Higher Maternal Education Level Research Articles

Trajectories of early-onset rhinitis in the Singapore GUSTO mother-offspring cohort.

The natural history of childhood rhinitis is not well described. This study aimed to identify different rhinitis trajectories in early childhood and their predictors and allergic associations. Rhinitis symptoms were ascertained prospectively from birth until 6years using standardized questionnaires in 772 participants. Rhinitis was defined as one or more episodes of sneezing, runny and/or blocked nose >2weeks duration. Latent trajectories were identified using group-based modelling, and their predictive risk factors and allergic associations were examined. Three rhinitis trajectory groups were identified: 7.6% (n=59) were termed early transient rhinitis, 8.6% (n=66) late transient rhinitis, and 6.6% (n=51) persistent rhinitis. The remaining 77.2% (n=596) were classified as non-rhinitis/reference group. Early transient rhinitis subjects were more likely of Indian ethnicity, had siblings, reported childcare attendance, early wheezing and eczema in the first 3years of life. Late transient rhinitis was associated with antenatal exposure to smoking, higher maternal education levels, andwheezing at age 36-72months. Persistent rhinitis was associated with male gender, paternal and maternal history of atopy, eczema, and house dust mite sensitization. Risk factors for early transient rhinitis involve a combination of genetic and early environmental exposures, whereas late transient rhinitis may relate to maternal factors and early respiratory infections independent of atopy. In contrast, persistent rhinitis is strongly associated with atopic risk and likely represents the typical trajectory associated with allergic disorders. Allergic rhinitis symptoms may commence as early as the first year of life and may inform development of early interventive strategies.

The Effects of an Infant Formula Enriched with Milk Fat Globule Membrane, Long-Chain Polyunsaturated Fatty Acids and Synbiotics on Child Behavior up to 2.5 Years Old: The COGNIS Study.

Although early life nutrition influences brain development and mental health, the long-term effects of supplemented infant formula on children´s behavior remain unclear. We analyzed the effects of a bioactive nutrients-enriched-infant formula on children’s behavior up to 2.5 years, compared to a standard infant formula or breastfeeding. Current analysis involved 70 children who were fed a standard infant formula (SF, n = 29) or a bioactive compounds enriched-infant formula (EF, n = 41), during their first 18 months of life, and 33 breastfed (BF) children (reference group) participating in the COGNIS study. Behavioral problems were evaluated using the Child Behavior Checklist at 18 months and 2.5 years. Different statistical analyses were performed using SPSS. EF children aged 2.5 years presented fewer pathological affective problems than SF children. Besides, SF children were classified more frequently as bordering on internalizing problems than BF children. Rates of externalizing problems were increased in SF infants compared to EF and BF infants. Higher maternal IQ was found to have beneficial effects on internalizing and total problem rate in their offspring at 18 months of life; finally, higher maternal educational level was related with fewer ADHD problems in children at 18 months, as well as internalizing, externalizing, total and anxiety problems in children aged 2.5 years. Our analysis suggests that enriched infant formula fed infants seem to show fewer behavioral problems up to 2.5 years compared to a standard infant formula-fed infants. In addition to type of early feeding, maternal IQ and educational level seem to play a key role on children behavioral development.

Maternal Education Level and Excessive Recreational Screen Time in Children: A Mediation Analysis.

There is increasing recognition of the adverse health consequences of excessive recreational screen time (RST) in children and adolescents. Early interventions that aim to reduce RST are crucial, but there are some controversies about which individual and parental variables affect RST in children. The aim of this study was to determine the relationship of parental education level with RST in children and early adolescents and to identify mediators of these relationships. This cross-sectional study examined a sample of children (2–14 year-old) who attended routine childcare visits in primary health care centers in Spain (n = 402; 53.7% males; mean age: 7 ± 4 year-old). A self-reported questionnaire was given to the parents to assess sociodemographic data, parental education, the home media environment, and RST in children. Separate analysis was performed for two age groups (2–6 year-old and 6–14 year-old). Path analysis, an application of structural equation modeling, was used to analyze the data. Fitty three percent of the children had excessive RST (≥2 h/day). The maternal education level, eating lunch/dinner in front of a TV, presence of a background TV, and the amount of parental TV viewing had significant associations with excessive RST in both age groups. For the younger group, the maternal education level had direct and indirect effects on RST (total effect: β = −0.29, p < 0.01). For the older group, maternal education level only had a significant indirect effect on RST, and this was mediated by the presence of a background TV and the time of parental TV viewing (total indirect effect: β = −0.11, p < 0.01). A higher maternal education level appears to be associated with certain environmental factors or habits that prevent excessive RST.

