Socioeconomic gradient in the developmental health of Canadian children with disabilities at school entry: a cross-sectional study

Objective To examine the relationship between developmental health and neighbourhood socioeconomic status (SES) in kindergarten children with disabilities.Design Cross-sectional study using population-level database of children’s developmental health at school entry (2002–2014).Setting 12 of 13 Cana...

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Main Authors: Martin Guhn, Marni Brownell, Eric Duku, Magdalena Janus, Teresa Bennett, Barry Forer
Format: Article
Language:English
Published: BMJ Publishing Group 2020-04-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/4/e032396.full
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author Martin Guhn
Marni Brownell
Eric Duku
Magdalena Janus
Teresa Bennett
Barry Forer
author_facet Martin Guhn
Marni Brownell
Eric Duku
Magdalena Janus
Teresa Bennett
Barry Forer
author_sort Martin Guhn
collection DOAJ
description Objective To examine the relationship between developmental health and neighbourhood socioeconomic status (SES) in kindergarten children with disabilities.Design Cross-sectional study using population-level database of children’s developmental health at school entry (2002–2014).Setting 12 of 13 Canadian provinces/territories.Measures Taxfiler and Census data between 2005 and 2006, respectively, were aggregated according to custom-created neighbourhood boundaries and used to create an index of neighbourhood-level SES. Developmental health outcomes were measured for 29 520 children with disabilities using the Early Development Instrument (EDI), a teacher-completed measure of developmental health across five domains.Analysis Hierarchical generalised linear models were used to test the association between neighbourhood-level SES and developmental health.Results All EDI domains were positively correlated with the neighbourhood-level SES index. The strongest association was observed for the language and cognitive development domain (β (SE): 0.29 (0.02)) and the weakest association was observed for the emotional maturity domain (β (SE): 0.12 (0.01)).Conclusions The magnitude of differences observed in EDI scores across neighbourhoods at the 5th and 95th percentiles are similar to the effects of more established predictors of development, such as sex. The association of SES with developmental outcomes in this population may present a potential opportunity for policy interventions to improve immediate and long-term outcomes.
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spelling doaj-art-eb190ceff26b43ddae1818245129b37c2025-08-20T02:19:55ZengBMJ Publishing GroupBMJ Open2044-60552020-04-0110410.1136/bmjopen-2019-032396Socioeconomic gradient in the developmental health of Canadian children with disabilities at school entry: a cross-sectional studyMartin Guhn0Marni Brownell1Eric Duku2Magdalena Janus3Teresa Bennett4Barry Forer5Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, CanadaDepartment of Community Health Sciences, University of Manitoba Faculty of Health Sciences, Winnipeg, Manitoba, CanadaDepartment of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, CanadaOfford Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada1 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, CanadaHuman Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, CanadaObjective To examine the relationship between developmental health and neighbourhood socioeconomic status (SES) in kindergarten children with disabilities.Design Cross-sectional study using population-level database of children’s developmental health at school entry (2002–2014).Setting 12 of 13 Canadian provinces/territories.Measures Taxfiler and Census data between 2005 and 2006, respectively, were aggregated according to custom-created neighbourhood boundaries and used to create an index of neighbourhood-level SES. Developmental health outcomes were measured for 29 520 children with disabilities using the Early Development Instrument (EDI), a teacher-completed measure of developmental health across five domains.Analysis Hierarchical generalised linear models were used to test the association between neighbourhood-level SES and developmental health.Results All EDI domains were positively correlated with the neighbourhood-level SES index. The strongest association was observed for the language and cognitive development domain (β (SE): 0.29 (0.02)) and the weakest association was observed for the emotional maturity domain (β (SE): 0.12 (0.01)).Conclusions The magnitude of differences observed in EDI scores across neighbourhoods at the 5th and 95th percentiles are similar to the effects of more established predictors of development, such as sex. The association of SES with developmental outcomes in this population may present a potential opportunity for policy interventions to improve immediate and long-term outcomes.https://bmjopen.bmj.com/content/10/4/e032396.full
spellingShingle Martin Guhn
Marni Brownell
Eric Duku
Magdalena Janus
Teresa Bennett
Barry Forer
Socioeconomic gradient in the developmental health of Canadian children with disabilities at school entry: a cross-sectional study
BMJ Open
title Socioeconomic gradient in the developmental health of Canadian children with disabilities at school entry: a cross-sectional study
title_full Socioeconomic gradient in the developmental health of Canadian children with disabilities at school entry: a cross-sectional study
title_fullStr Socioeconomic gradient in the developmental health of Canadian children with disabilities at school entry: a cross-sectional study
title_full_unstemmed Socioeconomic gradient in the developmental health of Canadian children with disabilities at school entry: a cross-sectional study
title_short Socioeconomic gradient in the developmental health of Canadian children with disabilities at school entry: a cross-sectional study
title_sort socioeconomic gradient in the developmental health of canadian children with disabilities at school entry a cross sectional study
url https://bmjopen.bmj.com/content/10/4/e032396.full
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