Inequalities in children’s health - a matter of migrant background? A mixed method study of health, lifestyle habits and Child Health Services´ response

Research problem and specific questionsSwedish children belong to the world’s healthiest, but inequalities persist, especially for those with migrant parents.

Despite high-quality universal Child Health Services (CHS), identifying and addressing needs and inequalities in early childhood remains a challenge.

Knowledge is insufficient about how CHS respond to the needs of children with migrant parents, particularly in Northern Sweden.Our main aim is to gain a deeper knowledge of the health and lifestyle (in)equalities among 3-year-olds and the responsiveness of CHS to the needs of migrant families and their children in Northern Sweden.

Specific aims:To investigate health and lifestyle (in)equalities among 3-year-olds in relation to parental migrant status and other sociodemographic factors.To explore CHS response to the needs of 3-year-olds with migrant parents from the perspectives of parents and nurses.To identify strategies to strengthen CHS to better respond to the needs of children with migrant parents.Data and methodWe will use a mixed methods design in three phases.

Phase I: Analyses of data on 3-year-olds who underwent a routine check-up at CHS centres in Västerbotten in 2014–2022, appr. 19,000 children whereof 2,500 have 1 – 2 migrant parents.

Data from a child questionnaire (health and lifestyle) are combined with National Register Data (e.g. parents´ country of birth) in outcome-wide epidemiological analyses and mapping of intersectional inequalities.

Phase II: Applying a phenomenological approach and inductive thematic analysis on interviews with migrant parents and nurses to enrich the quantitative studies.

Phase III: Insights from phases I – II will guide a participatory process involving representatives of migrant parents and migrant organizations, CHS, and decision makers to develop strategies for strengthening CHS response to the needs of children with migrant parents.Societal relevance and utilizationFindings of health and lifestyle (in)equalities related to parents´ migrant status, how CHS respond to diversity and diverse needs, and strategies to strengthen CHS will inform policies, guidelines, and practices to ensure equitable access to quality early childhood care for all.Plan for project realisationPhase I involves analyses of available data.

Phases II and III entail primary data collection.

The main budget item is salaries for the research team whose interdisciplinary expertise is crucial for conducting mixed methods research.