Community Determinants of Physical Growth and Cognitive Development among Indian Children in Early Childhood: A Multivariate Multilevel Analysis

Jongho Heo, Aditi Krishna, Jessica M. Perkins, Hwa-young Lee, Jong-koo Lee, S.V. Subramanian and Juhwan Oh
Additional contact information
Jongho Heo: National Assembly Futures Institute, 1 Uisadang-daero, Seoul 07233, Korea
Aditi Krishna: Centre for Global Child Health, The Hospital for Sick Children, 525 University Avenue, Toronto, ON M5G 2L3, Canada
Jessica M. Perkins: Department of Human and Organizational Development, Peabody College of Education and Human Development, Vanderbilt University, 230 Appleton Place, Nashville, TN 37203, USA
Hwa-young Lee: Takemi Fellow at the Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA
Jong-koo Lee: Department of Family Medicine, Seoul National University College of Medicine, 71 Ihwajang-gil, Seoul 110-810, Korea
S.V. Subramanian: Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, 9 Bow Street, Cambridge, MA 02138, USA
Juhwan Oh: JW Lee Center for Global Medicine, Seoul National University College of Medicine, Seoul National University College of Medicine, 71 Ihwajang-gil, Seoul 110-810, Korea

IJERPH, 2019, vol. 17, issue 1, 1-12

Abstract: Inadequate child physical growth and cognitive development share common individual-level risk factors. Less understood is how outcomes co-cluster at the community level and to what extent certain community-level characteristics influence the clustering. This study aims to quantify the extent to which child growth and development co-occur across communities, and to identify community-level characteristics associated with the clustering of the two development dimensions. We used longitudinal data from 1824 children (aged 5 years) across 98 communities in Andhra Pradesh, India in round 2 (2006) of the Young Lives study, who were followed up 3 years later in round 3 (2009). A multivariate, multilevel statistical model was estimated wherein the responses were nested within individuals, and communities. We used z-scores of height-for-age, weight-for-age, Peabody Picture Vocabulary Test, and a mathematics test in 2009 as outcome variables. At the community level, we included compositional variables representing community characteristics while controlling for child socio-demographic characteristics at the individual level. At the community level, children’s physical growth and cognitive development were strongly correlated (coefficient: 0.55–0.76) and, even after controlling for individual-level covariables, a more pronounced correlation was shown at the community level than individual level correlation. Greater local healthcare resources were associated with better physical growth. More local programs run by government and NGOs/charities were associated with higher child language skills. Local social problems were inversely associated with math scores. Our study showed that physical growth and cognitive development tended to be clustered and co-occurred within communities as well as individual children.

Keywords: community characteristics; local programs; health resources; Young Lives; India (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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