BALTIMORE — PCPs should be mindful that economic stability, independent of income, which often gives an incomplete picture as it does not account for debt and cost of living, may be an important socioeconomic determinant of child health, according to data presented at the Pediatric Academic Societies Meeting.
“Well over a third of families have no savings at all to cover unexpected expenses, and more and more families are stressed financially in this age of mounting debt and concentration of wealth at the top of the economic spectrum,” Adam B. Schickedanz, MD, a clinical instructor in pediatrics at the University of California, Los Angeles (UCLA), said in a press release. “Between the growing cost of housing, child care and other basic expenses, families aren’t left with much at the end of the month.”
To determine whether household financial asset poverty, as opposed to income alone, affects child health, obesity and chronic illness, Schickendanz and colleague Paul J. Chung, MD, also of UCLA, drew data from 2,907 U.S. children from families, collected between 1997 and 2007, in the Panel Study on Income Dynamics, the world’s longest-running longitudinal household study. According to the researchers, the conventional definition of financial asset poverty is net worth below the crash value of three months of basic household expenses, conservatively calculated as three months of income at the federal poverty level.
Family asset level was specified similar to income level as range multiples of the asset poverty threshold, either 0 to 100%, 101 to 200%, 201 to 300%, 301% to 400%, and more than 400%. Primary child health outcomes included parent- or child-related health, obesity and chronic illness count. Covariates included socioeconomic status — including parent income, education and employment — family structure and demographics.
According to the researchers, financial asset level was associated with overall child health, adjusting for other covariates. Children in families below twice the asset poverty threshold had higher odds (OR 1.48, 95% CI; 1.1 to 1.99) of worse health, compared to those in families with sufficient assets. In addition, those in asset-poverty families also had higher odds of being obese (OR 1.48, 95% CI; 1.02 to 2.13). Every additional year in asset poverty increased the odds obesity by 20% (OR 1.2, 95% CI; 1.07 to 1.34). The researchers also noted a trend of higher asset poverty counts predicting the number of child chronic illnesses (OR 1.06, 95% CI; 0.99 to 1.15).
“When families are living on the financial edge without any economic cushion to fall back on, it’s no surprise they find it hard to invest in healthy foods, a spot in a youth sports league, or a collective savings account, all of which can have lifelong implications for the health of their kids,” Schickedanz concluded. – by Jason Laday
Disclosure: Healio Family Medicine was unable to confirm the researchers’ relevant financial disclosures.
Schickedanz AB and Chung PJ. The impact of family financial assets and debt on child overall health, obesity and chronic illness. Presented at: Pediatric Academic Societies meeting; April 30 to May 3, 2016; Baltimore.