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 socio‐demographic 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. Conclusion: 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.