Document Type
Journal Article
Publication Date
11-1-2013
Journal
Paediatric and Perinatal Epidemiology
Volume
27
Issue
6
Inclusive Pages
575-586
DOI
10.1111/ppe.12086
Keywords
Child Development; Cognition; Health Status Disparities; Socioeconomic Factors
Abstract
BACKGROUND: Wealth disparities in child developmental outcomes are well documented in developed countries. We sought to (1) describe the extent of wealth-based neurocognitive development disparities and (2) examine potential mediating factors of disparities among a population-based cohort of children in rural Nepal.
METHODS: We investigated household wealth-based differences in intellectual, executive and motor function of n = 1692 children aged between 7 and 9 years in Nepal. Using linear mixed models, wealth-based differences were estimated before and after controlling for child and household demographic characteristics. We further examined wealth-based differences adjusted for three sets of mediators: child nutritional status, home environment, and schooling pattern.
RESULTS: We observed a positive gradient in child neurocognitive performance by household wealth. After adjusting for child and household control factors, disparities between children in the highest and lowest wealth quintiles persisted in intellectual and motor function, but not executive function. No statistically significant wealth-based differentials in outcomes remained after accounting for nutritional status, home environment, and schooling patterns. The largest differences in neurocognitive development were associated with schooling pattern.
CONCLUSIONS: Household wealth patterns child neurocognitive development in rural Nepal, likely through its influence on nutritional status, the home environment, and schooling. In the current context, improving early and regular schooling in this setting is critical to addressing wealth-based disparities in outcomes.
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.
APA Citation
Patel, S., Murray-Kolb, L., LeClerq, S., Khatry, S., Tielsch, J. M., Katz, J., & Christian, P. (2013). Household wealth and neurocognitive development disparities among school-aged children in Nepal.. Paediatric and Perinatal Epidemiology, 27 (6). http://dx.doi.org/10.1111/ppe.12086
Peer Reviewed
1
Open Access
1
Comments
Reproduced with permission of John Wiley & Sons, Inc. Paediatric and Perinatal Epidemiology.