Poor Urban Children Research Articles

Access to Mental Health Services: The Struggle of Poverty Affected Urban Children of Color

It is estimated that, in the United States, one in ten children and adolescents suffer from illness severe enough to cause some level of psychosocial dysfunction. Urban children, and in particular low-income children of color, are at greater risk of developing mental health problems, and are less likely to receive effective child mental health services. Prompt and effective access to mental health services by urban children of color is a critical direct practice and social policy concern. This article provides an overview of significant barriers to mental health care experienced by poverty affected urban children of color and their families. It also addresses a broad range of practice and policy issues that need to be raised in order to ensure competent delivery of mental health services for children living in urban environments. The role of social work in assisting poor urban children of color to access and benefit from mental health services is stressed.

The association of prolonged breastfeeding and allergic disease in poor urban children

The fact that breastfeeding may protect against allergic disease remains controversial, with hardly any reports from developing countries. This study investigated the association between allergic disease in children and prolonged breastfeeding. Data were collected from a 15% random sample of households from two poor suburbs of Cape Town, South Africa. Parents completed a validated International Study on Asthma and Allergies in Childhood questionnaire on allergic diseases for children aged 6-14 yrs. Other questions included breastfeeding duration, maternal smoking and parental allergy. Results were adjusted for possible confounders and for possible clustering within the household. Out of the 861 children included in the study, allergic disease in general, and hay fever in particular, were significantly less frequent in those with prolonged (> or =6 months) breastfeeding. There was a significant linear inverse association between breastfeeding duration and allergic disease in children without allergic parents, but not in children with an allergic predisposition. In conclusion, these results from a developing country suggest a protective effect of prolonged breastfeeding on the development of allergic disease, particularly hay fever, in children born to nonallergic parents. This protective effect was not found in children with an allergic predisposition.

Introduction: Addressing the Millennial Morbidity—The Context of Community Pediatrics

The test of the morality of a society is what it does for its children. Dietrich Bonhoeffer1 Pediatrics is a contextual specialty concerned about children, their families, and the communities in which they live. Historically, US pediatricians have demonstrated a deep appreciation of the relationship between community forces and child health outcomes. Abraham Jacobi, MD, and Job Lewis Smith, MD, the founders of American pediatrics, fought to ensure a clean water supply and decent housing for poor urban infants and children who were poor. They set the stage for pediatric activism in the community. In the decades since then, pediatricians have grappled to incorporate knowledge about the influences of the external environment into the practice of pediatrics.2 Although the morbidity and mortality of children have changed over the past 150 years, the need for engaging in the community with families and community-based partners has not. Rather, the salience of community pediatrics has risen as the effects of societal forces have intensified and knowledge of the bioenvironmental interface has become more sophisticated. This supplement is a collection of articles about training and practice in community pediatrics that offers specific examples of clinical practice and research aimed at fulfilling the promise that our profession has made to children in our society. The past century has seen astounding changes in the configuration of childhood health and illness (Table 1). In the early 1900s, infant mortality was as high as 140 per 1000 live births per year3; child health clinicians struggled to handle malnutrition and contagious illnesses. The major biological and medical breakthroughs of the midcentury created the basis for the subspecialty care of children with congenital and acquired organ-system illness. By the 1960s and 1970s, acute infectious morbidity increasingly was held in check by antibiotics and vaccines. Pediatricians began … Address correspondence to Judith S. Palfrey, MD, Children's Hospital, 300 Longwood Ave, Boston, MA 02115. E-mail: palfrey{at}fas.harvard.edu

Child Rights for Urban Poor Children in Child-Friendly Philippine Cities: Views from the Community

