Inequalities In Children Research Articles

Addressing health inequalities in the delivery of the human papillomavirus vaccination programme: examining the role of the school nurse.

BackgroundHPV immunisation of adolescent girls is expected to have a significant impact in the reduction of cervical cancer. UK The HPV immunisation programme is primarily delivered by school nurses. We examine the role of school nurses in delivering the HPV immunisation programme and their impact on minimising health inequalities in vaccine uptake.Methods and FindingsA rapid evidence assessment (REA) and semi-structured interviews with health professionals were conducted and analysed using thematic analysis. 80 health professionals from across the UK are interviewed, primarily school nurses and HPV immunisation programme coordinators. The REA identified 2,795 articles and after analysis and hand searches, 34 relevant articles were identified and analysed. Interviews revealed that health inequalities in HPV vaccination uptake were mainly related to income and other social factors in contrast to published research which emphasises potential inequalities related to ethnicity and/or religion. Most school nurses interviewed understood local health inequalities and made particular efforts to target girls who did not attend or missed doses. Interviews also revealed maintaining accurate and consistent records influenced both school nurses' understanding and efforts to target inequalities in HPV vaccination uptake.ConclusionsDespite high uptake in the UK, some girls remain at risk of not being vaccinated with all three doses. School nurses played a key role in reducing health inequalities in the delivery of the HPV programme. Other studies identified religious beliefs and ethnicity as potentially influencing HPV vaccination uptake but interviews for this research found this appeared not to have occurred. Instead school nurses stated girls who were more likely to be missed were those not in education. Improving understanding of the delivery processes of immunisation programmes and this impact on health inequalities can help to inform solutions to increase uptake and address health inequalities in childhood and adolescent vaccination programmes.

Children’s understanding of family financial resources and their impact on eating healthily

Socioeconomic inequalities in childhood are linked to childhood and adult health inequalities. They are particularly closely associated with inequalities in nutritional and consequently health status. Recent research links this to the high cost of nutrient-rich and low cost of nutrient-poor foods and explores how parents negotiate food purchase on a limited budget. However, we know little of children's perspectives on the material and social realities of their lives and their involvement in health-relevant behaviour. This contrasts with a growing body of research which emphasises children's active role in making sense of and participating in health practices while growing up and their potential to act in continuity with and as agents of change in family health cultures. This paper explores children's understanding of family finances and how they perceive this to relate to eating healthily. It draws upon data from a qualitative study of 53 children aged 9-10 from two socioeconomically contrasting schools in the North of England during 2010 and 2011. Data were generated in friendship group interviews and debates at school and individual interviews in the home, and analysed thematically. Children incorporated a variety of media information into their understandings and sought explanations from their personal experience. They had sophisticated ideas about the interrelationships between diet, cost and health and were acutely aware of how family finances influenced food purchase. Children proposed different strategies to facilitate eating healthily on a budget, but prioritised state and corporate responsibility in ensuring that eating healthily is affordable. This contrasts with current health-related policy, which does not address cost as a potential barrier to eating healthily in the home. Children also consistently conflated healthy eating with eating fruit and vegetables, highlighting a need to reinforce other important nutritional messages.

ECCE Services in Mexico: Reducing Social Inequalities

In Mexico, the socioeconomic and cultural situation creates educational inequalities, and its impact is greater on young children. Since the Early Childhood Care and Education (ECCE) services have become a major pathway to compensate for social inequalities, in 2008 they have begun to be implemented through the “Programme for Strengthening Early Education and Child Development.” In this article, it is presented a brief review of the main theoretical approaches on social inequalities in early childhood, the main benefits of ECCE to counter inequality, and the status of ECCE services in Mexico to create a model of indicators of good practice.

