Health and development among Mexican, black and white preschool children: An integrative approach using latent class analysis

BACKGROUND Building on an emerging scientific consensus that the concept of child health should encompass chronic conditions, functional abilities, and developmental domains, we delineate the multidimensional health statuses of Mexican, non-Hispanic black, and non-Hispanic white preschool children in the United States. This integrative approach provides the foundation for an in-depth analysis of healthdisparities. OBJECTIVE The research objectives are: (1) to demonstrate a new methodological approach to identifying the major child health statuses; (2) to documentdifferences in the prevalence of those health statuses among children in the largest ethnoracial groups in the U.S.; and (3) to assess whether key sources of disadvantage account for ethnoracial disparities in children's health. METHODS With datafrom a nationally representative sample, we use latent class analysis to estimate a set of latent health statuses that capture the nature of health at age four. Thelatent class membership of children is predicted using multinomial logistic regression. RESULTS Mexican and non-Hispanic black children are more likely than non-Hispanic white children to fall into health statuses distinguished by low cognitive achievement and multiple developmental problems. Mexican children are the most likely to be classified into these problematic health statuses. This pattern persists in multivariate models that incorporate potential explanatory factors, including health at birth, socio-demographic characteristics, home environment, well-child care and center-based child care. CONCLUSIONS Latent class analysis is a useful method for incorporating measures of physical conditions, functional problems, and development into a single analysis in order to identify key dimensions of childhood health and locate ethnoracial health disparities.