Children, Youth and Environments 15(2), 2005 Child Rights for Urban Poor Children in ChildFriendly Philippine Cities: Views from the Community Mary Racelis Angela Desiree M. Aguirre Institute of Philippine Culture Ateneo de Manila University Citation: Racelis, Mary and Angela Desiree M. Aguirre. (2005). “Child Rights for Urban Poor Children in Child-Friendly Philippine Cities: Views from the Community.” Children, Youth and Environments 15(2): 117-137. . Abstract This paper is an appraisal of the government and civil society actions that form child-friendly city programs in 27 neighborhoods of five cities in the Philippines (Manila City, Quezon City, Cebu, Davao and Pasay City), along with case studies of four informal settlements (two with child-friendly city programs, two without). These programs developed out of earlier urban basic services programs, but with the basic services focus greatly expanded to include child protection and participation within a child rights agenda. The paper describes the concepts underlying these programs and the sociopolitical context in which they emerged. Each city program is assessed, based on 24 child rights indicators. The paper also includes a summary of children’s views with regard to priorities for basic services, problems of crime and violence, and the possibilities for children’s participation. It ends with recommendations on how to make the child-friendly city programs more effective. Keywords: Child-friendly programs© 2005 Children, Youth and Environments Child Rights for Urban Poor Children in Child-Friendly Philippine Cities… 118 Introduction It has long been a staple of the poverty literature in developing countries that most poor people live in rural areas. Yet, in the Philippines, 55 percent of the population now live in cities and towns. Some 1.4 million poor households inhabit informal slum settlements. One half of them, or 3.5 million, are found in Metro Manila, making up a third of its population (Webster et al. 2002). The other half are concentrated in Metro Cebu and Metro Davao, joined by other large and medium-sized cities with growing numbers of urban poor. The Genesis of Urban Basic Services While several decades ago the United Nations Children Fund (UNICEF) focused programs on rural children, as early as the 1970s insightful program officers in major metropolitan areas already saw another reality emerging. Immediately around them were fast-growing, densely-packed slums and shanty towns. Children and their families spilled into narrow, muddy pathways snaking through perpetually-flooded marshlands or alongside fetid canals. Others clung to precarious hillside perches or clustered at the desert fringes of cities. Wherever they settled, their degraded environments and poverty-stricken lives exuded levels of collective misery rarely seen in even the poorest rural villages. Yet, their energy and drive to establish a toehold in the city in the hope of a better future were a source of wonder and admiration. Because children under threat merited attention wherever they were, this handful of development workers, along with risk-taking government and NGO national counterparts, began extending basic services to slums and informal urban settlements. They soon learned that the programming environment differed significantly from that in rural communities. Already marginalized in a city featuring extremes of wealth and squalor, poor urban children and women in informal settlements faced the added threat of eviction and relocation far from family work sites. Poor sanitation and drainage, limited supplies of clean water, residential crowding, the threat of fire and disease, lack of access to schools and health centers, victimization by corrupt politicians and criminal syndicates, and reliance on the informal economy along with the good will of helpful neighbors and relatives—all this called for a different way of reaching children. Thus, the urban basic services (UBS) approach was born, initiated by a distinguished UNICEF New Delhi program officer, Dr. William B. Cousins. The key characteristic of UBS was community participation—the principle that urban poor residents should organize themselves to identify problems and take action best suited to their needs. The leadership and determination of poor urban women quickly came to the fore. Enlightened government officials proved most helpful if their agency services converged in the community for greater efficiency and easier management by development workers and community residents alike. It became clear that the...

Influence of Socioeconomic Status on the Prevalence of Stunted Growth and Obesity in Prepubertal Indonesian Children

This cross-sectional study assesses the prevalence of stunting, overweight, and obesity in prepubertal children from different socioeconomic groups in Indonesia. Children from rural, poor urban, and nonpoor urban communities were studied (n = 3,010). The prevalences of stunting, wasting, overweight, and obesity were 19.3%, 5.0%, 2.7%, and 0.8%, respectively. The odds ratios (OR) for stunting, as compared with nonpoor urban children, were higher among rural children (2.92; 95% confidence interval [CI], 2.37-3.59) than among poor urban children (1.58; 95% CI, 1.18-2.13). The prevalence of wasting was not influenced by socioeconomic status. Both rural and poor urban children were significantly less likely to be overweight than were nonpoor urban children: in comparison with nonpoor urban children, the OR values were 0.19 (95% CI, 0.10-0.36) for rural and 0.13 (95% CI, 0.04-0.43) for poor urban children. Boys were more likely to be stunted or obese than girls: OR for stunting, 1.75 (95% CI, 1.44-2.12); OR for obesity, 4.07 (95% CI, 1.40-11.8). Stunted children were less likely than non-stunted children to be overweight: OR, 0.10 (95% CI, 0.03-0.43). In Indonesia, undernutrition is still related to poverty, whereas obesity is more related to prosperity.

