Income is not an equalizer: health development inequities by ethnoracial backgrounds in California kindergartners.

Judith L Perrigo, E Piper Block, Efren Aguilar, Chandler Beck, Neal Halfon

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Article in BMC public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1 · What the graph read from it

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1 citing paper in PubMed.

Evaluating and shaping early childhood policy in New Mexico: using kindergarteners' developmental health as a population health measure.BMC public health · 2026
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5 · Who and what money

Authors and funding

5 authors.

Judith L PerrigoDepartment of Social Welfare, University of California, Los Angeles (UCLA), Luskin School of Public Affairs, 337 Charles E Young Dr E, Los Angeles, CA, 90095, USA. jperrigo@luskin.ucla.edu.

E Piper BlockDepartment of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Center for Healthier Children, Families, and Communities, Los Angeles, USA.

Efren AguilarDepartment of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Center for Healthier Children, Families, and Communities, Los Angeles, USA.

Chandler BeckDepartment of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Center for Healthier Children, Families, and Communities, Los Angeles, USA.

Neal HalfonDepartment of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Center for Healthier Children, Families, and Communities, Los Angeles, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEarly childhood health development is positively associated with income, but the strength of this relationship with ethnoracial background remains unclear. This study examined the extent of health development inequities among California kindergarteners based on ethnoracial backgrounds and neighborhood-level income.

methodsThis cross-sectional study assessed health development inequities by analyzing neighborhood-level income, ethnoracial background, and health development data for California kindergarteners. Student-level data (n = 106,574) were collected through teacher report between 2010-2020 across 52 school districts and 964 schools. Student addresses were geocoded and linked to American Community Survey neighborhood income levels. Health development was measured using the Early Development Instrument, a population-level measure which includes physical health and well-being, social competence, emotional maturity, language and cognitive development, and communication skills and general knowledge domains. Outcomes included being "on-track" in each domain as well as overall health development.

resultsUsing a Generalized Estimation Equation with a log-link function, while accounting for interactions between ethnoracial background, income, and income-squared, we found significant health development inequities by ethnoracial background and neighborhood-level income. Regarding overall health development, as well as the physical, social and emotional domains, Black students had a lower likelihood of being on-track compared to the weighted average across income levels, whereas Asian students surpassed the weighted average. White students exhibited the steepest slope, and at the lowest income levels, their health development scores were akin to their Black and Hispanic/Latino/a low-income counterparts but resembled their Asian counterparts at higher income levels. For the general knowledge and communication domain, white students consistently had the highest likelihood of being on-track, while Hispanic/Latino/a students had the lowest likelihood across all income levels.

conclusionThis study examines health development inequities among California kindergarteners in diverse communities. Our analysis shows that the relationship between neighborhood-level income and kindergartners' health development varies by domain and is weaker for students of color. Given the scarcity of population-level data on health development outcomes, these analyses offer valuable insights for identifying ecosystems necessitating support in promoting equitable early childhood health development.

Indexed as

EcosystemIncomeCaliforniaChild, PreschoolCross-Sectional StudiesHumansPovertyEarly ChildhoodEarly Development Instrument (EDI)Kindergarten Inequities

Identifiers

PMID38082324

DOI10.1186/s12889-023-17246-7

PMCPMC10714585

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LicenceCC BY

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