Date of Award

5-31-2022

Document Type

Campus Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Sociology

First Advisor

Paul Benson

Second Advisor

Jason Rodriquez

Third Advisor

Pamela Ohman Strickland

Abstract

Children with developmental disabilities have greater exposure to social factors that can adversely affect health, deemed “social determinants of health”, and have poorer health outcomes than children without these disabilities. While health outcomes can be related to the etiology of a child’s disability, recent studies suggest 20-50% of their poorer mental and physical health outcomes are due to adverse social determinants. Due to the nature of developmental disabilities, these children are hypothesized to be more susceptible to adverse social determinants and to have lower innate resilience-related skills and resources. This dissertation examined children with developmental disabilities and their families regarding how they are exposed to social determinants of health across three levels– structural, intermediary, and proximal. It then examined how health-related outcomes were associated with these exposures, how frequently children with developmental disabilities and their families have potential mitigating resources and skills, and whether the presence of these factors changes the association between social determinants and health-related outcomes. I analyzed two years (2018-2019) of data from the U.S. National Survey of Children’s Health. Children with developmental disabilities had greater odds of exposure to adverse social determinants of health across multiple domains, and substantially worse mental and behavioral health outcomes and greater unmet medical needs than children without developmental disabilities. These outcomes were strongly associated with exposures to adverse social determinants of health. While social determinants across all three levels were significantly associated with these adverse outcomes, factors that affect the child’s family stability and function and their relationship with their parents were among those most strongly associated with poor mental and behavioral health outcomes and unmet medical needs in multivariable models. Children with developmental disabilities had significantly lower levels of resilience resources, and these resources were less effective in mitigating the association between adverse social determinants of health and poor mental and behavioral health outcomes and unmet medical needs than for children without developmental disabilities. This study contributes valuable evidence at the national level that may better enable public policy, public health programs and social and health-related service systems in mitigating adverse health outcomes for children with of developmental disabilities.

Comments

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