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      Pathways to inequalities in child health

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          Abstract

          From birth, children living in disadvantaged socioeconomic circumstances (SECs) suffer from worse health than their more advantaged peers. The pathways through which SECs influence children’s health are complex and inter-related, but in general are driven by differences in the distribution of power and resources that determine the economic, material and psychosocial conditions in which children grow up. A better understanding of why children from more disadvantaged backgrounds have worse health and how interventions work, for whom and in what contexts, will help to reduce these unfair differences. Macro-level change is also required, including the reduction of child poverty through improved social security systems and employment opportunities, and continued investment in high-quality and accessible services (eg, childcare, key workers, children’s centres and healthy school environments). Child health professionals can play a crucial role by being mindful of the social determinants of health in their daily practice, and through advocating for more equitable and child-focussed resource allocation.

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          Life course epidemiology.

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            Social Determinants and Their Unequal Distribution: Clarifying Policy Understandings

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              How could differences in 'control over destiny' lead to socio-economic inequalities in health? A synthesis of theories and pathways in the living environment.

              We conducted the first synthesis of theories on causal associations and pathways connecting degree of control in the living environment to socio-economic inequalities in health-related outcomes. We identified the main theories about how differences in 'control over destiny' could lead to socio-economic inequalities in health, and conceptualised these at three distinct explanatory levels: micro/personal; meso/community; and macro/societal. These levels are interrelated but have rarely been considered together in the disparate literatures in which they are located. This synthesis of theories provides new conceptual frameworks to contribute to the design and conduct of theory-led evaluations of actions to tackle inequalities in health.
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                Author and article information

                Journal
                Arch Dis Child
                Arch. Dis. Child
                archdischild
                adc
                Archives of Disease in Childhood
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                0003-9888
                1468-2044
                October 2019
                23 February 2019
                : 104
                : 10
                : 998-1003
                Affiliations
                [1 ] departmentMRC/CSO Social and Public Health Sciences Unit , University of Glasgow , Glasgow, UK
                [2 ] departmentDepartment of Public Health and Policy, Institute of Population Health Sciences , University of Liverpool , Liverpool, UK
                Author notes
                [Correspondence to ] Dr Anna Pearce, MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G2 3AX, United Kingdom; anna.pearce@ 123456glasgow.ac.uk
                Author information
                http://orcid.org/0000-0003-0085-5263
                Article
                archdischild-2018-314808
                10.1136/archdischild-2018-314808
                6889761
                30798258
                c44c4724-037e-4446-aa0d-f1320c5e9f5f
                © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 24 September 2018
                : 11 January 2019
                : 14 January 2019
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100004440, Wellcome Trust;
                Funded by: FundRef http://dx.doi.org/10.13039/501100000589, Chief Scientist Office;
                Funded by: FundRef http://dx.doi.org/10.13039/501100000265, Medical Research Council;
                Categories
                Review
                1506
                Custom metadata
                unlocked

                Medicine
                child health,health inequalities,life course,policy,social determinants of health
                Medicine
                child health, health inequalities, life course, policy, social determinants of health

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