The RICHER Social Pediatrics Model: Fostering Access and Reducing Inequities in Children's Health

Considerable evidence shows that children and families who are vulnerable because of their social and material circumstances shoulder a disproportionate burden of disease and are more likely to face both social and structural challenges in accessing healthcare. Addressing these issues in children is particularly important as evidence has demonstrated that inequities in health are cumulative over the life course. In this article, the authors report on the RICHER (Responsive, Intersectoral-Interdisciplinary, Child-Community, Health, Education and Research) social pediatrics initiative, which was designed to foster timely access to healthcare across the spectrum from primary care to specialized services for a community of inner-city children who have disproportionately high rates of developmental vulnerability. Their research shows that the initiative has effectively "reformed" health services delivery to provide care in ways that are accessible and responsive to the needs of the population. RICHER is an intersectoral, interdisciplinary outreach initiative that delivers care through the formation of innovative partnerships. The authors share research results that demonstrate that the RICHER model of engagement with children and families not only effectively fosters access for families with multiple forms of disadvantage, but also improves outcomes by empowering parents of particularly vulnerable children to become more active participants in care.

Poster 371 Health Care Inequities for Children With Disabilities Compared With Other Children With Special Health Care Needs

PM&RVolume 3, Issue 10S1 p. S302-S303 2011 AAPM&R Annual Assembly Abstract Poster 371 Health Care Inequities for Children With Disabilities Compared With Other Children With Special Health Care Needs Amy J. Houtrow MD, MPH, Amy J. Houtrow MD, MPH UCSF, San Francisco, CA, United StatesSearch for more papers by this author Amy J. Houtrow MD, MPH, Amy J. Houtrow MD, MPH UCSF, San Francisco, CA, United StatesSearch for more papers by this author First published: 22 October 2011 https://doi.org/10.1016/j.pmrj.2011.08.400Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume3, Issue10S1September 2011Pages S302-S303 RelatedInformation

Childhood socioeconomic position and objectively measured physical capability levels in adulthood: a systematic review and meta-analysis.

BackgroundGrip strength, walking speed, chair rising and standing balance time are objective measures of physical capability that characterise current health and predict survival in older populations. Socioeconomic position (SEP) in childhood may influence the peak level of physical capability achieved in early adulthood, thereby affecting levels in later adulthood. We have undertaken a systematic review with meta-analyses to test the hypothesis that adverse childhood SEP is associated with lower levels of objectively measured physical capability in adulthood.Methods and FindingsRelevant studies published by May 2010 were identified through literature searches using EMBASE and MEDLINE. Unpublished results were obtained from study investigators. Results were provided by all study investigators in a standard format and pooled using random-effects meta-analyses. 19 studies were included in the review. Total sample sizes in meta-analyses ranged from N = 17,215 for chair rise time to N = 1,061,855 for grip strength. Although heterogeneity was detected, there was consistent evidence in age adjusted models that lower childhood SEP was associated with modest reductions in physical capability levels in adulthood: comparing the lowest with the highest childhood SEP there was a reduction in grip strength of 0.13 standard deviations (95% CI: 0.06, 0.21), a reduction in mean walking speed of 0.07 m/s (0.05, 0.10), an increase in mean chair rise time of 6% (4%, 8%) and an odds ratio of an inability to balance for 5s of 1.26 (1.02, 1.55). Adjustment for the potential mediating factors, adult SEP and body size attenuated associations greatly. However, despite this attenuation, for walking speed and chair rise time, there was still evidence of moderate associations.ConclusionsPolicies targeting socioeconomic inequalities in childhood may have additional benefits in promoting the maintenance of independence in later life.

