Household Wealth and Neurocognitive Development Disparities among School-aged Children in Nepal
Article first published online: 10 OCT 2013
© 2013 The Authors. Paediatric and Perinatal Epidemiology published by John Wiley & Sons Ltd.
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Paediatric and Perinatal Epidemiology
Volume 27, Issue 6, pages 575–586, November 2013
How to Cite
Patel, S. A., Murray-Kolb, L. E., LeClerq, S. C., Khatry, S. K., Tielsch, J. M., Katz, J. and Christian, P. (2013), Household Wealth and Neurocognitive Development Disparities among School-aged Children in Nepal. Paediatric and Perinatal Epidemiology, 27: 575–586. doi: 10.1111/ppe.12086
- Issue published online: 17 OCT 2013
- Article first published online: 10 OCT 2013
- National Institutes of Health. Grant Number: R01 HD050254
- Bill and Melinda Gates Foundation, Seattle, Washington
- Sight and Life Research Institute, Baltimore, Maryland
- National Institutes of Health, Bethesda, Maryland. Grant Number: HD 38753
- Office of Health and Nutrition, US Agency for International Development, Washington DC. Grant Number: HRN-A-00-97-00015-00
- child development;
- cognitive function;
- motor function;
- household wealth;
- health disparities;
Wealth disparities in child developmental outcomes are well documented in developed countries. We sought to (1) describe the extent of wealth-based neurocognitive development disparities and (2) examine potential mediating factors of disparities among a population-based cohort of children in rural Nepal.
We investigated household wealth-based differences in intellectual, executive and motor function of n = 1692 children aged between 7 and 9 years in Nepal. Using linear mixed models, wealth-based differences were estimated before and after controlling for child and household demographic characteristics. We further examined wealth-based differences adjusted for three sets of mediators: child nutritional status, home environment, and schooling pattern.
We observed a positive gradient in child neurocognitive performance by household wealth. After adjusting for child and household control factors, disparities between children in the highest and lowest wealth quintiles persisted in intellectual and motor function, but not executive function. No statistically significant wealth-based differentials in outcomes remained after accounting for nutritional status, home environment, and schooling patterns. The largest differences in neurocognitive development were associated with schooling pattern.
Household wealth patterns child neurocognitive development in rural Nepal, likely through its influence on nutritional status, the home environment, and schooling. In the current context, improving early and regular schooling in this setting is critical to addressing wealth-based disparities in outcomes.