Date of Award
Doctor of Philosophy (PhD)
Irma T. Elo
Cross-disciplinary evidence suggests that household factors including maternal socioeconomic status, maternal health, and living arrangements can affect child health and well-being. This dissertation examines an array of countries and economic contexts to weigh the relative importance of household characteristics for child nutritional status. In Chapter 1, I examine characteristics predicting parental ideal family size and whether children of birth orders exceeding parental ideals experience worse nutritional status among the Tsimane, a high-fertility and high-mortality indigenous population in the Bolivian Amazon. I find minimal evidence that birth orders exceeding parental ideals are associated with worse height-for-age, weight-for-age, stunting, hemoglobin, and anemia in children aged 0-5. The observed mismatch between ideal and achieved family size does not predict lower child nutritional status in this population, perhaps due to mitigation of exceeding ideals via effective buffering strategies. In Chapter 2, I focus on a larger sample of Tsimane children to examine the association between maternal socioeconomic status and childhood nutritional status. I find that maternal Spanish proficiency is associated with improved height-for-age z-scores, a one-third reduction in odds of stunting for children aged 0-2, and nearly a halving in odds of stunting for children aged 2-5. This analysis suggests the importance of Spanish proficiency, which allows for increased access to markets, information, and health care. Chapter 3 examines the association between grandparental coresidence and child nutritional status in Ethiopia, India, Peru, and Vietnam. Grandparents are not uniformly associated with childhood nutritional status by sex, age, or wealth. There is evidence of a positive association between coresident grandmothers and child nutritional status in Peru, but in several countries households with higher wealth indices appear to buffer children against any negative nutritional outcomes stemming from the burden of coresident grandparents. Grandparental coresidence may affect other aspects of child development, but children in multigenerational households in the low- and middle-income countries in this sample have similar nutritional status to peers with non-coresident grandparents.
Costa, Megan Elizabeth, "Three Essays on Household Determinants of Child Health and Well-Being" (2016). Publicly Accessible Penn Dissertations. 1669.