Effects of wintertime ambient air pollutants on asthma exacerbations in urban minority children with moderate to severe disease

Urban minority children with asthma are at higher risk for severe exacerbations leading to hospitalizations and deaths. Because multiple studies have reported associations between air pollution and asthma worsening, elevated levels of air pollution are cited as a possible trigger for increased asthma morbidity in urban areas. Few studies have prospectively followed panels of urban children with asthma to determine whether air pollution levels are associated with clinically relevant outcomes such as asthma exacerbations. To determine the association between levels of ambient air pollutants and asthma exacerbations in urban poor children with moderate to severe asthma. A school-based panel of children with difficult-to-control disease was followed over a period of 3 consecutive winters in Denver, Colo. The panel consisted of predominantly urban African American children with moderate to severe asthma. Levels of Environmental Protection Agency criteria air pollutants were measured on a daily basis with concurrent monitoring of lung function, bronchodilator use, symptoms, and asthma exacerbations. After controlling for time-varying factors such as upper respiratory infections and meteorologic factors, a weak association was found between ambient carbon monoxide levels and bronchodilator use. Ozone levels were associated with daytime symptoms only. No association was observed between daily air pollution concentrations and daily levels of FEV 1 , peak flow, nighttime symptom scores, or asthma exacerbations over the 3-year period. Ambient levels of Environmental Protection Agency criteria air pollutants in Denver do not lead to clinically significant asthma worsening in urban children with moderate to severe asthma during winter months when children are primarily indoors.

Homelessness, poverty, and risks to health: beyond at risk categorizations of street children1

Homeless and street children are commonly portrayed in the academic and welfare literature as a prime category of ‘children at risk’. They have attracted world‐wide attention due to rising numbers in cities of the Western and developing world coupled with a discourse of childhood that ascribes risk to poor urban children unaccompanied by adults on the streets. This paper presents a critique of views about homeless and street children that rest upon an unhelpful blanket generalization of risk and, more specifically, that adopt polemical or categorical statements about homelessness as the most salient risk factor for poor health. Current research is distancing itself from a discourse that sets global characteristics for a ‘street lifestyle’, aiming instead to contextualize research on street children. Many studies have also questioned the stereotypical expectation that homeless children are the most vulnerable in deprived environments, arguing that poverty, not homelessness per se, carries the most significant risks to children's health. A risk discourse is unhelpful where it promotes a stereotype of vulnerability about children, resulting in further discrimination and social exclusion; it is most helpful when it focuses attention on ways to negotiate adverse situations. Some challenging academic and practical questions need to be raised regarding risk assumptions and risk assessment.

Common infectious diseases and skin test anergy in children from an urban slum in northeast Brazil.

Acute respiratory infection (ARI), diarrheal disease (DD) and infective dermatitis (ID) are important causes of morbidity in children under five, in Northeast Brazil. (a) to evaluate the morbidity of ARI, DD and ID; and (b) to determine their association with cellular immunity in poor urban children from Fortaleza, Brazil. A prospective cohort study. At enrollment, multipuncture skin-tests (Multitest CMI) were performed and interpreted according to standard procedures. Children were followed for infectious diseases by weekly home visits. Seventy-one children aged 6 to 21 months were recruited in an ongoing cohort of newborns. A mean of 39 (6 to 63) home visits per child were made, which detected 184.5 symptomatic days per child-year of observation. ARI was present in 62% of the days of illness (6,378 out of 10,221), DD in 23% (2,296 days), ID in 6% (597) and other infections in 4% (373). Episodes per child-year were: 10 for ARI, 7 for DD and 1 for ID. Twelve (17%) out of 71 children were anergic. The incidences of ARI, DD and ID were similar in responsive versus anergic children. The mean duration of ID in anergy was 8.5 days, while it was 4.3 in the responsive group (P=0.007). Anergy was independent of age, sex and nutritional status. A high incidence of ARI and DD was found in these poor urban children. Skin-test responsiveness was not related to malnutrition, nor to morbidity due to ARI and DD, however anergic children had a longer duration of infective dermatitis.

