The authors examined social risk factors (poverty, minority race/ethnicity, low parental education and not living with both biological parents) to assess whether an accretion of risk factors had a cumulative effect on child health. They also investigated whether having health insurance (assumed to indicate increased access to care) reduced disparities in children's health. Data were drawn from two years of survey information recorded in the National Health Interview Survey Disability Supplement. SPSS 10.0 and SUDAAN 7.0 were used for statistical analysis.
Limitations of the study were that all measures of health were by parental report; and some measures might possess two-way causality (i.e., poor health in children might cause relationship stress and therefore result in higher rates of single parenting). The authors conclude that the above issues may require further dissecting, but none is sufficiently confounding to negate the conclusion that social disadvantages have a cumulative negative effect on children's health.