Commentary on Roettger et al. (2011): Confronting the elephant in the room

Massive increases in American imprisonment since 1974 may have exacerbated inequality among adult men [1–7]. Because the risk of parental imprisonment has increased in tandem with the risk of imprisonment for adult men [8], mass imprisonment might also have exacerbated childhood inequality—but only if parental imprisonment harms children [9–11]. It is into this area that the excellent work by Roettger and colleagues [12] fits. By linking paternal incarceration with children's substance use trajectories, they extend knowledge about the effects of paternal incarceration in an important—and too long ignored—direction [12]. Yet the elephant in the room remains: does parental incarceration cause poor child outcomes? On this point, the authors are candid: too many obstacles to causal inference persist to be certain [12]. Unfortunately, candor (like correlation) takes us but part of the way to establishing causality. In this commentary, I discuss the substantial obstacles to causal inference in this area, with attention to how future work might try to overcome such obstacles. Discussions of obstacles to causal inference are often onerous, but because removing a (possibly) antisocial father from the household seems at first glance at least as likely to benefit children (or have no effect on them) as to harm them, deciphering whether these associations are causal is no mere academic exercise. Arguments suggesting that paternal incarceration does not cause poor child outcomes fall into two main groups. The first suggests that stable differences between individuals drive both the risk of imprisonment and poor child outcomes. Most research in this area uses covariate adjustment, propensity scores or fixed effects to address such concerns [5,9–13]. Covariate adjustment and propensity scores both approximate causal relationships only if all factors associated with imprisonment and child outcomes are controlled. Unfortunately, data sets rarely contain ideal measures of all such factors—and often contain no measures of some—so these methods are unlikely to produce causal estimates. Roettger and colleagues, for instance, include far more extensive controls than most research in this area, yet their only measures of parental drug and alcohol abuse are maternal self-reports of binge drinking [12]. (Some data sets do contain excellent measures, but these data sets rarely represent contemporary children [10].) Another method for dealing with such concerns is a fixed-effects model, which controls all bias due to stable characteristics. As Roettger and colleagues note [12], however, such models can be utilized only when change in the explanatory and dependent variables can be linked. Thus, as most incarcerations preceded the first measure of drug use, they cannot use these models [12]. As if this were not bad enough, researchers must contend with a second objection: that something else changed prior to the incarceration, explaining any association. This objection is especially troubling as it suggests that estimates derived from a model adjusting for all stable traits are only causal if no such changes preceded the incarceration. Unfortunately, it is nearly impossible to address this concern using survey data, and no research in this area has done so. So how do we tackle the elephant? I offer three imperfect suggestions for how to do so. First, surveys should include more information on factors that shape both the risk of parental incarceration and child outcomes. (If these measures capture change, all the better.) A full list of such measures is beyond the scope of this commentary, but research in this and related areas indicates that better measures of parental criminal justice contact, criminality, drug use and abuse and social marginalization would take us part of the way towards overcoming omitted variable bias [5,9–11,14]. Although the substantial investment such data collection requires may not have passed a cost–benefit test in 1974, it probably passes it now that the risk of parental imprisonment for black children exceeds 25% [8]. Secondly, researchers considering questions such as those considered by Roettger and colleagues [12] might try to test their hypotheses using data on slightly younger children, because so doing would enable them to use the fixed-effects models that strengthen causal inference even without improvements in survey measures. Finally, researchers should make much greater efforts to exploit natural variation in incarceration in order to provide stronger tests of causality. Such research designs are common in other fields such as economics and experimental psychology [15] and probably have the most potential for helping researchers in this field to generate causal estimates. Sadly, following these suggestions will not fully remove the elephant. None the less, recent work in this area [5,9–13] provides great motivation for overcoming obstacles to causal inference, as the associations it presents suggest that mass incarceration has the potential to exacerbate inequality not just among men, but also the children they leave behind. None.

Need and support: determinants of intra‐familial financial transfers in Sweden

Lennartsson C. Need and support: determinants of intra‐familial financial transfers in SwedenInt J Soc Welfare 2011: 20: 66–74 © 2010 The Author(s), Journal compilation © 2010 Blackwell Publishing Ltd and International Journal of Social Welfare.This study examined downward inter‐generational intra‐family financial transfers in Sweden made in the form of money transactions or gifts. The research questions focus on whether recipients of intra‐family financial transfers are children in ‘need’ of such support, and whether early family environment has any consequences for later financial transfers. Using data from a nationally representative survey, the results suggest that childhood disadvantages have long‐term consequences in connection with intra‐family financial transfers. Disadvantages and inequalities in childhood are likely to remain into adulthood, and children who experience adverse childhood conditions are less often recipients of later intra‐family financial support. Intra‐family transfers are also related to the ‘needs’ of the younger generation. Single parents and students from higher social class families are more often beneficiaries of financial support. In contrast, family support was no higher for unemployed children, for children lacking financial security in the form of a cash margin or for children reporting poor health.

