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Abstract
BackgroundBy explaining the development of health inequalities, eco-social theories highlight the importance of social environments that children are embedded in. The most important environment during early childhood is the family, as it profoundly influences children’s health through various characteristics. These include family processes, family structure/size, and living conditions, and are closely linked to the socioeconomic position (SEP) of the family. Although it is known that the SEP contributes to health inequalities in early childhood, the effects of family characteristics on health inequalities remain unclear. The objective of this scoping review is to synthesise existing research on the mediating and moderating effects of family characteristics on socioeconomic health inequalities (HI) during early childhood in high-income countries.MethodsThis review followed the methodology of “Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews”. To identify German and English scientific peer-reviewed literature published from January 1st, 2000, to December 19th, 2019, the following search term blocks were linked with the logical operator “AND”: (1) family structure/size, processes, living conditions, (2) inequalities, disparities, diversities, (3) income, education, occupation, (4) health and (5) young children. The search covered the electronic databases PubMed, PsycINFO, and Scopus.ResultsThe search yielded 7,089 records. After title/abstract and full-text screening, only ten peer-reviewed articles were included in the synthesis, which analysed the effects of family characteristics on HI in early childhood. Family processes (i.e., rules /descriptive norms, stress, parental screen time, parent–child conflicts) are identified to have mediating or moderating effects. While families’ living conditions (i.e., TVs in children’s bedrooms) are suggested as mediating factors, family structure/size (i.e., single parenthood, number of children in the household) appear to moderate health inequalities.ConclusionFamily characteristics contribute to health inequalities in early childhood. The results provide overall support of models of family stress and family investment. However, knowledge gaps remain regarding the role of family health literacy, regarding a wide range of children’s health outcomes (e.g., oral health, inflammation parameters, weight, and height), and the development of health inequalities over the life course starting at birth.
Highlights
By explaining the development of health inequalities, eco-social theories highlight the importance of social environments that children are embedded in
Hoffmann et al BMC Public Health (2022) 22:338 family health literacy, regarding a wide range of children’s health outcomes, and the development of health inequalities over the life course starting at birth
The core concept pertains to health that depends on the socioeconomic position (SEP) of the family, which is operationalised by parental education, occupation and/or income
Summary
By explaining the development of health inequalities, eco-social theories highlight the importance of social environments that children are embedded in. The most important environment during early childhood is the family, as it profoundly influences children’s health through various characteristics. These include family processes, family structure/size, and living conditions, and are closely linked to the socioeconomic position (SEP) of the family. Childhood has been found to be relevant for the development of health behaviour and for health in the long-term [2] This life stage spans several age groups, including newborns (birth to 1 month), infants (1 month to 1 year), toddlers (1 year to 2 years), and preschoolers (2 years to 6 years) [6]. Children under the age of six from families with a lower SEP are more likely to have asthma, a delayed cognitive development, a higher prevalence of overweight/obesity, and lower levels of physical activity [7,8,9,10,11]
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