Identify distinctive SES trajectory groups in the first 10 years of life and assess the risk of children's behavioral problems.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I collaborated in conceptualized the original idea, conducted the analysis, and interpreted findings.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.