Nutritional status of children in India: household socio-economic condition as the contextual determinant.

BackgroundDespite recent achievement in economic progress in India, the fruit of development has failed to secure a better nutritional status among all children of the country. Growing evidence suggest there exists a socio-economic gradient of childhood malnutrition in India. The present paper is an attempt to measure the extent of socio-economic inequality in chronic childhood malnutrition across major states of India and to realize the role of household socio-economic status (SES) as the contextual determinant of nutritional status of children.MethodsUsing National Family Health Survey-3 data, an attempt is made to estimate socio-economic inequality in childhood stunting at the state level through Concentration Index (CI). Multi-level models; random-coefficient and random-slope are employed to study the impact of SES on long-term nutritional status among children, keeping in view the hierarchical nature of data.Main findingsAcross the states, a disproportionate burden of stunting is observed among the children from poor SES, more so in urban areas. The state having lower prevalence of chronic childhood malnutrition shows much higher burden among the poor. Though a negative correlation (r = -0.603, p < .001) is established between Net State Domestic Product (NSDP) and CI values for stunting; the development indicator is not always linearly correlated with intra-state inequality in malnutrition prevalence. Results from multi-level models however show children from highest SES quintile posses 50 percent better nutritional status than those from the poorest quintile.ConclusionIn spite of the declining trend of chronic childhood malnutrition in India, the concerns remain for its disproportionate burden on the poor. The socio-economic gradient of long-term nutritional status among children needs special focus, more so in the states where chronic malnutrition among children apparently demonstrates a lower prevalence. The paper calls for state specific policies which are designed and implemented on a priority basis, keeping in view the nature of inequality in childhood malnutrition in the country and its differential characteristics across the states.

Social Class, School and Non-School Environments, and Black/White Inequalities in Children's Learning

As social and economic stratification between black and white Americans persists at the dawn of the twenty-first century, disparities in educational outcomes remain an especially formidable barrier. Recent research on the black/white achievement gap points to a perplexing pattern in this regard. Schools appear to exacerbate black/white disparities in learning while simultaneously slowing the growth of social class gaps. How might this occur? Using 1st grade data from the Early Childhood Longitudinal Study-Kindergarten Cohort (ECLS-K), I test—and find support for—the proposition that school factors play an elevated role in generating the black/white achievement gap while non-school factors primarily drive social class inequalities. These findings help explain why black/white achievement disparities grow mostly during the school year (when schools are in session and have their greatest impact on students' learning) while class gaps widen mostly during the summer (when school is out of session and non-school influences dominate). I conclude by discussing the implications for future research, especially as they pertain to what appears to be the most important contributor to the black/white achievement gap: school racial segregation.

The relationship between household income and childhood respiratory health in the United Kingdom

Growing empirical evidence on the association between household income and adverse child health outcomes has generated mixed results with some North-American studies showing a significant inverse relationship and some British studies identifying a much weaker association. We use data from the rich UK Millennium Cohort Study (MCS) dataset and check the robustness of these recent findings by focusing on the impact of household income on adverse childhood respiratory outcomes (i.e. asthma and wheezing). We also identify pathways, such as mother's child-health-related behaviours, parental health and grandparental socioeconomic status, through which income might influence child health. Our econometric strategy is to use, both in a cross-sectional and in a panel data context, detailed information in the MCS dataset to directly account for as many potential confounding factors as possible that might bias the income-child health nexus. Overall our results show that household income has a weak direct effect on child health after we control for potential mechanisms that mediate the income-child health association. We argue that our evidence should inform government health and broader fiscal policies aimed at reducing health inequalities in childhood.

Vermitteln Erziehungsressourcen von Müttern zwischen sozialer Ungleichheit und gesundheitsbezogener Lebensqualität bei Kindern?