A Priori and a Posteriori Dietary Patterns in Women of Childbearing Age in the UK.

Poor diet quality is a major cause of maternal obesity. We aimed to investigate a priori and a-posteriori derived dietary patterns in childbearing-aged women in UK. An online survey assessed food intake, physical activity (PA), anthropometry and socio-demographics. An a priori defined diet quality was determined via Mediterranean diet (MD) adherence score and Exploratory Factor Analysis (EFA) derived dietary patterns (DPs). Multiple linear regression explored associations between DPs with anthropometric measures, PA and socio-demographics. Participants (n = 123) had low-to-medium MD adherence (average MD-score: 4.0 (2.0)). Age was positively associated with higher MD adherence (X2 (2) = 13.14, p = 0.01). EFA revealed three DPs: ‘fruits, nuts, vegetables and legumes’ (“Vegetarian-style” DP); ‘sweets, cereals, dairy products and potatoes’ (“Dairy, sweets and starchy foods” DP); and ‘eggs, seafood and meats’ (“Protein-rich” DP). “Vegetarian-style” DP was positively associated with higher maternal educational level (p < 0.01) and PA (p = 0.01), but negatively with white ethnicity (p < 0.01). “Dairy, sweets and starchy foods” DP was positively associated with white ethnicity (p = 0.03) and negatively with age (p = 0.03). “Protein-rich” DP was positively associated with age (p < 0.001) and negatively with PA (p = 0.01). A poor diet quality was found among childbearing-aged women; notably in the younger age category, those of white ethnicity, that were more physically inactive and with a lower socioeconomic background.

Physical activity patterns in a representative sample of adolescents from the largest city in Latin America: a cross-sectional study in Sao Paulo.

ObjectivesWe examined the patterns of total and domain-specific physical activity (PA) by sex, socioeconomic status and maternal education level in adolescents from Sao Paulo city, Brazil.DesignCross-sectional study.ParticipantsWe included a representative sample of 2682 (52.2% boys) adolescents aged 14–15 years from public and private schools in Sao Paulo, 2017. Socioeconomic status was assessed using a wealth index derived from principal component analysis. Descriptive analyses evaluated differences in total and domain-specific PA by sex, socioeconomic status and maternal education level.Outcome measuresWe collected data on the frequency and duration that adolescents spent in each PA domain (active transportation, leisure PA and physical education classes) through a self-report questionnaire.ResultsOn average, adolescents spent 197.7 min/week (95% CI 190.6–204.8) in total PA. The proportion of adolescents achieving at least 60 min/day (≥420 min/week) was 12.7% (95% CI 11.4–14.1), with a higher prevalence in boys (18.3%) and in those with higher socioeconomic status (17.4%). Similar patterns were observed for leisure PA and physical education classes. Active transportation was higher in girls (46.0 min/week; 95% CI 42.6–49.6) than in boys (43.4 min/week, 95% CI 39.9–46.6). Boys and adolescents with higher socioeconomic status and higher maternal education level had higher levels of total PA.ConclusionsWe found a variation in patterns of total and domain-specific PA by sex, socioeconomic status and maternal education level in adolescents from Sao Paulo. Initiatives for promoting PA in adolescents should take these findings into account.

Unsafe child feces disposal status in Ethiopia: what factors matter? Analysis of pooled data from four demographic and health surveys

