Intermediary and Structural Determinants of Early Childhood Health in Colombia: Exploring the Role of Communities

XREAP2012-13

49 Pages Posted: 27 Jun 2012

See all articles by Ana Maria Osorio

Ana Maria Osorio

Pontifical University Javeriana Cali - Faculty of Economics and Business Administration; University of Barcelona - Riskcenter-IREA

Catalina Bolancé

University of Barcelona - Department of Econometrics

Nyovani Madise

University of Southampton - Division of Social Statistics

Date Written: June 27, 2012

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

Osorio, Ana Maria and Bolancé, Catalina and Madise, Nyovani, Intermediary and Structural Determinants of Early Childhood Health in Colombia: Exploring the Role of Communities (June 27, 2012). XREAP2012-13, Available at SSRN: https://ssrn.com/abstract=2094666 or http://dx.doi.org/10.2139/ssrn.2094666

Ana Maria Osorio

Pontifical University Javeriana Cali - Faculty of Economics and Business Administration ( email )

Calle 40 No. 6-23 Piso 8
Bogota
Colombia

University of Barcelona - Riskcenter-IREA ( email )

Av. Diagonal, 690
Barcelona, 08034
Spain

Catalina Bolancé (Contact Author)

University of Barcelona - Department of Econometrics ( email )

Av. Diagonal 690
Barcelona, E-08034
Spain

Nyovani Madise

University of Southampton - Division of Social Statistics ( email )

Highfield, Southampton SO17 1B
United Kingdom

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