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Intermediary and structural determinants of early childhood health in Colombia: exploring the role of communities

Author

Listed:
  • Ana Maria Osorio

    (University of Barcelona, Department of Econometrics, Barcelona-Spain and Pontificia Universidad Javeriana, Department of Economics, Cali-Colombia)

  • Catalina Bolancé

    (University of Barcelona, Department of Econometrics, Barcelona-Spain)

  • Nyovani Madise

    (University of Southampton, Division of Social Statistics and Centre for Global Health, Population, Poverty, and Policy, Southampton-United Kingdom)

Abstract
This study examines how structural determinants influence intermediary factors of child health inequities and how they operate through the communities where children live. In particular, we explore individual, family and community level characteristics associated with a composite indicator that quantitatively measures intermediary determinants of early childhood health in Colombia. We use data from the 2010 Colombian Demographic and Health Survey (DHS). Adopting the conceptual framework of the Commission on Social Determinants of Health (CSDH), three dimensions related to child health are represented in the index: behavioural factors, psychosocial factors and health system. In order to generate the weight of the variables and take into account the discrete nature of the data, principal component analysis (PCA) using polychoric correlations are employed in the index construction. Weighted multilevel models are used to examine community effects. The results show that the effect of household’s SES is attenuated when community characteristics are included, indicating the importance that the level of community development may have in mediating individual and family characteristics. The findings indicate that there is a significant variance in intermediary determinants of child health between-community, especially for those determinants linked to the health system, even after controlling for individual, family and community characteristics. These results likely reflect that whilst the community context can exert a greater influence on intermediary factors linked directly to health, in the case of psychosocial factors and the parent’s behaviours, the family context can be more important. This underlines the importance of distinguishing between community and family intervention programmes.

Suggested Citation

  • Ana Maria Osorio & Catalina Bolancé & Nyovani Madise, 2012. "Intermediary and structural determinants of early childhood health in Colombia: exploring the role of communities," Working Papers XREAP2012-13, Xarxa de Referència en Economia Aplicada (XREAP), revised Jun 2012.
    • Handle: RePEc:xrp:wpaper:xreap2012-13
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    4. Ana Maria Osorio & Catalina Bolancé & Nyovane Madise & Katharina Rathmann, 2013. "Social Determinants of Child Health in Colombia: Can Community Education Moderate the Effect of Family Characteristics?," Working Papers XREAP2013-02, Xarxa de Referència en Economia Aplicada (XREAP), revised Mar 2013.
    5. Mercedes Ayuso & Montserrat Guillen & Jens Perch Nielsen, 2019. "Improving automobile insurance ratemaking using telematics: incorporating mileage and driver behaviour data," Transportation, Springer, vol. 46(3), pages 735-752, June.
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    Child health; intermediary determinants; structural determinants; communities; Colombia.;
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