It’s Just the Fact It’s Against Us: The Role of Social Determinants of Health in Young Children’s Caregivers’ Preventive Health Behaviors

Abstract

Persistent racial-, ethnic-, and income-related disparities in health outcomes for children suggest that there is still much to do to develop interventions that are responsive to communities’ needs. Cultural health capital, the health-related attitudes, beliefs, and behaviors needed to engage in a healthy lifestyle, is acquired throughout childhood and informs adult preventive health behaviors (PHBs). However, primary caregivers’ social determinants of health (SDH) dictate the opportunities they have for building children’s cultural health capital. Given that targeted, responsive interventions and policies to promote PHB in young children are needed, the purpose of this study was to explore how caregivers with varying SDH define preventive health and what affects their engagement in PHBs for themselves and their children. Six focus groups with primary caregivers of young children ( N = 37, 89% female, mean age = ∼37.9 years old, ∼36% White) were conducted at community organizations. Data were analyzed using a deductive approach, and emergent themes were categorized by types of SDH (downstream, upstream, or both) within each focus group. Focus groups were categorized into three clusters based on participants’ SDH and access to resources: high-resource, low-income/moderate-resource, and low-income/low-resource. Caregivers’ definitions of preventive health were rooted in upstream and downstream determinants and differed by cluster. All clusters identified money and access to resources as barriers to engaging in PHBs and acknowledged that structural inequity impacted access to resources. Policies, programs, and structural change to address systemic barriers and mistrust in systems are vital to reduce disparities in health outcomes for children.