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

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Author Info

  • 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.

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File URL: http://www.pcb.ub.edu/xreap/aplicacio/fitxers/XREAP2012-13.pdf
File Function: First version, 2012
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File URL: http://www.pcb.ub.edu/xreap/aplicacio/fitxers/XREAP2012-13.pdf
File Function: Revised version, 2012
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Bibliographic Info

Paper provided by Xarxa de Referència en Economia Aplicada (XREAP) in its series Working Papers with number XREAP2012-13.

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Length: 49 pages
Date of creation: Jun 2012
Date of revision: Jun 2012
Handle: RePEc:xrp:wpaper:xreap2012-13

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Postal: Espai de Recerca en Economia, Facultat de Ciències Econòmiques i Empresarials, Universitat de Barcelona, c/ Tinent Coronel Valenzuela, 1-11, 08034 Barcelona
Phone: +34+934039653
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Web page: http://www.pcb.ub.edu/xreap
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Related research

Keywords: Child health; intermediary determinants; structural determinants; communities; Colombia.;

This paper has been announced in the following NEP Reports:

References

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  1. Marta Arespa, 2011. "Macroeconomics of extensive margins: a simple model," Working Papers XREAP2011-19, Xarxa de Referència en Economia Aplicada (XREAP), revised Nov 2011.
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  3. Marta Arespa, 2011. "A New Open Economy Macroeconomic Model with Endogenous Portfolio Diversifi cation and Firms Entry," Working Papers XREAP2011-15, Xarxa de Referència en Economia Aplicada (XREAP), revised Oct 2011.
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  6. Ulf Olsson, 1979. "Maximum likelihood estimation of the polychoric correlation coefficient," Psychometrika, Springer, vol. 44(4), pages 443-460, December.
  7. Hatt, Laurel E. & Waters, Hugh R., 2006. "Determinants of child morbidity in Latin America: A pooled analysis of interactions between parental education and economic status," Social Science & Medicine, Elsevier, vol. 62(2), pages 375-386, January.
  8. Magadi, Monica Akinyi & Madise, Nyovani Janet & Rodrigues, Roberto Nascimento, 2000. "Frequency and timing of antenatal care in Kenya: explaining the variations between women of different communities," Social Science & Medicine, Elsevier, vol. 51(4), pages 551-561, August.
  9. Varela-Irimia, Xosé-Luís, 2011. "Age effects, unobserved characteristics and hedonic price indexes: The Spanish car market in the 1990's," Working Papers 2072/169683, Universitat Rovira i Virgili, Department of Economics.
  10. Philippe Bocquier & Nyovani Madise & Eliya Zulu, 2011. "Is There an Urban Advantage in Child Survival in Sub-Saharan Africa? Evidence From 18 Countries in the 1990s," Demography, Springer, vol. 48(2), pages 531-558, May.
  11. Laia Castany & Enrique Lopez-Bazo & Rosina Moreno, 2007. "Decomposing differences in total factor productivity across firm size," IREA Working Papers 200705, University of Barcelona, Research Institute of Applied Economics, revised Mar 2007.
  12. Ana María Osorio & Catalina Bolancé & Manuela Alcañiz, 2011. "Measuring early childhood health: a composite index comparing Colombian departments," IREA Working Papers 201122, University of Barcelona, Research Institute of Applied Economics, revised Oct 2011.
  13. Vicente Royuela, 2012. "What about people in European Regional Science?," Working Papers XREAP2012-12, Xarxa de Referència en Economia Aplicada (XREAP), revised May 2012.
  14. Karina Acosta O., 2012. "La desnutrición en los primeros años de vida: Un análisis regional para Colombia," DOCUMENTOS DE TRABAJO SOBRE ECONOMÍA REGIONAL 009297, BANCO DE LA REPÚBLICA - ECONOMÍA REGIONAL.
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Citations

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Cited by:
  1. Anna Castañer & Mª Mercè Claramunt, 2014. "Optimal stop-loss reinsurance: a dependence analysis," Working Papers XREAP2014-04, Xarxa de Referència en Economia Aplicada (XREAP), revised Apr 2014.
  2. Antonio Manresa & Ferran Sancho, 2012. "Leontief versus Ghosh: two faces of the same coin," Working Papers XREAP2012-18, Xarxa de Referència en Economia Aplicada (XREAP), revised Oct 2012.

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