Disparities in children's vocabulary and height in relation to household wealth and parental schooling: A longitudinal study in four low- and middle-income countries

• Authors: Sarah A. Reynolds, University of California Berkeley; Chris Andersen, Harvard T.H. Chan School of Public Health; Jere Behrman, University of Pennsylvania; Abhijeet Singh, University College London; Aryeh D Stein, Emory University; Liza Benny, University of Oxford; Benjamin T. Crookston, Brigham Young University; Santiago Cueto, Pontificia Universidad Católica del Perú; Kirk Dearden, IMA World Health; Andreas Georgiadis, University of Oxford; Sonya Krutikova, The Institute for Fiscal Studies; Lia C.H. Fernald, University of California Berkeley
• Journal Title: SSM - Population Health
• Volume: Volume 3
• Publisher: Elsevier | 2017-12-01, Pages 767-786
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1016/j.ssmph.2017.08.008
• Subjects: Health Sciences, Public Health

Abstract

Children from low socio-economic status (SES) households often demonstrate worse growth and developmental outcomes than wealthier children, in part because poor children face a broader range of risk factors. It is difficult to characterize the trajectories of SES disparities in low- and middle-income countries because longitudinal data are infrequently available. We analyze measures of children's linear growth (height) at ages 1, 5, 8 and 12y and receptive language (Peabody Picture Vocabulary Test) at ages 5, 8 and 12y in Ethiopia, India, Peru and Vietnam in relation to household SES, measured by parental schooling or household assets. We calculate children's percentile ranks within the distributions of height-for-age z-scores and of age- and language-standardized receptive vocabulary scores. We find that children in the top quartile of household SES are taller and have better language performance than children in the bottom quartile; differences in vocabulary scores between children with high and low SES are larger than differences in the height measure. For height, disparities in SES are present by age 1y and persist as children age. For vocabulary, SES disparities also emerge early in life, but patterns are not consistent across age; for example, SES disparities are constant over time in India, widen between 5 and 12y in Ethiopia, and narrow in this age range in Vietnam and Peru. Household characteristics (such as mother's height, age, and ethnicity), and community fixed effects explain most of the disparities in height and around half of the disparities in vocabulary. We also find evidence that SES disparities in height and language development may not be fixed over time, suggesting opportunities for policy and programs to address these gaps early in life.