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Urban-rural health and achievement gaps across childhood: development and mediating mechanisms in Peru and India

Betancur, Laura (2021) Urban-rural health and achievement gaps across childhood: development and mediating mechanisms in Peru and India. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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In recent decades, poverty has become more urbanized in low- and middle-income countries (LMIC). Yet, the majority of poor families continue to live in rural settings. Evidence suggests that children growing up in rural areas fare worse than their urban counterparts in education and health. Previous evidence suggests that these differences could be due to lower economic and infrastructural resources in rural areas. However, these studies have limited their attention to singular elements of families or infrastructure while also examining outcomes at adolescence or adulthood. Thus, there is little knowledge of how health and achievement gaps develop from early childhood to adolescence and there is limited empirical assessment of the multiple infrastructural and behavioral mechanisms underlying urbanicity-related differences. Furthermore, researchers have not considered whether urban children are also at a disadvantage due to higher pollution and violence in cities. Drawing data from the Young Lives Study, a longitudinal investigation following economically disadvantaged children in India and Peru, this project addressed these limitations. First, we described the development of urban-rural health and achievement gaps from age five to age fifteen. Second, we examined whether age-specific community characteristics and child time-use explained the urban advantage at ages 5, 8, 12, and 15. Third, we explored whether cumulative experiences of community factors and child time-use explained differences in children’s trajectories of development. Results showed that while in Peru the urban advantage was large at early childhood and remained stable over time, the urban advantage in India was small at early childhood and modestly closed over development. When considering cumulative experiences, urban children’s advantage was partially due to more time studying and less time working. At early childhood, higher access to educational and utility services showed to be central in explaining the early urban advantage. Some findings differed by country. In India, urban children were more exposed to the detrimental effects of violent crime on achievement at adolescence. In Peru, across all ages, the urban advantage was partially due to increased access to utility services. These identified processes have important implications for improving contextual supports for disadvantaged children and target scarce public resources.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Betancur, Lauralab193@pitt.edulab1930000-0002-0412-2529
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairVotruba-Drzal, Elizabethevotruba@pitt.eduevotruba
Committee MemberBachman, Heatherhbachman@pitt.eduhbachman
Committee MemberHanson, Jamiejamie.hanson@pitt.edujamielh
Committee MemberShafiq, Najeebmnshafiq@pitt.edumnshafiq
Date: 20 January 2021
Date Type: Publication
Defense Date: 16 November 2020
Approval Date: 20 January 2021
Submission Date: 9 November 2020
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 133
Institution: University of Pittsburgh
Schools and Programs: Dietrich School of Arts and Sciences > Psychology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Poverty, low and middle income countries, community effects, child time use
Date Deposited: 20 Jan 2021 18:14
Last Modified: 20 Jan 2021 18:14

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