Chaos as a social determinant of child health: Reciprocal associations?

Abstract

This study informs the social determinants of child health by exploring an understudied aspect of children’s social contexts: chaos. Chaos has been conceptualized as crowded, noisy, disorganized, unpredictable settings for child development (Evans et al., 2010). We measure chaos at two levels of children’s ecological environment - the microsystem (household) and the mesosystem (work-family-child care nexus) – and at two points in early childhood (ages 3 and 5). Using data from the Fragile Families and Child Wellbeing Study (N=3288), a study of predominantly low-income women and their partners in large US cities, we develop structural equation models that assess how maternal-rated child health (also assessed at ages 3 and 5) is associated with latent constructs of chaos, and whether there are important reciprocal effects. Autoregressive crosslagged path analysis suggest that increasing chaos (at both the household and maternal work levels) is associated with worse child health, controlling for key confounders like household economic status, family structure, and maternal health status. Child health has little effect on chaos, providing further support for the hypothesis that chaos is an important social determinant of child health in this sample of relatively disadvantaged children. This suggests child health may be improved by supporting families in ways that reduce chaos in their home and work/family environments, and that as researchers move beyond SES, race, and family structure to explore other sources of health inequalities, chaos and its proximate determinants may be a promising avenue for future research.

Early exposure to environmental chaos and children's physical and mental health

“…Research has found associations between maternal relationship instability (movements in or out of marriage or cohabitation) and young children’s behavior problems in both low-income and economically diverse samples of families (Ackerman, Brown, D’Ermo, & Izard, 2002; Ackerman, Kogos, Youngstrom, Schoff, & Izard, 1999; Cavanagh & Huston, 2006; Fomby & Cherlin, 2007; Magnuson & Berger 2009; Osborne & McLanahan 2007), with some evidence of links to emotional problems as well, as found in research with older children from the same sample as the current study (Bachman, Coley, & Carrano, 2011). Work on residential instability has delineated associations with worse physical health outcomes (Busaker & Kasehagen, 2012; Cutts et al, 2011; Kamp Dush, Schmeer, & Taylor, 2013) as well as heightened emotional and behavioral problems among young children, as found in research with older children from the current study as well as other datasets (Coley et al, 2013; Ziol-Guest & McKenna, 2013). As with environmental disorder, evidence suggests that aspects of environmental instability are correlated within families (Kull, Coley, & Lynch, 2013).…”

Home sweet home? Home physical environment and inflammation in children

“…Children need stable, supportive social environments and access to resources within the home to enhance cognitive, emotional, and physical development (Bronfenbrenner, 2001). Alternatively, unstable, noisy, chaotic home environments have negative effects on children’s health (Dush et al, 2013) and development (Evans, 2003; Evans and English, 2002). Low-income children are more likely to face poor quality home environments, across multiple domains, than their wealthier counterparts (Bradley et al, 2001; Evans and English, 2002; Holupka and Newman, 2011); and, low-income parents are often forced to choose between healthy and affordable homes (Breysse et al, 2004).…”

“…In a study of four housing characteristics (housing type, cost, quality, and stability) poor housing quality most consistently predicted low-income children’s emotional and behavioral problems and lower cognitive skills (Coley et al, 2013). Several studies indicate that household social and physical disorder (including hazardous, crowded, cluttered, and unclean homes) are associated with worse health in children (Breysse et al, 2004; Cutts et al, 2011; Delgado et al, 2002; Dush et al, 2013; Leventhal and Newman, 2010; Suglia et al, 2010). …”

Getting Under the Skin: Children’s Health Disparities as Embodiment of Social Class

“…Low-income children whose mothers are socially isolated exhibit higher rates of serious accidents, injuries, and poisonings (Leininger, Ryan, & Kalil, 2009). Maternal perceptions of instrumental support predict higher levels of child health (Turney, 2013), whereas greater household chaos (meaning, a crowded, noisy, and unpredictable environment) predict lower levels of child health (Dush, Schmeer, & Taylor, 2013). In sum, health is likely maximized among children who belong to a family in which both the parent-child and sibling relationships are characterized by high levels of closeness and warmth, as well as high levels of social support which may buffer the child from the full effects of stressful events.…”