Disparities in children’s health and behaviour: The importance of race/ethnicity in the UK and US

Disparities in children’s health and behaviour: The importance of race/ethnicity in the UK and US is a research project funded by the Economic and Social Research Council and the National Institutes for Health which examines ethnic/racial disparities in early child development – comparing the UK and US.

This collaborative project involves an eminent team of child health experts from the UK and the US and is examining how racial/ethnic disparities in childhood health and development vary across group, to what extent those who migrate to countries like the US and UK face disparities and how these disparities vary across country of origin, country of destination, circumstances of migration, and generation. It is also looking at whether racial/ethnic disparities in health are influenced by policies related to access to the health care system and whether universal policies on early childhood health and education promote equality in outcomes between the majority population and minorities.

Exploring similarities and differences in childhood health and developmental outcomes across the UK and US and examining explanations for observed patterns in childhood health and development in UK and US settings, this project is unique in its pursuit of examining differences by ethnic/racial group, including those who have recently migrated into the US and UK, in children’s health and development, an issue of key importance to policymakers.

The work is expected to make a major contribution to the field of development, education, and policy and will provide sophisticated analyses and products that will be beneficial to both countries.

Background

Early childhood health and development, a term that encompasses physical health, socioemotional behaviour and cognitive ability, tells us a great deal about the health of our children now but can also help us predict future health and life chances. In the UK and US ethnic/racial differences in early childhood health and development have been documented.

Work in the US and the UK reveals the complexity of the ethnic/racial patterning of childhood health and development. A range of socio-economic, cultural and behavioural factors are involved, and these relate in complex ways to historical and contemporary features of US and UK society. However, there is very little comparative work on markers of early childhood health and development across UK and US settings.

Comparative analyses of outcomes within countries allows for a more precise examination of the factors that might relate to ethnic/racial disparities, because they provide greater heterogeneity in historical and contemporary factors and in the populations of interest. A comparison across countries further amplifies the power to do
this, because of more fundamental variations in social systems, patterns of migration and both historical and contemporary ethnic/race relations.

Data and methods

The research makes use of two data sets that are remarkable in the similarity of both the timing of data collection and the measures collected, despite having been designed independently. The first is the US Early Childhood Longitudinal Study-Birth
Cohort (ECLS-B) and the second is the UK Millennium Cohort Study (MCS).

The topics covered in the ECLS-B and MCS that tap into the domains of early childhood health and development are conceptually equivalent, i.e. cognitive ability, socio-emotional behaviours and physical health. For the MCS, data were collected when the cohort member was aged approximately 9 months, 3, 5, and 7 years, and in the ECLS-B at 9 months, 2, 4 and 5/6 years of age. For some topics the measures available are entirely equivalent, e.g. growth and
obesity (height, weight and BMI), and asthma. While for other topics, e.g. cognitive ability and socio-emotional behaviours, different measures addressing the same concept are available in the datasets.

What the researchers will do

The research team has three specific aims:

1. To describe the patterning of ethnic/racial disparities in child health and development in the US and UK. We will examine data on the three components of childhood health and development, namely:

• physical markers such as growth, obesity, and asthma
• cognitive test performance and school readiness
• socio-emotional behaviours such as hyperactivity, inattention and peer relationships

This will allow similarities and differences in ethnic/racial patterning of childhood health and development in UK and US contexts to be identified.

2. To examine factors that might explain ethnic/racial disparities at an individual level. The researchers are concerned here to examine the contribution of a range of socioeconomic, cultural and behavioural factors to the observed disparities in outcomes. These factors might include things such as economic position, educational level of parents, degree of acculturation, social and cultural norms and beliefs, migration status, household structure and family networks, residential neighbourhood, and exposure of parent and child to racism.

3. To explore explanations for ethnic/racial disparities at a macro-level. This aim is specifically designed to exploit structural differences between the US and UK and to provide both a descriptive and a predictive examination. These important differences include:

• migratory factors, such as the motivation for and recency of migration to the host country
  and within ethnic/racial group levels of spoken English
• the socio-economic characteristics of the country of origin and the socio-economic location of individuals in their country of origin
• social and public policies and structures for the delivery of health and child care and education
• historical and contemporary ethnic/race relations.