Quantitative assessment of multidimensional health disparities and their determinants among vulnerable children

Background: Despite global efforts to advance health equity and social development, significant gaps remain in safeguarding children’s health. This study quantitatively assessed multidimensional health disparities between vulnerable children and non-vulnerable children. The aim was to provide empirical evidence to inform the development of strategies for reducing health disparities, promoting health equity, and improving welfare outcomes for this population.

Methods: A cross-sectional survey design was employed to assess general health outcomes and to investigate the potential impact of familial structural factors among vulnerable children. Data were collected from students in 14 primary schools located in Shanxi Province, China. Of the 1,560 questionnaires distributed, 1,516 were returned, and 1,464 were valid, yielding a response validity rate of 96.6%. Among the respondents, 283 met the criteria for classification as vulnerable children.

Results: Significant differences in physical and psychological health were observed between vulnerable children residing in urban and rural settings. Functional capacities presented a tendency to decline with increasing grade level. Learning ability and self-concept demonstrated a downward trend as grade level increased. Psychological concerns were prevalent and varied by sex. Families of vulnerable children faced challenges related to economic status, cultural capital, and family structure, with family composition demonstrating a potential impact on health outcomes. Greater parental level of involvement was associated with improved quality of life (QoL), while children with psychological needs were at a potential elevated risk for adverse outcomes.

Conclusions: Children identified as vulnerable demonstrated pronounced disadvantages in psychosocial well-being, physical health, and living conditions. Key factors associated with general health status included household economic conditions, parental marital and educational status, and the degree of parental attention to the psychological needs of children. Enhancing the general health and QoL for vulnerable children necessitates targeted policy interventions, enhanced family-based support, and expanded access to community-based health and social services.