BackgroundThe only safest way to dispose of a child’s feces is to help the child use a toilet or, for very young children, to put or rinse their feces into a toilet, whereas other methods are considered unsafe. This study aimed to determine the magnitude and factors associated with unsafe child feces disposal in Ethiopia.MethodsThis was a cross-sectional study using pooled data from the four rounds of Demographic and Health Surveys (DHS) conducted in Ethiopia (2000, 2005, 2011, and 2016). Data on child feces disposal practice was collected for all children born during the 5 years preceding survey. Mothers were asked for the youngest child born, “The last time child passed stools, what was done to dispose of the stools?”.Descriptive statistics were computed to illustrate the given data. Multivariable logistic regression was performed to identify factors associated with unsafe child feces disposal.ResultsThe pooled dataset contains data for 40,520 children younger than 5 years, male accounts 20,629 (50.9%). Overall, 77.7% (95%CI: 76.3–79.0) of children feces disposed of unsafely. In the multivariable logistic regression model, those mothers whose child was 13–24 months [AOR: 0.68, 95% CI: (0.60–0.78)] and ≥ 25 months [AOR: 0.66, 95% CI: (0.60–0.72)] were lower odds of unsafe child’s feces disposal. Children born into households having two or fewer children were 33% lower [AOR: 0.67, 95% CI: (0.56–0.79)] odds of unsafe child’s feces disposal than their counterparts. The odds of disposing of feces unsafely among households having improved toilet facility was 76% lower [AOR: 0.24, 95% CI: (0.19–0.29)] that of households lacking such facilities. Further, being an urban resident, having improved drinking water facility, a high level of maternal and paternal education, paternal occupational status (work in non-agriculture), and maternal age (25–34 and ≥ 35 years) were factors that associated with lower odds of unsafe child’s feces disposal.ConclusionsThree in four Ethiopian children feces disposed of unsafely. Household and socio-demographic factors, such as access to improved toilet facility, the child’s age (older age), and both higher maternal and paternal education levels were important factors that significantly associated with lower odds of unsafe child feces disposal.

Associations between Infant and Parent Characteristics and Measures of Family Well-Being in Neonates with Seizures: A Cohort Study

To characterize and determine risk factors for key dimensions of well-being at hospital discharge in families of neonates with acute symptomatic seizures. This prospective, observational cohort study enrolled 144 parent-infant dyads among neonates with acute symptomatic seizures from 9 pediatric hospitals in the Neonatal Seizure Registry. One parent per family completed a discharge survey, which included measures of anxiety and depression, health-related quality of life, and impact on the family. Multivariable regression analyses adjusted for site were constructed to examine parent and infant characteristics associated with well-being. At discharge, 54% of parents reported symptoms of anxiety and 32% reported symptoms of depression. Parents of infants with hypoxic-ischemic encephalopathy reported more depression and worse quality of life than parents of infants with other seizure etiologies. Parental quality of life was also lower with greater infant age at discharge. A higher level of maternal education was associated with greater impact on the family. All these differences were medium to large effect sizes, ranging from 0.52 to 0.78. Symptoms of anxiety and depression are common in parents of infants with neonatal seizures, and several parent and infant characteristics are associated with poorer parental quality of life and family well-being. These findings are a call to action to improve mental health screening and services for parents of infants with neonatal seizures.

Chinese mothers’ intention to vaccinate daughters against human papillomavirus (HPV), and their vaccine preferences: a study in Fujian Province

ABSTRACT Little is known regarding Chinese mothers’ intention to vaccinate their daughters against human papillomavirus (HPV) since the HPV vaccine was approved for use in China in 2016. The aim was to explore maternal HPV vaccination acceptance, preference for 2-, 4- or 9-valent HPV vaccine and acceptance of domestically manufactured HPV vaccines. Study participants were mothers of primary school children in Southeastern region of Fujian. An online cross-sectional survey was undertaken between June and August 2019. Among the total of 3,586 completed responses (response rate 28.5%), the intention to vaccinate daughter against HPV was high (83.3%). Higher maternal education and perceived benefit and barriers were associated with greater intention to vaccinate. Among mothers who did not intend to vaccinate their daughters, the three most common reasons were daughter being too young to receive HPV vaccination (40.6%), fear of side effects (31.9%) and vaccine price is too high (16.0%). The largest proportion (41.4%) preferred their daughter to be vaccinated with the 9-valent HPV vaccine (9vHPV). Greater preference for 9vHPVwas strongly associated with higher maternal education level and annual household income. The majority of mothers expressed a preference for imported HPV vaccine (56.3%). Our result indicates that lower intentions to vaccinate daughters against HPV among less educated and lower-income mothers may lead to significant social inequalities in HPV vaccine uptake in the country.