A Clear Vision for Equity and Opportunity

Educators work very hard to help students solve the cognitive problems that impede their learning. Sometimes, the authors argue, it's the problems we can't that need to be fixed first. TWO OF THE most pressing issues in education today are the demands for improved academic performance and higher test scores and the mandate to close the achievement gaps between poor and middle-class students and minority and nonminority students. In response to these challenges, increased attention is being given to staff development that focuses on instructional methods, reading strategies, differentiated teaching and learning, test-taking strategies for students, and so on. However, before these approaches can begin to bring about improved student performance and close the achievement gaps, schools need to address a much more basic issue affecting learning for many students, especially those who live in poverty. This is the issue of undetected and uncorrected vision problems. It is estimated that one out of four school-age children have undiagnosed vision problems significant enough to affect their performance in school and in life. Research shows that in at-risk populations, such as children born in poverty, this percentage is likely to be much higher.1 Since 70% of classroom learning depends on the visual system, students with uncorrected vision problems are at a tremendous disadvantage before they even enter the classroom.2 It seems obvious that if a student cannot see clearly, he or she is going to have a very difficult time reading, writing, and even participating in sports. Yet parents and educators almost always overlook vision problems as a possible roadblock to learning. Vision Problems of Children in Poverty In April 2001 the Harvard Graduate School of Education hosted a conference at which educators and optometrists shared their findings on the topic of Visual Problems of Children in Poverty and Their Interference with Learning. Dr. Antonia Orfield, an optometrist at the Harvard University Health Services Eye Clinic and chief investigator of the Inner-City Vision and Learning Project at the Boston Mather School, discussed the high incidence of visual problems in urban poor children and reported that 53% of the children tested at the Mather School had vision problems that could hinder their ability to read. School vision screenings typically check only for nearsightedness, which affects reading at a distance -- looking at chalkboards or whiteboards. Dr. Orfield recommended expanding the screenings to test for conditions that affect close-up (book) reading, such as farsightedness and problems with tracking. Dr. Rochelle Mozlin, associate clinical professor of optometry at the College of Optometry, State University of New York, New York City, presented her research on vision problems of urban at-risk high school students. She tested students at two inner-city high schools, where 52% of the students failed the vision screening. She emphasized that treating the students proved to be difficult because parents and students generally did not follow up, even though there were several offers of free services. Only 17 of the 62 students (or 27%) identified as priority cases actually received the vision care they needed. Dr. Robert Duckman, pediatric optometrist and professor of optometry at the SUNY College of Optometry, researched vision problems of children in foster care in New York City. He found that a staggering 83.5% of the 351 children he tested had vision problems.3 Vision Problems and Juvenile Delinquency Several studies have linked uncorrected vision problems with juvenile delinquency. One rather alarming statistic is that in the population of all school-age students, 25% suffer from undiagnosed vision problems; however, among juvenile offenders, it is estimated that 70% have undiagnosed vision problems. If we understand that vision problems result in skill deficiencies, difficulty in reading and learning, and poor academic performance -- which, in turn, create feelings of failure, low self-esteem, and lack of interest in academics -- then the connection to delinquency becomes clear. …

Child rights for urban poor children in child friendly Philippine cities: views from the community

This paper is an appraisal of the government and civil society actions that form child friendly city programmes in 27 neighbourhoods of five cities in the Philippines (Manila City, Quezon City, Cebu, Davao and Pasay City), along with case studies of four informal settlements (two with child friendly city programmes, two without). These programmes developed out of earlier urban basic services programmes, but with the basic services focus greatly expanded to include child protection and participation within a child rights agenda. The paper describes the concepts underlying these programmes and the sociopolitical context in which they emerged. Each city programme is assessed, based on 24 child rights indicators. The paper also includes a summary of children’s views with regard to priorities for basic services, problems of crime and violence, and the possibilities for children’s participation. It ends with recommendations on how to make the child friendly city programmes more effective.

Child rights for urban poor children in child friendly Philippine cities: views from the community

This paper is an appraisal of the government and civil society actions that form child friendly city programmes in 27 neighbourhoods of five cities in the Philippines (Manila City, Quezon City, Cebu, Davao and Pasay City), along with case studies of four informal settlements (two with child friendly city programmes, two without). These programmes developed out of earlier urban basic services programmes, but with the basic services focus greatly expanded to include child protection and participation within a child rights agenda. The paper describes the concepts underlying these programmes and the sociopolitical context in which they emerged. Each city programme is assessed, based on 24 child rights indicators. The paper also includes a summary of children’s views with regard to priorities for basic services, problems of crime and violence, and the possibilities for children’s participation. It ends with recommendations on how to make the child friendly city programmes more effective.

