Transcript Racial/Ethnic Disparities in Adults Reading to Two Year Old Children: A Population-based Study Olivia Sappenfield Emory University School of Public Health Office of Family.

Racial/Ethnic Disparities in Adults Reading to Two Year Old Children:
A Population-based Study
Olivia Sappenfield
Emory University School of Public Health
Office of Family Health, Oregon Public Health Division
Kenneth D. Rosenberg, MD, MPH
Introduction
Office of Family Health, Oregon Public Health Division
Over a wide range of adverse health outcomes, people with low literacy have 1.5 to 3 times
higher risk of poor health outcomes than people whose literacy is not low. If a parent begins
reading to a child by the age of two, the child is more likely to read well in third grade. Third
graders who do not read at grade level are more at risk for poor educational performance
Risk factors associated with reading to children every day
• High parental education
• High family income
• Lower birth order
•
• Family history of reading habits
• Support from pediatric provider
• Mother not depressed
Results
62.4% of respondents reported reading to their child every day.
Hispanic and non-Hispanic Black mothers were the least likely to report reading to their child every
day.
Hispanic and non-Hispanic Black mothers were most likely to report low poverty status, low
education and low maternal age.
First > Second > Third
• More books at home (including library books)
Racial/ethnic disparities
Studies have indicated racial/ethnic disparities exist in reading to children. Previous research
found Black and Hispanic parents were less likely than white parents to read to their children;
Spanish speaking families had fewer children’s books at home; and Spanish speaking families
were more likely to never read to their children than non-Spanish speaking families. This
study proposed to assess the association between maternal race/ethnicity and reading to two
year olds.
Methods
Research Question: Is there an association between maternal race/ethnicity and reading to a
two year old every day?
Dataset: 3 linked datasets:
• 2004-2005 Oregon Birth Certificate
• 2004-2005 PRAMS
• 2006-2008 PRAMS-2
1911 Participants, Final Sample: 1868 Mothers
• 37 did not answer question about reading to child
• 6 did not answer race/ethnicity question
Outcome: Whether the mother or someone else in her household read to her
two year old every day
Exposure: Maternal race/ethnicity
Other covariates: maternal nativity, birth order, maternal age, household
income, maternal education, maternal depression, childcare, marital status,
whether mother lives with another adult, time child spent watching tv
Weighted bivariate analysis determined covariates for the model.
Multivariate logistic regression was used for the final model
Reading to racial/ethnic minorities
Table 1
Hispanic mothers are 70% less likely to
report reading to their 2 year old
everyday than NH White mothers (ORa
0.30; 95% CI: 0.20, 0.44).
NH Black mothers are 68% less likely to
report reading to their 2 year old every
day than NH White mothers. (ORa 0.32;
95% CI: 0.21, 0.48).
NH American Indian/Alaska Native
mothers are 42% less likely to report
reading to their 2 year old every day
than NH White mothers (ORa 0.58; 95%
CI: 0.39, 0.87).
NH Asian/Pacific Islander mothers are
61% less likely to report reading to their
2 year old every day than NH White
mothers. (ORa 0.39; 95% CI: 0.27, 0.57).