Stillbirth and Fetal Autopsy Rates in the United States: Analysis of Fetal Death Certificates [35O

INTRODUCTION: Fetal autopsy is recommended by ACOG as an important part of the evaluation of stillbirth. Stillbirth Collaborative Research Network data show that it can yield a probable or possible cause of stillbirth in approximately 80% of cases and is singularly useful in 42%. Rates of perinatal autopsy approach 100% in countries with similar resources. Our aim was to identify national rates of fetal autopsy and maternal and fetal characteristics related to consent to autopsy. METHODS: This is a population-based retrospective cohort study using United States Fetal Death certificates of stillbirths (20 weeks or over) delivered between January 2014 and December 2016. Multiple gestations were excluded. Fetal autopsy rates were calculated by gestational age, maternal age, race, education, and having at least one living child. RESULTS: There were 60,328 stillbirths meeting inclusion criteria. Fetal autopsy was performed in 20.9%. Increasing gestational age positively correlated (r=0.55; P=.003), while increasing maternal age negatively correlated with autopsy (r=-0.66; P &lt;.001). Hispanic women had the lowest rates (17.8%), compared to non-Hispanic black (22.9%) and non-Hispanic white (20.5%) women (P&lt;.001). Higher levels of maternal education were associated with increased rates, women with a Doctorate degree had twice the fetal autopsy rate (32.0%) than women with an educational level of 8th grade (15.3%) (P&lt;.001). Women with at least one living child had lower rates of fetal autopsy (P&lt;.001). CONCLUSION: Fetal autopsy rates are quite low throughout the US. The reasons for low autopsy rates warrant further exploration in order to inform strategies to increase availability and uptake.

Knowledge and management of fever in parents of children under 5 years of age at a children's hospital.

In pediatrics, fever is a common reason for consultation. The objective was to assess parental knowledge, behaviors, and fears in the management of fever in their children. Observational, analytical, cross-sectional study. In 2018, a survey was administered to the parents of children aged 6 months to 5 years who attended Hospital de Niños Ricardo Gutiérrez, in the Autonomous City of Buenos Aires. The association between sociodemographic outcome measures and knowledge, behaviors, and fears in cases of fever was analyzed. A total of 201 surveys were completed: 56.7 % of parents considered that fever was bad for health; 37 % defined fever between 37 °C and 37.5 °C, and 59 %, between 38 °C and 38.5 °C. The mean temperature considered severe was 39.2 °C (standard deviation: 0.69). Physical methods were used by 93 % of caregivers; 97 % administered antipyretic agents, and 14.5 % used alternating agents. Fears of consequences included seizures in 82 %, dehydration in 41 %, brain damage in 18 %, and death in 12 %. Also, 86.5 % woke up their children to give them an antipyretic agent. Among the higher maternal education level, fear of fever was lower (odds ratio: 0.5; 95 % confidence interval: 0.28-0.91). One-third of survey respondents considered low body temperature values as fever. Fear of fever was high, and the level of maternal education may mitigate it.

Determinants of early attendance of ECEC for families with a Turkish migration background in four European countries

ABSTRACTResearch has demonstrated educational inequalities for children with migrant background. This article focuses specifically on children and families with a Turkish immigration background in four European countries. Because of the great potential of high quality Early Childhood Education and Care (ECEC) for decreasing educational disparities, we examined associations between family characteristics (structural characteristics and acculturation attitudes) and early ECEC attendance (under the age of two) for families with a Turkish immigration background in England, Germany, The Netherlands, Norway (N = 943), using data from a standardized survey. Group-wise logistic regressions revealed differences among the predicting factors across countries. Nevertheless, factors that related to family socio-economic background were found to be associated with early ECEC attendance across all countries: higher levels of maternal education (England, Germany, The Netherlands), maternal employment (Norway), and more material deprivation (England) significantly predicted early ECEC use. In addition to these SES associations, factors related to socio-cultural adoption were associated with early ECEC use in three (out of four) countries. The findings can be partly related to country-specific ECEC characteristics.

Exclusive breastfeeding counseling and free health checks as efforts to improve community healthy awareness

The success of exclusive breastfeeding is a high level of maternal education, a fairly high level of maternal knowledge, the existence of support and understanding of husbands to breastfeed exclusively, the role of potential groups to provide information to pregnant and breastfeeding mothers, the existence of counseling, supportive attitudes of officers and want to respond to every problem that is being faced. From the results of the study it is recommended to maintain and even increase and promote the success of exclusive breastfeeding. ASI is a fat emulsion in a solution of protein, lactose and organic salts that are secreted by the two glands of the mother's breast as the main and best food for infants because in the milk it contains immune, anti-infectious and nutritional nutrients needed to grow and develop and control excess weight gain. body or obesity. Exclusive breast milk is breast milk that is given to infants without additional food at least until the age of 4-6 months

Impaired frequency selectivity and sensitivity to temporal fine structure, but not envelope cues, in children with mild-to-moderate sensorineural hearing loss.

