National Study Links Hardship and Wellness among Low-Income Children
Participating in a national study, Dr. Mariana Chilton, an assistant professor and expert in poverty and child hunger at the Drexel University School of Public Health, co-authored a new report finding that the cumulative effects of food, housing and energy insecurity decrease the chances of normal growth and development, as well as good physical health, among infants and toddlers in Philadelphia.
The findings were part of a study by pediatricians from Boston Medical Center and colleagues from its Children’s HealthWatch in Minneapolis, Little Rock, Philadelphia and Baltimore. The results of the study, which found similar results nationwide, were first announced on April 12, 2010 in the journal Pediatrics.
The researchers believe that findings bring into focus the preventable conditions – besides a lack of access to health insurance – that influence the health, development and growth of America’s youngest children.
“Our findings bring to light what is often invisible to the general public: that the very young children growing up in poverty in Philadelphia and around the country are at serious risk,” said Dr. Chilton. “This risk is exposure to poor housing, inadequate energy assistance and lack of consistent access to food. In turn, these multiple hardships manifest in children’s poor health, increased hospitalizations and developmental delay.”
According to the researchers, poverty influences a child’s well-being through multiple environmental stressors, but research and intervention programs often fail to take account of “material hardships” that may have direct physiologic impact on children. These hardships include food insecurity, unstable or crowded housing, inability to afford home heating or cooling and lack of health insurance.
“Approximately 60 percent of the young children under the age of three whose caregivers were interviewed at St. Christopher’s Hospital for Children experienced moderate or severe hardship,” said Dr. Chilton. “While this is a study that is nationally relevant, our Philadelphia numbers suggest that Philadelphia lawmakers and public officials must take a good hard look at our evidence showing how a large percentage of Philadelphia’s children are being left behind. These multiple risks are preventable through more comprehensive anti-poverty policy: this includes improved housing programs, improved access to energy assistance, and to food assistance.”
Ongoing since 2005, the Philadelphia research of Children’s HealthWatch is being carried out in the emergency room at St. Christopher’s Hospital for Children. Interviewers have spoken with over 3,500 caregivers who have children under the age of three. They ask about participation in public assistance programs, employment, child health and development, hospitalizations and maternal depression.
For the larger study, the researchers evaluated more than 7,000 children nationwide between 4 and 36 months old who were waiting for care at one of five urban primary care clinics or emergency departments. After controlling for social-medical risk factors, including demographic and perinatal variables and caregivers’ depressive symptoms, the researchers found that as any combination of these hardships increased in severity, the chances of young children experiencing “well-being” declined.
According to the researchers these cumulative hardships may exert direct negative physiologic consequences on children, via diets of inadequate quality or quantity, heat or cold stress and enhanced exposure to infectious disease or noise in crowded households.
“The current findings raise serious concerns about the future well-being of America’s young children, given the fluctuations of food and energy costs,” explained lead author Deborah Frank, MD, director of BMC’s Grow Clinic and a professor of pediatrics at Boston University School of Medicine. “We know that deprivations in early life can become biologically embedded in a child. This can force children onto negative paths that limit their health and ability to earn a living as adults.”
Major funding for this study was provided by W.K. Kellogg Foundation, with additional support from the Annie E. Casey Foundation, Claneil Foundation, and Merck & Co. foundation.
Dr. Chilton is an assistant professor in the Department of Health Management and Policy at the Drexel University School of Public Health. She is the Principal Investigator for The Philadelphia GROW Project and Co-Principal investigator of Children's HealthWatch in Philadelphia. She most recently launched “Witnesses to Hunger” to increase women’s participation in the national dialogue on hunger and poverty. Dr. Chilton received her PhD from the University of Pennsylvania, Master of Public Health in Epidemiology from the University of Oklahoma, and Bachelor or Arts Degree from Harvard University.
The Drexel University School of Public Health promotes the health of communities through education, research, service and practice. As the only fully-accredited school of public health in southeastern Pennsylvania, Drexel’s innovative academic and research programs integrate real-world experience with classroom learning in one of the most diverse and culturally rich communities in the United States. Drexel’s School of Public Health is built on a foundation of understanding that health and human rights are inextricably entwined. For more information about the School of Public Health visit http://publichealth.drexel.edu.
Boston Medical Center is a private, not-for-profit, 639-licensed bed, academic medical center affiliated with Boston University School of Medicine. Committed to providing high-quality health care to all, the hospital offers a full spectrum of pediatric and adult care services including primary and family medicine and advanced specialty care with an emphasis on community-based care. Boston Medical Center offers specialized care for complex health problems and is a leading research institution. Boston Medical Center and Boston University School of Medicine are partners in the Boston HealthNet—15 community health centers focused on providing exceptional health care to residents of Boston. For more information, please visit www.bmc.org
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