Table 1: Protective factors for reading to two year old children every day, Oregon PRAMS-2, 2004-2005 birth
cohorts (n=1868)
Characteristic
na
Read to child
Bivariate OR
Multivariate OR
everyday
(95% CI)
(95% CI)
(weighted)b
Total
1868
62.4%
-
-
White, non-Hispanic
819
71.6%
Referent
Referent
Hispanic
358
34.1%
0.21 (0.15, 0.28)
0.30 (0.20, 0.44)
Black, non-Hispanic
186
38.8%
0.25 (0.17, 0.37)
0.32 (0.21, 0.48)
AI/AN, non-Hispanic
218
53.9%
0.46 (0.33, 0.66)
0.58 (0.39, 0.87)
Asian/ Pacific Islander, non-Hispanic
287
58.4%
0.56 (0.40, 0.77)
0.39 (0.27, 0.57)
Less than 100% FPL
379
37.0%
Referent
Referent
100-199% FPL
385
52.0%
1.84 (1.18, 2.88)
1.26 (0.76, 2.09)
200% FPL or higher
990
77.2%
5.77 (3.91, 8.52)
2.54 (1.56, 4.13)
Less than 25 years
515
49.9%
Referent
Referent
25 - 29 years
518
61.5%
1.60 (1.10, 2.32)
1.40 (0.86 2.26)
30 years or older
835
72.6%
2.66 (1.88, 3.76)
2.03 (1.27, 3.25)
Third child or greater
450
48.2%
Referent
Referent
Second child
579
65.5%
2.04 (1.41, 2.97)
1.84 (1.17, 2.91)
First child
838
68.1%
2.30 (1.61, 3.28)
2.43 (1.56, 3.79)
12th grade or lower
679
45.6%
Referent
Referent
Higher than 12th grade
1181
73.4%
3.28 (2.42, 4.45)
1.55 (1.01, 2.38)
Maternal race/ethnicity (birth certificate):
Poverty Status (PR2):
Maternal age at birth of index child (PR):
Birth order (birth certificate):
Maternal education (PR2):
Discussion
This study found significant racial/ethnic disparities among mothers reading to two year old
children. Compared with non-Hispanic (NH) White mothers, Hispanic and NH Black mothers were
significantly less likely to report that they or someone else in the household read to the child
every day. Hispanic and NH Black mothers were also more likely to report low income, low
education and low maternal age.
Given that there are still racial/ethnic disparities after adjusting for age, education,
household income and birth order, cultural factors specific to race/ethnicity could explain
the remaining disparities. Some Hispanic parents may have limited access to bilingual
resources, feel they should wait until their child is 5 to read to them, be uncomfortable
reading to their child or feel it is the school’s responsibility to teach their child to read. NH
Black children are more likely to come from a single-parent household, are discriminated
against or reside in disadvantaged neighborhoods which impede academically relevant
verbal skills. Also NH Black mothers may be more stressed than other mothers. NH
American Indian/Alaska Native children may participate in programs promoting early
literacy such as Early Head Start. NH American Indians/Alaska Natives have a history of
oral traditions and values such as children’s worth contribute to reading aloud.
Reading Interventions
Two programs have been shown to be effective in increasing adults reading to young
children. Reach Out and Read (ROR) is a program which utilizes pediatric providers to
encourage parents to read to their children. The providers provide instruction and advice
on reading to children, give books at every pediatric visit from 6 months to 5 years and
volunteers in waiting rooms model how to read to children. Families participating in ROR
score higher on language development exams. The second program is the federally funded
community-based Early Head Start (EHS) which serves low-income families from birth to
three years. Services provided by EHS include, but are not limited to, parent-child activities,
home-visits, development plans and adult education. Children participating in EHS score
higher on language cognitive tests. The program also improves parental support for literacy
development and daily reading to their children.
Strengths and Weaknesses
The strengths of this study include being population-based and large sample size. Some of
the study’s limitations include data were self-reported; child care providers were not asked
whether they read to the children; race/ethnic categorizations may not accurately describe
the differences among Hispanic groups, Asian/PI groups or multiracial groups; the weighted
response rate was only 56.6% which is excellent for a population-based survey but limits
generalizability; the data cannot be generalized beyond Oregon; and the study was crosssectional so causality cannot be established.
Public Health Implications
The results of this study can help us understand other factors that influence educational
outcomes. The disparities among racial/ethnic groups indicate there may be other cultural
factors which affect reading to children and programs developed for early childhood
education need to be culturally sensitive. Expansion of existing interventions could lead to
improved early learning which could lead to improved academic performance and health
outcomes. Future efforts should focus on testing interventions on a larger scale.