Psychophysical thresholds were measured for 8-16 year-old children with mild-to-moderate sensorineural hearing loss (MMHL; N = 46) on a battery of auditory processing tasks that included measures designed to be dependent upon frequency selectivity and sensitivity to temporal fine structure (TFS) or envelope cues. Children with MMHL who wore hearing aids were tested in both unaided and aided conditions, and all were compared to a group of normally hearing (NH) age-matched controls. Children with MMHL performed more poorly than NH controls on tasks considered to be dependent upon frequency selectivity, sensitivity to TFS, and speech discrimination (/bɑ/-/dɑ/), but not on tasks measuring sensitivity to envelope cues. Auditory processing deficits remained regardless of age, were observed in both unaided and aided conditions, and could not be attributed to differences in nonverbal IQ or attention between groups. However, better auditory processing in children with MMHL was predicted by better audiometric thresholds and, for aided tasks only, higher levels of maternal education. These results suggest that, as for adults with MMHL, children with MMHL may show deficits in frequency selectivity and sensitivity to TFS, but sensitivity to the envelope may remain intact.

Maternal Education and Chinese First Graders’ Performance in Language and Literacy and Math: Role of Home Environment

Research shows that maternal education influences children’s academic performance indirectly through the quality of the home environment. In this study, we tested the role of 12 variables within the home environment (e.g., eating meals together, reading for fun at home, number of children’s books, watching TV, and bedtime) to help identify those that were effected by maternal education and then in turn affected first graders’ performance in Language and Literacy and Math. We collected home environment data from 313 Chinese parents and academic performance data directly from the children’s school. From the 12 variables, path analyses identified three that were significant: the number of children’s books at home, the number of hours that the child watched TV daily, and the number of extracurricular activities. Specifically, a higher maternal education level was related to more children’s books at home and fewer hours of TV watching daily, which were related to better performance in Language and Literacy; a higher maternal education level was related to more children’s books at home and more extracurricular activities, which were then related to better performance in math. As the identified variables are all malleable, intervention strategies that make reading materials available to children at home, limit children’s exposure to excessive TV, and promote extracurricular activity involvement may benefit children’s academic performance. Interventions that focus on increasing less educated mother’s awareness of the importance of providing reading materials to children at home, regulating children’s TV time, and involving children in extracurricular activities could also be beneficial.

Risk and protective factors for pre- and postnatal bonding.

Since disturbances in the mother-child bond increase the risk of negative consequences for child development, it is important to identify risk and protective factors for bonding as well as longitudinal associations. Previous research has used different bonding instruments during pregnancy and the postnatal phase, leading to inconsistent results. In the current study, the same instrument was used during the various phases. In a large, community-based sample (N = 793), general information, feelings of pre- and postnatal bonding (Pre- and Postnatal Bonding Scale), depressive symptoms (Edinburgh Postnatal Depression Scale), and partner support (subscale Tilburg Pregnancy/Postnatal Distress Scale) were measured at both 32 weeks of pregnancy and 8 months postnatally. Partner support was found to be a protective factor for suboptimal pre- and postnatal bonding, as was the engagement with fetal movements for prenatal bonding. High maternal educational level was a risk factor for suboptimal prenatal bonding, as were depressive symptoms for suboptimal postnatal bonding. The associations between most prenatal determinants and postnatal bonding were mediated by prenatal bonding, which underlines the importance of promoting prenatal bonding. Professionals in clinical practice should be aware of partner support, engagement with fetal movements, and postnatal depressive symptoms: All these factors offer opportunities for improving the bonding processes.

Association between maternal education and breast feeding practices in China: a population-based cross-sectional study

ObjectiveTo investigate the association between maternal education and breast feeding in the Chinese population, with a consideration of household income and health-seeking behaviours.DesignA nationally representative population-based cross-sectional study.Setting77 counties from...

Behavioural outcome in twin–twin transfusion syndrome survivors treated with laser surgery

ObjectiveEvaluate the incidence of and risk factors for behavioural problems in twin–twin transfusion syndrome (TTTS) survivors treated with fetoscopic laser coagulation.DesignObservational cohort study.SettingNational referral center for fetal therapy, Leiden University...

Teen mothers' educational attainment and their children's risk for teenage childbearing.

