Total Environment Assessment Model for Early Child Development

Spheres of
Influence:
The Family
figure 2: socioeconomic gradients
in stunting among three
andean countries
diseases as they have emerged. Data from
the turn of the century for countries such as
England and Wales show the gradient effect
for the major causes of disease and death of
the time (infectious diseases) among adults.
Over the next 3-5 decades those diseases
declined and were replaced by chronic
diseases such as heart disease. At first, heart
disease displayed a different epidemiological
pattern, disproportionately affecting those
who were privileged enough to live long
enough to get it. But over time the socioeconomic
gradient re-asserted itself. In the case
of heart disease this occurred by the 1950s.
For children’s health, the association
with ses is rather weak in the resource-rich
nations, in large part due to the lack of
chronic physical illness or death in children
in these countries. However, there is strong
indication that ses is association with lead
exposure and incidence of asthma there
[64, 87-89]. However, the evidence in
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