Intergenerational Disadvantage and pediatric health disparities in acute respiratory illness and diarrhea - 2025-ongoing
Every year, millions of children under the age of five die from diseases that could have been prevented due to lack of basic health services. These diseases disproportionately affect disadvantaged communities, highlighting the glaring inequities in healthcare access within and between countries, including Nepal.
Understanding the underlying social determinants driving these disparities is crucial, especially during early childhood, as this developmental stage significantly impacts long-term health outcomes. Yet, current research lacks detailed socio-demographic and contextual data necessary for a comprehensive analysis. We intend to use the Chitwan Valley Family Study's vast dataset, which offers a wealth of data on home and community dynamics over nearly three decades, to close this gap.
Our study aims to uncover how these factors shape the burden of infectious diseases in early childhood and subsequently influence lifelong health trajectories. Through rigorous analysis of existing data and new measures collected through daily symptom diaries, we seek to inform targeted interventions that mitigate health disparities and promote equitable access to healthcare for vulnerable populations.
This is quantitative Cohort study. In this study, after an interview to collect baseline information about children’s health and well-being and household characteristics, we will ask parents to record daily information about children’s acute illness symptoms using a simple paper checklist provided by the study. We will ask parents to complete daily checklists for up to 52 weeks. At the end of each week, we will contact parents via phone for a short interview to collect weekly information about symptoms and healthcare utilization in the case of acute illness.
Professional interviewing staff from ISER-N will visit all households identified as potentially eligible based on the Chitwan Valley Family Study household registry. Interviewers will describe the study and confirm the ages of all children residing in the household. Detailed information about the study will be provided to the respondent. Then interviewer will obtain written informed consent from the respondent to collect information on children’s symptoms in weekly follow-up via phone. For each participating child, parents and caregivers will complete a daily paper checklist provided by ISER-N to mark which symptoms of ARI and diarrheal disease, if any, their child experienced that day. Families will receive a text message from ISER-N each day reminding them to complete the symptom diary for each participating child. All parents/caregivers will be contacted via phone each week for 52 weeks for a follow-up interview to collect the information they documented on the daily checklists. All interviews will be conducted using computer-assisted personal interview procedures. The 52-week follow-up period will allow us to capture data throughout the year, regardless of seasonality.
Data cleaning is a routine process that is carried out alongside data collection. Once data collection is complete, the final dataset is compiled. This final dataset is then handed over to investigators for analysis.
This proposal will combine existing CVFS data with new high-frequency measures of ARI, diarrhea disease, and healthcare utilization among children under five to achieve our long term goal. Our long-term goal is to identify whether children with intergenerational disadvantage are more likely to experience a greater burden of infectious disease, and whether and how this disadvantage conditions short- and long-term implications for their health, particularly immune health, throughout the life course. We anticipate that this study will yield critical insights into the role of intergenerational disadvantage in determining disparities in the burden of ARI and diarrhea in early childhood, and how families are able to respond to acute illness. Strategies that mitigate long-term experiences of disadvantage and improve timely access to trained healthcare providers may provide interventional points to disrupt persistent disparities in under-five health and mortality in South Asia, the United States, and other settings globally.
Data will be available upon completion.
No publications yet.
Ongoing/2024-2029
Chitwan
Children Health