The present study examines the influence of socioeconomic position and the family's living conditions on children's self-reported quality of life. The aim is to analyse to what extent these relationships are mediated by maternal parenting resources (coping strategies, psychological health and maternal self-efficacy). We used data from 691 children (aged 8 - 12 years) and their mothers, collected in mother-child rehabilitation centres in Germany. The children's quality of life was measured by the KID-KINDL (self-report). Maternal parenting resources were measured by the SVF-60 (coping strategies), the SCL-K-9 (psychological health) and the FKE-K (maternal self-efficacy). Analyses of variance were used for estimating the effects of social factors on children's self-reported quality of life and on parenting resources. The relationship between children's quality of life and maternal parenting resources was assessed by computing correlation measures. The mediating effects of parenting resources on relationships between social factors and children's quality of life were estimated by means of multiple regression. Overall girls and boys showed high quality of life levels. A social gradient was only found for girls. The most significant influence was shown by receiving social welfare (t-test, p=0.000), flat size (VA, p=0.011) and single motherhood (t-test, p=0.011). The influence depends on the type of indicator for family living conditions as well as on specific dimensions of quality of life. Overall the influence of living conditions on the quality of life was small. Probably this is due to the sample being drawn from a clinical population. A social gradient was also found for maternal parenting resources: Psychological health as well as maternal self-efficacy were significantly different depending on whether families received social welfare or not (t-test, p=0.000; p=0.001). Single mothers showed more negative coping strategies and lower psychological health and maternal self-efficacy (t-test, each with p=0.002). Maternal parenting resources were substantially correlated with quality of life (boys: r (Max)=0.28**; girls: r (Max)=0.24**). They had mediating effects on the relationship between social factors and quality of life of girls. This may be explained by a direct effect of socioeconomic conditions and by an indirect effect of maternal parenting resources. Our findings emphasise the importance of gender-specific analyses dealing with health inequality in childhood. Socialisation was found to be relevant for the transmission of health inequality between generations. The results emphasise the need for programmes directed towards promoting parental resources for deprived mothers.

The implications of US experiences with early childhood interventions for the UK Sure Start Programme

The UK Government introduced a large-scale early childhood intervention programme, Sure Start, in 1999. Sure Start is to be further expanded, to achieve national coverage. US experience is highly relevant for anticipating challenges that this expansion will raise. This is a focused, narrative review. We examine the impact, funding, quality-improvement and programme objectives of Head Start and Early Head Start programmes. (1) Early childhood interventions can make a significant difference to children's life chances; (2) expansion without adequate funding threatens quality; (3) narrower objectives, which are easier to measure, can crowd out broader objectives, which are difficult to measure; (4) programmes must balance fidelity to the model and flexibility to local conditions; (5) multiple objectives may conflict; and (6) programmes may have differential impacts. We consider the implications of these findings for Sure Start, focusing on funding, quality control and parental involvement. We also consider that the potential Sure Start should offer for tackling health inequalities in early childhood and suggest ways in which this aspect of the Programme could be enhanced. Head Start has been dogged by concerns about quality and effectiveness. Many of these problems stemmed from an over-hasty expansion, which locked the Programme into inadequate funding and uneven project- and staff-quality. These issues have been addressed through large funding increases and more rigorous performance measures. Nevertheless, concerns about the aims of the Programme and the extent of parental involvement in management remain. Current funding for Sure Start appears to be adequate, while systematic evaluation procedures have been built in from its inception. Concerns have been raised about the implications of expansion for funding, quality and for parental involvement in management of local programmes. US experience shows that these are centrally important issues and that, if they are not addressed early on, they can take many years to rectify.

