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

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.