ABSTRACT
BACKGROUND: There is a well-established link between various measures of socioeconomic status and the schooling achievement and cognition of children. However, less is known about how cognitive development is impacted by childhood improvements in growth, a common indicator of child nutritional status. This study examines the relationship between socioeconomic status and child growth and changes in cognitive achievement scores in adolescents from resource-poor settings. METHODS: Using an observational cohort of more than 3000 children from four low- and middle-income countries, this study examines the association between cognitive achievement scores and household economic, educational, and nutritional resources to give a more accurate assessment of the influence of families on cognitive development. A composite measure of cognition when children were approximately 8, 12, and 15 years of age was constructed. Household factors included maternal schooling, wealth, and children's growth. RESULTS: A positive and statistically significant relationship between household factors and child cognition was found for each country. If parents have more schooling, household wealth increases, or child growth improves, then children's cognitive scores improve over time. Results for control variables are less consistent. CONCLUSION: Our findings suggest there is a consistent and strong association between parental schooling, wealth, and child growth with child cognitive achievement. Further, these findings demonstrate that a household's ability to provide adequate nutrition is as important as economic and education resources even into late childhood and adolescence. Hence, efforts to improve household resources, both early in a child's life and into adolescence, and to continue to promote child growth beyond the first few years of life have the potential to help children over the life course by improving cognition.