Socioeconomic risk, parenting during the preschool years and child health age 6 years

Parent child relationships and parenting processes are emerging as potential life course determinants of health. Parenting is socially patterned and could be one of the factors responsible for the negative effects of social inequalities on health, both in childhood and adulthood. This study tests the hypothesis that some of the effect of socioeconomic risk on health in mid childhood is transmitted via early parenting. Prospective cohort study in 10 USA communities involving 1041 mother/child pairs, selected at birth at random with conditional sampling. income, maternal education, maternal age, lone parenthood, ethnic status and objective assessments of mother child interaction in the first 4 years of life covering warmth, negativity and positive control. mother's report of child's health in general at 6 years. Modelling: multiple regression analyses with statistical testing of mediational processes. All five indicators of socioeconomic status (SES) were correlated with all three measures of parenting, such that low SES was associated with poor parenting. Among the measures of parenting maternal warmth was independently predictive of future health, and among the socioeconomic variables maternal education, partner presence and 'other ethnic group' proved predictive. Measures of parenting significantly mediated the impact of measures of SES on child health. Parenting mediates some, but not all of the detectable effects of socioeconomic risk on health in childhood. As part of a package of measures that address other determinants, interventions to support parenting are likely to make a useful contribution to reducing childhood inequalities in health.

Tackling child poverty is not a Sure Start

Liz Rhodes questions whether good parenting really is the key to tackling poverty and inequality in childhood

Evidence on equalisation in health in youth from the West of Scotland

Many studies report few socioeconomic (SES) differences in health in youth, a pattern contrasting with that of health inequalities in childhood and adulthood. This paper focuses on the child–youth transition to examine the hypothesis of equalisation in health over this period. Specifically, we test two hypotheses: (a) that equalisation is more likely for health state measures (physical and malaise symptoms and accidents) than health status ([limiting] longstanding illness and self-rated health) or health potential (height), and (b) that the patterning of health over this period is similar between occupational (social class) and non-occupational (deprivation, housing tenure and family affluence) SES measures. Data are derived from the West of Scotland 11 to 16 cohort, followed from late childhood (aged 11) through early (13) to mid (15) adolescence. The results showed very little evidence of SES differences in (limiting) longstanding illness at any age for both sexes, while self-rated health exhibited some differentiation, and height (as expected) consistent gradients throughout. By contrast, among males evidence of equalisation was found for both physical and malaise symptoms and pedestrian road traffic accidents (RTAs). Among females, equalisation was confined to specific physical symptoms, pedestrian RTAs, sports injuries and burns/scalds, while for malaise symptoms a reverse gradient at age 11 strengthened with age. These patterns were generally unaffected by the SES measure used. We conclude that while some of the evidence is consistent with the equalisation hypothesis, it needs extending to accommodate patterns of no SES differences, and particularly reverse gradients, in childhood. These patterns may reflect the increasingly pervasive influence of youth culture, suggesting that in the UK the boundary between childhood and youth should be set at an earlier age. This in turn suggests that international comparisons have considerable analytic potential for identifying the conditions under which equalisation does and does not occur.

Reducing health inequalities: Ethical issues in a Scottish child health home visiting program

Childhood inequalities have far-reaching consequences throughout the life cycle. Reducing health inequalities for children is an important goal for health policy, grounded in justice and the desire to prevent avoidable ill health. The purpose of this article is to report and discuss the results of a qualitative study into the ethical issues identified by staff involved in a paediatric home visiting program in Scotland. One of the major aims of the visiting program was to reduce health inequalities. The results presented here relate to two issues identified by study participants: conflicting responsibilities, and ethical tensions inherent in the very task of reducing inequalities. The requirement for evaluation, meeting targets and working with partners led to conflicting responsibilities for some participants. Working to reduce health inequalities led to some paradoxical effects, and a fear that root causes of inequality were not being addressed. These results suggest that programs aimed at reducing inequalities may lead to unexpected ethical tensions. Policy-makers and those implementing such programs need to be aware of possible unintended effects and tensions experienced by staff.