Poor intestinal permeability in mildly stunted Nepali children: associations with weaning practices and Giardia lamblia infection

Studies in the Gambia, using the lactulose–mannitol dual-sugar intestinal permeability test (lactulose:mannitol ratio) as a non-invasive way of investigating mucosal damage, have shown that food malabsorption is significantly associated with early growth retardation. In this cross-sectional study, 210 poor urban Nepali children, 0–60 months old, were recruited and measured for height or length and weight, 167 were examined for intestinal permeability and 173 for parasite infection. Weaning and morbidity data were collected from 172 caretakers. Children were mildly stunted (mean height-for-age Z-score −1·45) and underweight (mean weight-for-age Z-score −1·62). The lactulose:mannitol ratio (0·26) was poorer than that of UK children (0·12), but similar to that found in Bengali children of the same age (0·24). Two stages of weaning, the onset supplementary feeding (6 months) and the cessation of breast-feeding (23 months), were shown to have differential impact. In children currently breast-feeding, the duration of supplementation was negatively related to lactose (P<0·001) and lactose:lactulose values (P<0·0001), indicating lactose maldigestion. In children who had ceased breast-feeding, a longer period of lactation was associated with poorer intestinal permeability (P=0·031), and poorer height-for-age (P=0·024), which was an unexpected result. No significant relationships were found between intestinal permeability and growth, or with morbidity and helminth infection, except in children withGiardia lambliawho had worse lactulose:mannitol ratios than those without (0·43v.0·25 respectively,P=0·014). It is likely that insults to the gut (e.g. Giardia) and challenges to the immune system (weaning) have a different impact in early and late infancy.

Poor intestinal permeability in mildly stunted Nepali children: associations with weaning practices and Giardia lamblia infection.

Studies in the Gambia, using the lactulose-mannitol dual-sugar intestinal permeability test (lactulose:mannitol ratio) as a non-invasive way of investigating mucosal damage, have shown that food malabsorption is significantly associated with early growth retardation. In this cross-sectional study, 210 poor urban Nepali children, 0-60 months old, were recruited and measured for height or length and weight, 167 were examined for intestinal permeability and 173 for parasite infection. Weaning and morbidity data were collected from 172 caretakers. Children were mildly stunted (mean height-for-age z-score -1.45) and underweight (mean weight-for-age z-score -1.62). The lactulose:mannitol ratio (0.26) was poorer than that of UK children (0.12), but similar to that found in Bengali children of the same age (0.24). Two stages of weaning, the onset supplementary feeding (6 months) and the cessation of breast-feeding (23 months), were shown to have differential impact. In children currently breast-feeding, the duration of supplementation was negatively related to lactose (P<0.001) and lactose:lactulose values (P<0.0001), indicating lactose maldigestion. In children who had ceased breast-feeding, a longer period of lactation was associated with poorer intestinal permeability (P=0.031), and poorer height-for-age (P=0.024), which was an unexpected result. No significant relationships were found between intestinal permeability and growth, or with morbidity and helminth infection, except in children with Giardia lamblia who had worse lactulose:mannitol ratios than those without (0.43 v. 0.25 respectively, P=0.014). It is likely that insults to the gut (e.g. Giardia) and challenges to the immune system (weaning) have a different impact in early and late infancy.

Environmental Threats to Children's Health: A Challenge for Pediatrics: 2000 Ambulatory Pediatric Association (APA) Presidential Address

Public health accomplishments have dramatically improved children's lives. Sanitation programs, vaccines, better nutrition, surveillance and monitoring of disease, and the development of antibiotics have led to extraordinary reductions in infant and child mortality.1 Ambulatory pediatricians have contributed, through research, teaching, and advocacy, and especially through the delivery of improved medical care to this dramatic trend. Despite these advances, children are in trouble:

Environmental tobacco smoke exposure among urban children.

Environmental tobacco smoke (ETS) exposure is a well-known health hazard for children. Poor urban children may be at increased risk of exposure from nonparental sources of tobacco smoke. The unique problems of ETS exposure in urban children have previously not been well-defined. This study was conducted: 1) to identify the sources of ETS exposure for children attending a hospital-based pediatric resident practice; and 2) to examine caregivers' perceptions of the pediatrician's role and action in addressing ETS exposure. Questionnaires were administered to a convenience sample of 174 caregivers of children visiting a children's hospital-based resident practice. A structured face-to-face interview was used. All caregivers agreed to participate in the study. Most of the caregivers interviewed were mothers (87.9%). Although only 14% of caregivers were smokers, 49.4% reported caring for at least 1 smoke-exposed child. Most smoke exposure occurred in the home; smoking is allowed in the home of 75% of the children who live with a smoker (48/64). Thirty-four percent of the caregivers who reported no smoking in the home reported having a child who spends time in homes where other people smoke. Most exposure outside the home occurred at a grandparent's home. A ban on smoking in the home did not eliminate a child's risk of residential smoke exposure but did predict whether smoking occurred in the same room as the child. All caregivers reported believing that tobacco smoke is harmful. Approximately one half of caregivers who smoke (54.2%) would like smoking cessation advice from the child's pediatrician. Interest in receiving advice on helping others quit smoking was also high (51.3%) among nonsmoking caregivers who cared for a smoke-exposed child. Nonparental sources of ETS exposure are reported to be common in urban children. Children may be exposed to tobacco smoke even in homes where smoking is banned. Many caregivers would like help from pediatricians in reducing children's exposure to tobacco smoke.

