Health inequities can be measured in children as young as 5 years old, UCLA researchers have found. The results of this nationwide study, conducted with the help of kindergarten teachers, contribute to a growing body of literature revealing that children of color who are also poor face greater health inequities than their white counterparts.
The study was conducted using the Early Development Instrument (EDI), an assessment tool that measures children’s physical, social, emotional and language development. Researchers trained kindergarten teachers in 98 school districts across the United States to administer the EDI to more than 185,000 kindergarteners from 2010 to 2017, with UCLA piloting the tool in Santa Ana in 2009 in partnership with First Five Orange County.
After analyzing and correlating the results according to where the children lived, the investigators found that 30% of children in the lowest-income neighborhoods were vulnerable in one or more domains of health development, compared to 17% of children in higher-income settings.
The researchers also found that income-related vulnerabilities varied substantially among children from different ethnic and racial groups. Black children, for example, were at highest risk, followed by Latina/o children. Asian children were at lowest risk. The differences in developmental vulnerability between Black children and white children were most pronounced at the higher socioeconomic levels and tended to narrow for Black and white children from lower-income neighborhoods.
These early disparities can have a profound influence on children’s long-term development, leading to higher rates of chronic conditions such as diabetes, heart disease, drug use, mental health disorders and dementia as adults. “Many other studies have highlighted patterns of income and racial inequality in health and educational outcomes. What this study shows is that these patterns of inequality are clearly evident and measurable before kids start school,” says Neal Halfon, MD, MPH, director of the Center for Healthier Children, Families and Communities at UCLA and professor of pediatrics, public health and public policy in the David Geffen School of Medicine at UCLA, the UCLA Fielding School of Public Health and the UCLA Luskin School of Public Affairs.
The report also underscores the value of understanding these inequities at the most micro levels, which “helps cities and local grassroots efforts develop targeted supports and services,” says Lisa Stanley, DrPH, project director for Transforming Early Childhood Community Systems at the UCLA Center for Healthier Children, Families, and Communities.
UCLA researchers have made this data accessible to local communities to help them develop their own initiatives. “Only by addressing the historical exploitation and exclusion of marginalized communities can we begin to repair the pains and exploitative practices of the past and redesign our community systems so that all children thrive,” says Efren Aguilar, head of geographic information systems at the center.
— Jane Murcia
“Measuring Equity from the Start: Disparities in the Health Development of U.S. Kindergartners,” Health Affairs, October 2020