Child Development and the Physical Environment

Many children in Palestine live in an environment characterized by the constant threat of violence in their homes, schools, and neighborhood communities. It is within this context that an examination of the meaning of home is relevant. For home tends to represent a beloved and "safe" place for children in families in the context of political violence. Yet, as this paper illustrates, the meaning of home is much more complicated, and can be both positive and negative. Drawing from qualitative research with 18 families living in Palestine, home is first considered as a positive physical space, or a castle, for families affected by occupation and political violence. As a castle, home serves as (1) a site of family practices, (2) a center of identity, and (3) a place of protection. Secondly, this paper will conceptualize home as a cage for many of these same families, exploring (1) the unhealthy conditions that families live in, (2) the lack of privacy that characterizes many homes, and (3) the feeling that one is a prisoner within one's home. The paper ends by suggesting how practitioners and policymakers can better understand children and families multiple meanings of home in order to encourage the positive and mitigate the negative elements of home.

Health disparities research spans multiple fields and methods and documents strong links between social disadvantage and poor health. Associations between socioeconomic status (SES) and health are often taken as evidence for the causal impact of SES on health, but alternative explanations, including the impact of health on SES, are plausible. Studies showing the influence of parents' SES on their children's health provide evidence for a causal pathway from SES to health, but have limitations. Health disparities researchers face tradeoffs between "rigor" and "vigor" in designing studies that demonstrate how social disadvantage becomes biologically embedded and results in poorer health. Rigorous designs aim to maximize precision in the measurement of SES and health outcomes through methods that provide the greatest control over temporal ordering and causal direction. To achieve precision, many studies use a single SES predictor and single disease. However, doing so oversimplifies the multifaceted, entwined nature of social disadvantage and may overestimate the impact of that one variable and underestimate the true impact of social disadvantage on health. In addition, SES effects on overall health and functioning are likely to be greater than effects on any one disease. Vigorous designs aim to capture this complexity and maximize ecological validity through more complete assessment of social disadvantage and health status, but may provide less-compelling evidence of causality. Newer approaches to both measurement and analysis may enable enhanced vigor as well as rigor. Incorporating both rigor and vigor into studies will provide a fuller understanding of the causes of health disparities.methodology | social determinants of health | cumulative risk G ood health and longevity are unequally distributed in populations. Although some unavoidable variations in health emanate from individual differences in vulnerability to disease, others are linked to membership in socially disadvantaged groups. The latter are unjust and have been the focus of considerable research and policy (1). Research on these health disparities has demonstrated consistent graded associations between various components of socioeconomic status (SES) and a wide range of health indicators; at each step up the social ladder, whether indexed by higher income, education, and/or occupational level, rates of morbidity and mortality decrease (2). The prevailing understanding of this relationship is that SES is a "fundamental cause" of health status (3), which operates through physical and/or psychosocial resources that are more readily available as SES increases, and hardships and adverse exposures that are more intense and frequent as SES decreases.Evidence for the SES-health gradient comes primarily from cross-sectional data linking contemporaneous measures of SES in adulthood with prevalence of disease, poor health, or mortality. Smaller literatures have established associations between socioeconomic conditions in childhood and childhood health, and betwe...

General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. AbstractBackground Developmental problems in children can be alleviated to a great extent with early detection and intervention through periodic screening for developmental delays during pre-school ages. Currently, there is no established system for developmental screening of children in Sri Lanka. Although some developmental norms, which are similar to those of Denver Developmental Screening Test-II (DDST-II), have been introduced into the Sri Lankan Child Health Developmental Record (CHDR), those norms have not been standardized to the Sri Lankan child population. The aim of this research was to establish Sri Lankan norms for DDST-II and to test the universal and regional applicability of developmental screening tests by comparing the Sri Lankan norms with the norms of DDST-II and DDST-Singapore norms, the geographically nearest standardization of DDST-II. The norms were also compared with the milestones already available in the CHDR. Methods DDST-II was adapted and standardized on a sample of 4251 Sri Lankan children aged 0-80 months. Thirteen public health nursing sisters were trained to collect the data as part of their routine work. The 25th, 50th, 75th and 90th percentile ages of acquiring each developmental milestone were then calculated using logistic regression. Results The Denver Developmental Screening Test for Sri Lankan Children (DDST-SL) was created. Most of the established DDST-SL norms were different to the comparable norms in DDST-II, DDST-Singapore and the CHDR. Conclusions In view of the results of the study, it is imperative that developmental screening tests are used in context and are adapted and standardized to the populations in question before utilization.