Introduction: Dimensions of Children’s Inequality

INTRODUCTIONIn the last third of the 20th century, children's special protected status has been affirmed by nearly every nation (UNICEF 2002). Yet throughout the world, are still more likely to live in poverty than are adults (European Commission 2001). Some national governments have attempted to reduce and eliminate childhood poverty. In 1964 the American President Johnson launched 'War on Poverty.' In 1975 the European Commission created its first European Poverty Program, and the British Labour Party under the leadership of Tony Blair took child poverty pledge in 2001, aiming at bringing another million out of poverty in the UK by 2005 (Lemann 1998; Gauthier 1996; BBC 2001). The United Nation's Convention on the Rights of the Child had been signed by every nation, signifying their intention to eliminate child poverty and create a world fit for children (UNICEF 2002a). Despite these political efforts, poverty still affects one child out of four in the United States, and one child out of five in the United Kingdom. Globally, the World Bank estimated that 1.2 billion people world-wide were living in poverty in 1998 - large proportion of which was (World Bank 2002).Poverty is, however, only one dimension of inequality. In recent decades, the political discourse has endorsed larger definition of inequality, going beyond monetary definition of poverty, and referring more broadly to the right to health and education, and equal social participation. For example, the United Nations and other organizations have called for the elimination of discrimination against children, as well as women and girls, and the elimination of racial discrimination - all obvious forms of inequality (UNFPA 2000; UN 2001 ; UNICEF 2002a). And the European Union has mandated the elimination of social exclusion as part of its 1999 Treaty of Amsterdam (EU 2002). The mandate to combat these inequalities is broadly construed, including addressing such problems as unemployment, low levels of education, school drop-out, and occupational training, low incomes, poor housing, high crime rates, poor health and family breakdown (UK Social Exclusion Unit 2001 ; UNICEF 2002a).While social scientists have long studied the economic well-being of and have in fact been responsible for bringing children's problems to the attention of politicians, they have only recently begun to measure children's status using more complex and nuanced methodologies (Mauser, Brown, and Presser 1997). Our intention in this volume is to bring together some of these new measures and methods for studying and inequality.The articles included in this special issue all examine specific dimensions of inequality among children, ranging from the traditional monetary dimension to issues of health, schooling, and public resources, and the intervening factors of family structure and resources. In this introduction to the special issue, we discuss the dimensions of inequality that serve to group the articles included in the volume - dynamic measures of income inequality, inequality in health and education, particularly by gender and ethnicity, and finally, multi-dimensional measure of social exclusion. In doing so, we intend to point out the unique insights provided . by viewing children's inequality through different lenses. We go on to discuss the policy implications suggested by these studies and others that address children, families, and inequality.MEASURING INEQUALITYWhen different dimensions of inequality are considered, measuring inequality becomes more complex. Measuring inequality has been the subject of numerous recent books and articles (Bradbury and Jantti 1999; Ringen 1988; Vleminckx and Smeeding 2001). We summarize here three approaches in an attempt to map some of the between and within-country variations, as well as locating the contribution of each paper in this special issue.INCOME-BASED ENEQUALITYChildren's economic well-being generally depends upon their parent's income. …

Gender inequality in childhood: Toward a life course perspective

Gender inequality does not begin with adulthood, yet scholarship has dealt most appreciably with indicators summarizing patterns for adults. Life course differences need to be recognized and incorporated into the study of gender inequality. I propose various societal practices (such as female infanticide, harsher punishment, social ceremonies, and inclusion) and beliefs (such as son preference, affection, and evaluation) as cross-cultural indicators of gender inequality in childhood. The analysis of preindustrial societies in the Standard Cross-Cultural Sample (Murdock and White, 1969) finds that childhood gender inequality is related to hunger, warfare, patrilocality, and the economic contribution and control of women. Childhood gender inequality shares some similarities with adulthood gender inequality but differs in theoretically relevant ways; for example, familial explanations, which are often relegated to secondary status in gender inequality theory, are high-lighted. The implications of focusing on childhood and the life course for gender inequality theory are discussed.

Inequalities in Children's Environment

This article uses data from the British Household Panel Survey to examine inequalities in children's environment. In particular, it examines the relationship between income and deprivation. Results show that although income is a major determinant of deprivation, the two concepts do not overlap entirely. For example, more than 40 percent of the most deprived children are not found in the poorest income category. Furthermore, about 15 percent of the poorest children fare better than average on the deprivation index. Multivariate analysis reveals that household structure accounts partly for the relatively weak relationship between income and deprivation. Children growing up with never-married lone mothers appear especially disadvantaged, even after controlling for income.