Educating Canada's Urban Poor Children

Across Canada, child poverty is escalating while funding for education is falling. Alberta, where funding for education was reduced by approximately 15.6% from 1993 to 1996, may be the most extreme example (Peters & Richards, 1995), but Ontario is close on Alberta's heels and no province has avoided reductions. Education policy-makers have had no choice but to balance their budgets. In doing so, they have found themselves in the unenviable position of having to eliminate or restructure some existing programs, almost all of which are highly valued by stakeholders in the education system. Educational poverty programs, already a low priority among policy issues (Levin, 1995), are particularly vulnerable. The communities served by such programs tend to have weak political voices, policy makers tend to have little direct knowledge of issues related to inner-city education, and few policy makers are aware of research supporting programs in place (Levin, 1995; W. G. Maynes, 1993b). This last situation is exacerbated because many Canadian programs have been implemented without plans to evaluate their effectiveness (W. G. Maynes, 1993a, pp. 21-22) and because policy makers now tend to dismiss U.S. research on inner-city education as contextually irrelevant to Canadian cities.

Differences in stressors experienced by urban African American, White, and Hispanic children

The frequency of occurrence of 30 stressful life events and circumstances (SLE-Cs), most major and chronic stressors, was compared among 1179 African American, White, and Hispanic secondto sixth-grade, poor (76% eligible for free or reduced-cost lunch) urban children, and their families. Parents completed a Life Events Checklist (LEC) reporting all SLE-Cs experienced by child and family. Factor analysis identified a 5-factor solution for the LEC: Family Turmoil, Poverty, Family Separation/Social Services, Injury/Illness, and Unsafe/Violent Neighborhood. Although the three groups did not differ in overall number of SLE-Cs reported, there were significant group differences on 15 of the 30 LEC items distributed across all five factors. Implications of these findings, both for identifying future research directions and framing preventive interventions, are considered. © 1998 John Wiley & Sons, Inc. A R T I C L E

Differences in stressors experienced by urban African American, White, and Hispanic children

The frequency of occurrence of 30 stressful life events and circumstances (SLE-Cs), most major and chronic stressors, was compared among 1179 African American, White, and Hispanic second- to sixth-grade, poor (76% eligible for free or reduced-cost lunch) urban children, and their families. Parents completed a Life Events Checklist (LEC) reporting all SLE-Cs experienced by child and family. Factor analysis identified a 5-factor solution for the LEC: Family Turmoil, Poverty, Family Separation/Social Services, Injury/Illness, and Unsafe/Violent Neighborhood. Although the three groups did not differ in overall number of SLE-Cs reported, there were significant group differences on 15 of the 30 LEC items distributed across all five factors. Implications of these findings, both for identifying future research directions and framing preventive interventions, are considered. © 1998 John Wiley & Sons, Inc.

Exercise induced bronchospasm in Ghana: differences in prevalence between urban and rural schoolchildren.

BACKGROUND: As more developing countries adopt a westernised style of living, an increase in the prevalence of asthma can be expected to occur in these areas. A study was undertaken...

Patterns of psychopathology among urban poor children: comorbidity and aggression effects.

A sample of 3,647 children from Grades 1-6 of inner-city and other urban poor communities and diverse ethnic groups were evaluated for co-occurrence of clinical-level scores on syndrome scales of the Teacher Report Form of the Child Behavior Checklist. Besides examining the relative rate of co-occurring syndromes, the contribution of residence location, ethnicity, age, and gender to such patterns were examined. Latent class analyses were applied to determine the makeup of basic patterns of co-occurring syndromes. Results suggest that comorbidity and the type of comorbidity pattern are related to residence. Gender and ethnicity are also related to pattern. Aggression seems to be a central aspect of the type of co-occurring patterns found among urban poor children. Its presence relates to poorer functioning, particularly in conjunction with internalizing syndromes.