PEDIATRICS Vol. 99 No. 1 January 1997, pp. 80-87
Received Nov 16, 1995; accepted Mar 5, 1996.
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From the * Department of Pediatrics, Johns Hopkins University,
School of Medicine, Baltimore, Maryland; the
Department of Health
Policy and Management, Johns Hopkins University, School of Hygiene and
Public Health, Baltimore, Maryland; the § Departments of Neurology and
Biostatistics, Johns Hopkins University, Schools of Medicine and
Hygiene and Public Health, Baltimore, Maryland; the
Department of
Population Dynamics, Johns Hopkins University, School of Hygiene and
Public Health, Baltimore, Maryland; and the ¶ Department of Neurology,
Johns Hopkins University, School of Medicine, Baltimore, Maryland.
Objectives. Some inner-city infants grow to be successful, self-sufficient adults. This study is designed to identify characteristics from early childhood that foster or impede favorable outcomes and are useful for formulation of public policy.
Methods. Population: 2694 children (G-2s), born 1960 through 1965, to 2307 inner-city women (G-1s) enrolled in the Johns Hopkins Collaborative Perinatal Study. Data: 1) prospective observations (birth through 8 years) of neurologic and cognitive development, health, behavior, and family and neighborhood socioeconomic characteristics and 2) completed interviews with 1758 G-2s (age 27 to 33) and 1552 G-1s, bridging the period from age 9 to present status. An intergenerational, life course model of development identified significant characteristics and events associated with G-2 outcome (education, physical and mental health, healthy lifestyle, and financial independence of public support, emphasizing educational attainment of a high school diploma or a graduate equivalency degree). Multiple logistic regression equations identified independent, predictive variables during infancy, preschool and early school years, and adolescence. The probability of a good outcome was estimated in the presence of combinations of the six variables most strongly associated with that outcome.
Results. Among G-2s, 79% had a successful outcome for education, 60% health, 70% lifestyle, and 76% for financial independence. Black G-2s had more favorable outcomes than white G-2s in education and lifestyle, whites for financial outcome; health did not differ by race. The six variables most predictive of adult education were: G-1 education at G-2 birth and G-2 attainment of honor roll, average or better reading skills at 8 years, avoidance of regular smoking, and pregnancy before age 18, and not repeating a grade in school.
Conclusions. Substantial proportions of inner-city children become successful adults. Attention to improving public education, particularly language and reading skills, and the prevention of smoking and adolescent pregnancy are clearly indicated.
Key words: inner-city children and adolescents, successful adult outcomes, health, lifestyle, financial independence, predictors of educational attainment.
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