Breaking the Intergenerational Cycle of Disadvantage: The Three Generation Approach

Abstract

Health disparities in the United States related to socioeconomic status are persistent and pervasive. This review highlights how social disadvantage, particularly low socioeconomic status and the health burden it brings, is passed from 1 generation to the next. First, we review current frameworks for understanding the intergenerational transmission of health disparities and provide 4 illustrative examples relevant to child health, development, and well-being. Second, the leading strategy to break the cycle of poverty in young families in the United States, the 2-generation approach, is reviewed. Finally, we propose a new 3-generation approach that must combine with the 2-generation approach to interrupt the intergenerational cycle of disadvantage and eliminate health disparities.

MATERNAL PERCEPTIONS OF PARENTING FOLLOWING AN EVIDENCE‐BASED PARENTING PROGRAM: A QUALITATIVE STUDY OF LEGACY FOR CHILDRENTM

“…Poverty exhibits direct and indirect effects on families' social, emotional, and physical health and well-being, disproportionately affecting the capacity to address basic needs and access healthcare and education as well as overall morbidity and mortality (Evans & Kim, 2013;Johnson, Riis, & Noble, 2016). The burden of income inequality, coupled with the chronic stress associated with resource-poor environments (Cheng et al, 2016), leads to increased challenges related to parenting for families living in poverty as compared to their higher income counterparts (Brooks-Gunn & Duncan, 1997;Jocson & McLoyd, 2015;Pascoe et al, 2016). Just as low-income populations are denied access to buffering supports, parents living in poverty may lack access to those resources which specifically support positive parenting, such as the ability to spend time with their children, procurement of childcare and transportation, and access to parenting information and social support (Johnson, Riis, & Noble, 2016;Kaiser & Delaney, 1996).…”

“…Many negative outcomes are associated with poverty during childhood, including increased risk of chronic disease and stress as well as behavior and emotional problems, difficulties in concentration and memory, and delays in language development (American Psychological Association, 2013;Bitsko et al, 2016;Duncan, Ziol-Guest, & Kalil, 2010;Luby et al, 2013;Pascoe, Wood, Duffee, & Kuo, 2016). Studies also have demonstrated that children living in poverty during early childhood experience negative effects into adulthood (Cheng, Johnson, & Goodman, 2016;Duncan et al, 2010).…”

A Population-Based Study Comparing Child (0-4) and Adult (55-74) Mortality, GDP-Expenditure-on- Health and Relative Poverty in the UK and Developed Countries 1989-2014. Some Challenging Outcomes

“…Income Inequality [10,] is a measure of relative poverty, known to be associated with poorer child health outcomes [11][12][13][14][15][16][17] and is the other major socio-economic context in which all health services operate.…”

“…On the other hand, these 21 Western countries are amongst the very richest in the world [8], though this is not to deny there are differences between them. For example based upon US Census Bureau data, who report mortality by ethnicity, African American children die at virtually double the rate of White 0-4 year olds and such feature occurs in other Western countries but here we are reviewing the nation's mortality rates in their entirety [6,9,[11][12][13][14][15][16][17].…”

Influence of maternal characteristics and caregiving behaviours on children's caries experience: An intergenerational approach

“…It is here that intergenerational transmission of health disparities arises. It is of concern, as a child born to poor parents is likely to remain poor as an adult and, if he or she becomes a parent, to raise poor children …”