Spatial Dependence in Child Behavior Problems:

Implications for Individual and Community-Wide Interventions

Spatial Dependence in Child Behavior Problems:

Implications for Individual and Community-Wide Interventions

Margaret O’Brien Caughy, Sc.D.Associate Professor and

Director, Maternal and Child Health Training ProgramUniversity of Texas School of Public Health

Policy Forum on Neighborhoods, Community and Well-BeingFederal Reserve Bank of Dallas

December 11, 2012

Behavioral health a leading concern for parents

Behavioral health a leading concern for parents

Simpson, G. A., Cohen, R. A., Pastor, P. N., & Reuben, C. A. (2008). Use of mental health services in the past 12 months by children aged 4-17 years: United States, 2005-2006 NCHS data brief, No. 8. Hyattsville, MD: National Center for Health Statistics.

Childhood behavior problems generate significant societal costs

Childhood behavior problems generate significant societal costs

World Health Organization. (2003). Investing in mental health. Geneva, Switzerland: Department of Mental Health and Substance Dependence.

Determinants of child behavior problems

Determinants of child behavior problems

Conduct Disorder

Sociocultural Context

Mental Processes

Biological Predisposition

Peers

Parenting

Adapted from Dodge & Pettit, (2003). A biopsychosocial model of the development of chronic conduct problems in adolescence. Developmental Psychology, 39, 349-371.

Baltimore neighborhoods and child behavior problems

Baltimore neighborhoods and child behavior problems

Total

prob

lems

Inte

rnali

zing

prob

lems

Exter

naliz

ing p

roble

ms

45

47

49

51

53

55

Low Negative ClimateHigh Negative Climate

T-s

core

Caughy, O'Campo, & Nettles, (2008). American Journal of Community Psychology, 42, 39-50.

Limitations of existing researchLimitations of existing research

• Relying upon fixed administrative boundaries to define neighborhood (census tracts, census block groups)

• Failure to capture the complex nature of neighborhood effects

• Relying upon fixed administrative boundaries to define neighborhood (census tracts, census block groups)

• Failure to capture the complex nature of neighborhood effects

6

Study OverviewStudy Overview

• Parent reported behavior problems for 261 youth (82% African American)

• Spatial analysis of effects of:– Housing conditions– Geographic peers

• Parent reported behavior problems for 261 youth (82% African American)

• Spatial analysis of effects of:– Housing conditions– Geographic peers

4-5 6-9 10-12 13-15 16-180

10

20

30

40

50

60

Child Age

%

Distribution of dilapidated housing in Fair Park

Geographic distribution of childrenGeographic distribution of children

Study FindingsStudy Findings

• The geography that matters for: – Physical environment:

400-800m around child’s home

– Behavior problems of neighborhood peers: 255m around child’s home

• Effects were simultaneous

• The geography that matters for: – Physical environment:

400-800m around child’s home

– Behavior problems of neighborhood peers: 255m around child’s home

• Effects were simultaneous

Implications for interventionImplications for intervention

“The goal of the field of translational developmental science is to use ‘‘basic science’’ to cause population-level impact on raising healthy children, that is, to improve the overall rates of healthy outcomes and to decrease the overall rates of problem outcomes for the population of children in society. . . Unfortunately, the field has not yet demonstrated success in the goal of population impact.”

(emphasis added)

Implications for interventionImplications for intervention

• Community context is an important target for interventions to reduce child behavior problems

• Measuring geographic peer effects would provide a more accurate picture of effects of community-level interventions

• Community context is an important target for interventions to reduce child behavior problems

• Measuring geographic peer effects would provide a more accurate picture of effects of community-level interventions