Modernity’s paradox and the structural determinants of child health and well-being


The decline in indicators of human development linked to rising social inequalities, despite post-modern society’s unprecedented economic prosperity, has been called ‘modernity’s paradox’ (Keating & Hertzman 1999).

Scholars of developmental health suggest that micro-level influences from the social, economic and psychological circumstances in early life may explain social inequalities across the lifespan.However, children’s poor developmental and health outcomes are also a product of the wider contexts of their lives.

This paper extends the human developmental framework by linking the proximal determinants of health and well-being with macro-level forces. It reviews recent changes in the political, economic and social environments in developed countries, to provide insights into the recent trends in poor outcomes in children and youth, which remain paradoxical given the expectations of economic prosperity and the advances in medical and other technologies. The paper concludes with policy and research recommendations to reduce social disparities in child outcomes.


Jianghong Li
Centre for International Health, School of Public Health, Curtin University of Technology, Perth WA

Anne M McMurray
Research Centre for Clinical and Community, Practice Innovation, Griffith University, Gold Coast QLD; Murdoch University, Mandurah WA

Fiona Stanley
Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth WA


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neo-liberalism, disparities, political economy, child health and development, sociology, global changes


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