Double Jeopardy

This article examines whether children with both biomedical and social risk factors are less healthy than children with one or neither of these conditions. Both biomedical and social risks are linked to poor health, but most research examines only one of these categories of risk while adjusting for the other, so little is known about how the combination of risk factors affects health. Children living in poverty are more likely to have health problems than peers with higher incomes. Biomedical risks such as low birth weight and chronic conditions are also associated with poor health.

The authors analyzed data from 8,174 children participating in the 2002 National Health Interview Survey. They compared participants grouped into four categories: (1) children with low social and low biomedical risk; (2) low social and high biomedical risk; (3) high social and low biomedical risk; and (4) high social and high biomedical risk.

Key Findings:

  • Seven to nine percent of all children had both high social and high biomedical risk. Children in this category were much more likely to have poor health care and heavy health care utilization than other children.
  • Twenty-six percent of children had high social risk and low biomedical risk, while 21-31 percent of children (depending on the measure chosen) had high biomedical risk and low social risk. Social risk was as likely to result in poor health as biomedical risk.

Children with high biomedical and social risk factors are much more likely to be in poor health than other children, suggesting that more attention should be paid to this very vulnerable group of children.