Social determinants of health refer to environmental factors that can impact a child or person’s long-term health and trajectory. For instance, neighborhoods differ in the quality of available resources, such as access to education, healthy food, and safe play spaces.
Researchers from NICHD’s Epidemiology Branch evaluated data from the Upstate KIDS Study, which had followed infants for several years after birth. The study team used this long-term data to assess the effects of neighborhood quality on children’s development through four years of age.
- The study used a measure called the Childhood Opportunity Index (COI), which is a national metric for neighborhood-level social determinants of health. The COI includes:
- education indicators from preschool through postsecondary enrollment
- health and environment indicators assessing healthy environments, toxic exposures, and health insurance coverage
- social and economic indicators, such as adult employment, poverty and income, public assistance rate, and single-headed households
- A score higher than 50 means that a neighborhood is above average at a national level.
- The study team linked participant addresses to COI scores and then analyzed the children’s scores from various developmental questionnaires, as well as results from a clinic visit at age 4. The clinic assessment was done by a trained staff member who was unaware of the COI scores.
- The team found that children with higher COI scores were less likely to have developmental delays from 4 to 36 months, as well as better developmental performance at 4 years.
- After fully adjusting for family and individual level factors, higher COI scores were also associated with reduced odds of having motor and personal-social delays.
- If the findings are replicated, a child's neighborhood could be used for targeted developmental screening by healthcare providers, similar to how zip codes are used for lead exposure screening.
Reference
Putnick DL, Bell EM, Tyris J, McAdam J, Ghassabian A, Mendola P, Sundaram R, and Yeung E. Place-Based Child Opportunity at Birth and Child Development from Infancy to Age 4. Journal of Pediatrics DOI: 10.1016/j.jpeds.2024.113909 (2024)
Learn more about the Division of Population Health Research (DiPHR): https://www.nichd.nih.gov/about/org/dir/dph
BACK TO TOP