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.

Key Findings:

• Minority status was not a significant social disadvantage for child health; ethnic/race disparities in child morbidity and mortality appear to be related to income rather than to ethnicity.
• Children with more risk factors had greater risks of having all the conditions being studied (poor health in general, a chronic condition, or an activity restriction) with one exception: low education. Low education was inconsistent in adding to risk of health problems.
• Access to health insurance did not change the relationship of social disadvantage to health.

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.