Johnson Sara B, Raghunathan Radhika S, Li Mengying, Nair Divya, Matson Pamela A
Department of Pediatrics, Johns Hopkins School of Medicine, Division of General Pediatrics, Baltimore, MD, USA.
Department of Population, Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
SSM Popul Health. 2022 Mar 4;17:101064. doi: 10.1016/j.ssmph.2022.101064. eCollection 2022 Mar.
Understanding when and how socioeconomic position (SEP) influences cognitive development is key to reducing population inequalities in health and achievement. The objective of this study was to determine the unique association between prenatal family SEP and child cognitive development, and to determine whether marked postnatal social mobility was associated with improvements in child cognitive performance to age 7.
Data were from children enrolled in the US National Collaborative Perinatal Project (NCPP) (n = 28,761) during 1959-1965, a dataset large enough to observe marked mobility, which remains uncommon. Multivariable linear regression was used to examine the relationship between SEP (i.e., parental income, education, occupation) during gestation and cognitive performance at 8 months (Bayley Scales of Infant Development Mental Development Index) and at 7 years (Wechsler Intelligence Scale for Children).
Holding demographic and perinatal factors constant, family SEP during gestation was not associated with cognitive performance at 8 months (B = -0.03, 95% CI: -0.07-0.01) but was positively associated with performance at 7 years even after accounting for SEP at 7 years (B = 1.28, 95% CI: 1.11-1.45). Children whose families experienced the most extreme upward mobility (from the lowest to highest income quartile) showed a 12 percentile increase in cognitive performance in the first 7 years of life. Those with the most extreme downward mobility (from the highest to lowest income quartile) still experienced an 8 percentile increase in cognitive performance in this interval.
The proportion of children in poverty today is similar to 1965 and intergenerational mobility has declined markedly. Prenatal SEP may contribute to inequalities in child cognitive performance that even extraordinary social mobility cannot erase. To optimize cognitive development across generations, current means-tested programs to support families with young children should be supplemented by universal approaches to ensure access to opportunity before young people become parents.
了解社会经济地位(SEP)在何时以及如何影响认知发展,是减少健康和成就方面人口不平等现象的关键。本研究的目的是确定产前家庭SEP与儿童认知发展之间的独特关联,并确定显著的产后社会流动是否与儿童7岁时认知表现的改善相关。
数据来自1959年至1965年参加美国国家围产期协作项目(NCPP)的儿童(n = 28761),该数据集规模大到足以观察到显著的社会流动情况,而这种情况仍然并不常见。采用多变量线性回归来研究孕期SEP(即父母收入、教育程度、职业)与8个月时(贝利婴儿发展量表心理发展指数)和7岁时(韦氏儿童智力量表)认知表现之间的关系。
在控制人口统计学和围产期因素不变的情况下,孕期家庭SEP与8个月时的认知表现无关(B = -0.03,95%可信区间:-0.07至0.01),但即使在考虑了7岁时的SEP之后,仍与7岁时的表现呈正相关(B = 1.28,95%可信区间:1.11至1.45)。家庭经历了最极端向上流动(从最低收入四分位数到最高收入四分位数)的儿童,在生命的前7年认知表现提高了12个百分点。那些经历了最极端向下流动(从最高收入四分位数到最低收入四分位数)的儿童,在此期间认知表现仍提高了8个百分点。
如今贫困儿童的比例与1965年相似,代际流动已显著下降。产前SEP可能导致儿童认知表现的不平等,即使是超常的社会流动也无法消除这种不平等。为了优化代际间的认知发展,当前针对有幼儿家庭的收入调查项目应辅以普惠性措施,以确保年轻人在成为父母之前有机会获得各种资源。