Research project INEQUALITIES IN CHILDREN’S HEALTH - A MATTER OF MIGRANT BACKGROUND? A MIXED METHOD STUDY OF HEALTH, LIFESTYLE HABITS AND CHILD HEALTH SERVICES´ RESPONSE
Swedish children are among the healthiest in the world, yet significant health inequalities persist, particularly among children with migrant parents. Despite universal, high-quality Child Health Services (CHS), identifying and addressing the needs of all children in early childhood remains challenging. Through this project, Umeå University aims to generate in-depth knowledge about health and lifestyle (in)equalities among three-year-old children and to examine the responsiveness of Child Health Services to the needs of migrant families and their children in Northern Sweden.
Children in Sweden enjoy some of the best health and life prospects globally; however, significant and widening inequalities persist, particularly in relation to parental socio-economic status, migrant background, and place of residence. Inequalities emerging in early childhood can have lasting consequences for health, education, employment, and life expectancy, making early interventions critical. At age three, children reach key developmental milestones, and systematic monitoring is essential to identify those in need of additional support.
Children with migrant backgrounds often experience poorer health outcomes and reduced access to resources, including healthcare services, yet health and lifestyle inequalities within this heterogeneous group remain insufficiently understood, especially in Northern Sweden. The influence of maternal and paternal migrant status and interactions with other social determinants of health are unclear. Despite high-quality universal Child Health Services, migrant families frequently face unmet needs due to language barriers, limited system familiarity, and insufficiently tailored services. A deeper understanding of both health inequalities and the responsiveness of Child Health Services is needed to support equitable early childhood development.
OVERALL AIM
The overall aim of this mixed-methods project is to examine and gain a deeper understanding of the health and lifestyle (in)equalities among 3-year-old children. The study will focus on the interplay between parents’ migrant status (country of birth), gender, income, and education - all significant determinants of health - and the responsiveness of CHS to address the unique needs of children with a migrant background. Ultimately, our goal is to develop strategies that strengthen CHS, ensure equitable access to quality early childhood care for all, and better respond to the needs of 3-year-olds with a migrant background.
SPECIFIC AIMS AND RESEARCH QUESTIONS:
Specific Aim I. INVESTIGATE health and lifestyle (in)equalities among 3-year-olds in relation to parental migrant status and other sociodemographic factors.
· Research questions 1: What are the patterns of health (e.g. overweight/obesity and social-emotional problems) and lifestyle indicators (e.g. eating habits and screen time), in relation to parental migrant status?· Research questions 2: What are the sociodemographic factors and parental migrant status combinations (intersectional strata) that are associated with poor (disadvantaged) or good (privileged) health and lifestyle outcomes in 3-year-olds?
Specific Aim II: EXPLORE Child Health Services response to the needs of 3-year-olds with migrant parents from the perspectives of parents and nurses
· Research questions 3: What are the experiences and perceptions of migrant parents regarding the ability of Child Health Services to respond to their children’s care needs?
· Research questions 4: What are the experiences and perceptions of nurses regarding migrant parents’ participation in the 3-year-old visit (including completion of a routine questionnaire), and the ability of the Services to respond to the specific needs of children with migrant parents?
Specific Aim III: IDENTIFY strategies to strengthen Child Health Services to better respond to the needs of 3-year-olds with migrant parents.
· Research questions 5: How can Child Health Services be strengthened to better respond the needs of 3-year-old children with migrant parents?
Analysing patterns of health and lifestyle inequalities among three-year-old children can help identify priority areas for action and inform early interventions. Assessing how responsive Child Health Services are to the diverse needs of children with migrant backgrounds and their families is essential for improving policies, guidelines, and care practices, and for ensuring equitable access to services. Because health inequalities established in early childhood often persist across the life course, timely intervention is critical.
Improving health, lifestyle habits, and access to healthcare for children with migrant parents supports the principle that no child should be left behind, contributes to national public health goals and the UN Agenda 2030 (Goals 3, 4, 5, 10, and 17), and aligns with the Swedish National Public Health Policy. Actively involving migrant parents, policymakers, and healthcare providers strengthens knowledge co-creation and enhances the relevance and impact of the research.
