Socio-economic differences in daycare arrangements and use of medical care and antibiotics in Swedish preschool children.

Abstract

In this study we describe socio-economic patterns of daycare enrolment, medical care and antibiotics in children, 0-5 y, whose parents participated in the Swedish Survey of Living Conditions 1996-97. Children in families with low socio-economic status and unemployed parents were less often enrolled in out-of-home care. Multivariate analyses (adjusted for various sociodemographic indicators, type of daycare and chronic morbidity) demonstrated that children 1-5 y in families with low social status (low parental education and/or low SES) were less likely to have paid a visit to a physician because of an acute infection during the previous 3 mo [odds ratio (OR) 0.6 (0.4-0.8)] or to have consumed antibiotics during the previous 12 mo [OR 0.8 (0.6-1.0)] compared to children with a higher social status. Children in out-of-home care more often had paid a visit to a physician because of an acute infection during the previous 3 mo [OR 1.5 (1.2-1.9)] and more often had consumed antibiotics during the previous 12 mo [OR 1.7 (1.3-2.1)] than children in home care. The effect of out-of-home care on use of medical care and antibiotics decreased with increasing age of the child, and deviated from the null hypothesis in children 1-3 y only. Preschool children in families with a low social status consume less medical care and are less likely to attend out-of-home care compared to children with a higher social status in Swedish society. This inequity needs to be addressed in social and health policy.