Wehby George L, Trujillo Antonio J
Department of Health Management and Policy, University of Iowa, Iowa City, Iowa, United States; National Bureau of Economic Research, Cambridge, MA, United States.
Department of International Health Johns, Hopkins School of Public Health, United States; Johns Hopkins University, Baltimore, MD, United States.
Infant Behav Dev. 2017 Feb;46:100-114. doi: 10.1016/j.infbeh.2016.12.001. Epub 2017 Jan 6.
We examine disparities in early child cognitive and receptive-expressive skills by ethnic ancestry among infants aged 3-24 months from Brazil and Argentina. We employ unique data on the neurodevelopment of children who were seeking routine well-child care at a set of pediatric clinics in these countries. The sample included children who had normal birth outcomes and no major health complications, allowing us to focus on variation in neurodevelopment among children without major physical health limitations. The physicians attending the pediatric clinics were trained in administering the Bayley Infant Neurodevelopmental Screener, a standardized instrument used to screen an infant's risk of neurodevelopmental problems on various domains of abilities. We evaluate disparities in overall neurodevelopmental scores and risk for neurodevelopmental problems as well as in cognitive functioning and receptive-expressive neurodevelopment. We also examine the extent to which household demographic and socioeconomic characteristics and geographic location explain these disparities. We find large gaps in both cognitive and receptive-expressive neurodevelopment by ancestry. In Brazil, children of African ancestry have lower scores on both cognitive and receptive-expressive domains and on overall neurodevelopment than children of European ancestry. In Argentina, children of Native ancestry have lower scores on these outcomes than children of European ancestry. These gaps however are largely explained by differences in geographic location and household characteristics, highlighting the importance of policies that reduce socioeconomic and geographic disparities in social capital and economic development for eliminating ethnic disparities in infant neurodevelopment.
我们研究了巴西和阿根廷3至24个月大婴儿按种族血统划分的早期儿童认知及接受-表达技能方面的差异。我们使用了关于在这些国家的一组儿科诊所寻求常规儿童健康护理的儿童神经发育的独特数据。样本包括出生结局正常且无重大健康并发症的儿童，这使我们能够专注于没有重大身体健康限制的儿童之间神经发育的差异。在儿科诊所坐诊的医生接受过使用贝利婴儿神经发育筛查工具的培训，该工具是一种标准化仪器，用于筛查婴儿在各个能力领域出现神经发育问题的风险。我们评估了总体神经发育分数和神经发育问题风险以及认知功能和接受-表达神经发育方面的差异。我们还研究了家庭人口统计学和社会经济特征以及地理位置在多大程度上解释了这些差异。我们发现，按血统划分，认知和接受-表达神经发育方面都存在巨大差距。在巴西，非洲裔儿童在认知和接受-表达领域以及总体神经发育方面的得分低于欧洲裔儿童。在阿根廷，原住民血统儿童在这些方面的得分低于欧洲裔儿童。然而，这些差距在很大程度上可以由地理位置和家庭特征的差异来解释，这凸显了减少社会资本和经济发展方面的社会经济及地理差异的政策对于消除婴儿神经发育方面的种族差异的重要性。
