Theses and Dissertations
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- All Subjects: Children
Significant health inequalities exist between different castes and ethnic communities in India, and identifying the roots of these inequalities is of interest to public health research and policy. Research on caste-based health inequalities in India has historically focused on general, government-defined categories, such as “Scheduled Castes,” “Scheduled Tribes,” and “Other Backward Classes.” This method obscures the diversity of experiences, indicators of well-being, and health outcomes between castes, tribes, and other communities in the “scheduled” category. This study analyzes data on 699,686 women from 4,260 castes, tribes and communities in the 2015-2016 Demographic and Health Survey of India to: (1) examine the diversity within and overlap between general, government-defined community categories in both wealth, infant mortality, and education, and (2) analyze how infant mortality is related to community category membership and socioeconomic status (measured using highest level of education and household wealth). While there are significant differences between general, government-defined community categories (e.g., scheduled caste, backward class) in both wealth and infant mortality, the vast majority of variation between communities occurs within these categories. Moreover, when other socioeconomic factors like wealth and education are taken into account, the difference between general, government-defined categories reduces or disappears. These findings suggest that focusing on measures of education and wealth at the household level, rather than general caste categories, may more accurately target those individuals and households most at risk for poor health outcomes. Further research is needed to explain the mechanisms by which discrimination affects health in these populations, and to identify sources of resilience, which may inform more effective policies.
It is estimated that about one in six children aged 3 to 7 have one or more developmental disabilities (DD) in the United States. These conditions can include ADHD, cerebral palsy, Autism spectrum disorder, vision impairment, hearing loss, learning/intellectual disabilities, and other developmental delays. Many children with developmental disabilities are also at a higher risk of being undernourished or lacking nutrition. Inadequate nutrient intake, feeding problems/disorders, and motor dysfunctions associated with DD are often related to poor nutritional status. However, there are many other social factors, that are often overlooked, which can contribute to the overall poor nutritional status of children with developmental disabilities. This thesis aimed to take a holistic look at the physical, environmental, and social determinants of health that affect the nutritional status and mealtime success of children with developmental disabilities using an intersectional approach. The research also includes a synthesis of interviews collected from parents of children with DD, social workers, occupational therapists, and speech and language therapists in order to survey what challenges children with developmental disabilities face during mealtime, nutritional challenges from parents/professionals, and assessment of nutritional programs available in the community.