The children of teen mothers are at elevated risk for becoming teen parents themselves. The current study aimed to identify how levels of mothers' education were associated with risk of teenage childbearing for children of teen versus nonteen mothers. Through structural equation modeling, we tested whether children's environmental and personal characteristics in adolescence and subsequent sexual risk behaviors mediated the relationship between their mothers' educational attainment and their risk for teenage childbearing. With multiple-group models, we assessed whether the associations of maternal educational attainment with children's outcomes were similar for the children of teen and nonteen mothers. The sample (N = 1,817) contained linked data from female National Longitudinal Survey of Youth, 1979 (NLSY79) participants and their first-born child (son or daughter) from the NLSY79 Children and Young Adults. The mediating pathways linking higher levels of maternal education to lower risk for teenage childbearing, and magnitudes of the associations, were mostly similar for children of teen and nonteen mothers. However, nonteen mothers experienced greater associations of their high school diploma attainment (vs. no degree) with some of their children's outcomes. Also, the association of earning a high school diploma (vs. a GED) with household incomes was greater for nonteen mothers; there was no significant difference between degree types for teen mothers. Findings provide support for teen mother secondary school support programming, but point to a need for further research regarding the long-term behavioral and social outcomes associated with the high school equivalency certificate for teen mothers and their children. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Full Immunization Coverage and Associated Factors among Children Aged 12-23 Months in a Hard-to-Reach Areas of Ethiopia.

Introduction Childhood immunization averts 2.5 million annual child deaths globally. However, poor monitoring, possibly due to a lack of locally available data on immunization, might affect full protection of vaccines from Vaccine Preventable Diseases. This study was aimed at bringing data about immunization service coverage and its associated factors from Sekota Zuria district, which is one of the hard-to-reach areas in Amhara Region, Ethiopia. Methods A community-based cross-sectional study was conducted from September 20 to October 28, 2017, among 620 children aged 12-23 months in seven randomly selected rural kebeles of Sekota Zuria district. Socio-demographic child conditions and vaccine-related data were collected using a pretested interviewer-administered questionnaire. Multivariable logistic regression analysis was carried out to identify factors associated with immunization coverage at a p-value ≤ 0.05. Crude and Adjusted Odds Ratio (AOR) with their confidence interval were reported. Results 77.4% (95%CI: 74.0%-80.6%) of children aged 12-23 months were fully immunized. Having antenatal care visit (AOR=2.75, 95%CI: 1.52-5.0), higher level of maternal education (AOR=2.39, 95%CI: 1.06-5.36), mothers' good knowledge on immunization (AOR=3.70, 95%CI: 2.37-5.79), short distance to health facility (AOR=2.65, 95%CI: 1.61-4.36), and being born in health institutions (AOR=2.58, 95%CI: 1.66-3.99) had increased the odds of full immunization coverage while having five and more family size reduced the odds of children's vaccine uptake (AOR=0.62, 95%CI: 0.38-0.99). Conclusion Full immunization coverage of the district was lower than the target set by the World Health Organization. Improving mother's health seeking behavior toward pregnancy follow-up and enhancing mothers' knowledge on child immunization, strengthening outreach services, community engagement, and actively working with local community-based health agents are recommended to increase number of children to be vaccinated.

The association between urbanization and child height: a multilevel study in China

BackgroundRecent economic development in China has been accompanied by well-documented health inequalities between regions. The impact of individual factors on child height has been widely studied, but the influence of community-level factors has not yet been fully studied.MethodsThe cross-sectional data of 1606 Chinese children aged 5–18 years from the China Health and Nutrition Survey 2011 were used. Multilevel analysis was used to examine the association of community factors (using urbanization index) with child height. Child height was measured following standardized procedures, and height-for-age Z scores were calculated as outcome variables. Datasets were presented at two levels: community variable (Level-2) was an urbanization index which is a composite score summarizing 12 community-level contextual factors. Individual variables (Level-1) were child gender, ethnicity, percentage of energy intake from protein, maternal height, maternal education level, and family income.ResultsUrbanization index was associated with child height. Among the 12 community-level factors, ‘education’ were positively associated with child height. Additionally, stratified analyses by age showed that ‘population density’ and ‘housing’ were positively significantly associated with the height of elder children (13–18 years). At the individual level, male sex, higher maternal height, higher maternal education levels, higher family income, and higher percentage of energy intake from protein, were significantly positively associated with child height.ConclusionsOur findings point to the role of contextual factors that generate differences between regions in shaping the distribution of child physical health outcomes. Our study suggests that public health programs and policies for child’s physical development may need to combine individual-centered strategies and also approaches aimed at changing residential environments.