Social contexts and children's health outcomes: Researching across the boundaries

Abstract

While significant progress has been made on several fronts in child health research in recent years, research findings have not always been readily translated to better policies and programs for creating healthy conditions for children. Child health policies and research have not always aligned in a manner that would inform each other to the benefit of children. In this paper it is argued that child health research and interventions need to proceed from an explicit recognition of the fundamental causes of poor child health, namely parents’ socioeconomic status and the social context in which children live. A conceptual framework is presented that organizes the key domains of child health determinants and the possible causal pathways that link these domains to produce health outcomes. This framework assisted the development of a multi-method research program specifically linking community members, program developers and policy-makers in the research process. It also helped to identify methodological issues inherent in a comprehensive approach to child health research, which is commented on drawing from illustrative examples from the authors’ research program. The article concludes with some observations on the authors’ experience in engaging policy and civil society constituents in order to better align research, policy and intervention programs.

Keywords:

• Child health
• socioeconomic status
• neighborhoods
• health policy
• GIS mapping
• mixed-methods

Acknowledgments

Thanks are offered to the following. For participation and contribution to the research cited in this paper: Sue Delanoy, Dennis Chubb, David Mykota, and Tom McIntosh. For preparation of this manuscript: Fleur Macqueen Smith and two anonymous reviewers. Canadian Institutes of Health Research (through career awards to NM, RL), Canadian Population Health Initiative, Social Development Canada, and Saskatchewan Health Research Foundation for their generous funding of this research.

Notes

Note

1.  A child's right to health-promoting conditions is actually embodied in several human rights covenants, to which all nations are state parties. The instrumental argument for policy interventions to improve health (i.e. that such health investments are good for the economy) can lead to a form of triage, where health-promoting policies that show low economic growth returns are given lower priority.