Abstract
Measuring early socioeconomic inequalities in health provides evidence to understand the patterns of disease. Thus, our aim was to determine which children's health outcomes are patterned by socioeconomics and to what extent the magnitude/direction of the differences vary by socioeconomic measure and outcome. Data on early childhood (4 years) health was obtained from Generation XXI birth cohort (n = 8647). A total of 27 health outcomes and 13 socioeconomic indicators at the individual level and neighbourhood level were used to calculate the relative index of inequality (RII). Socioeconomic inequalities were evident across 21 of the 27 health outcomes. Education, occupation and income more often captured inequalities, compared with neighbourhood deprivation or employment status. Using highest maternal education as reference category, we observed that seizures (RII = 8.64), obesity (2.94), abdominal obesity (2.66), urinary tract infection (2.26), language/speech problems (2.24), hypertension (2.08) and insulin resistance (1.33) were heavily socially patterned, much more common in disadvantaged children. Contrastingly, eczema (0.26) and rhinitis (0.26) were more common among more advantaged children. Socioeconomic inequalities were evident for almost every health outcome assessed, although with varying magnitude/direction according to the socioeconomic indicator and outcome. Our results reinforce that the social gradient in health manifests early in childhood.
Highlights
Socioeconomic factors are one of the strongest predictors of morbidity and mortality.[1]
To understand the mechanisms by which socioeconomic disadvantage leads to poor health, one must start looking at what happens in early childhood, since the effects of living in less favourable socioeconomic circumstances can become biologically embedded over their lifetimes, especially during this developmentally sensitive period.[2]
Childhood constitutes an important window of opportunity to build a strong foundation for future development and health and a growing number of studies have demonstrated that the health effects of adverse socioeconomic circumstances in childhood track into adulthood.[3,4]
Summary
Socioeconomic factors are one of the strongest predictors of morbidity and mortality.[1]. Measuring early socioeconomic inequalities in health provides evidence to understand the patterns of disease. Our aim was to determine which children’s health outcomes are patterned by socioeconomics and to what extent the magnitude/direction of the differences vary by socioeconomic measure and outcome. Using highest maternal education as reference category, we observed that seizures (RII = 8.64), obesity (2.94), abdominal obesity (2.66), urinary tract infection (2.26), language/speech problems (2.24), hypertension (2.08) and insulin resistance (1.33) were heavily socially patterned, much more common in disadvantaged children. CONCLUSIONS: Socioeconomic inequalities were evident for almost every health outcome assessed, with varying magnitude/direction according to the socioeconomic indicator and outcome.
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