Socioeconomic disadvantage and health in early childhood: a population-based birth cohort study from Portugal

Data de publicação: 01/09/2020 Data Ahead of Print: 01/01/2020

Autores da FMUP

• Ana Isabel Correia Ribeiro

  Autor

• Sílvia Jesus Silva Fraga

  Autor

• José Henrique Dias Pinto De Barros

  Autor

Participantes de fora da FMUP

• Correia Costa, L
• McCrory, C

Unidades de investigação

• Ciências da Saúde Pública e Forenses, e Educação Médica

Abstract

Background 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. Methods 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). Results 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. Conclusions 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.

Keywords

• DEPRIVATION INDEX; INFANT-MORTALITY; INEQUALITIES; POSITION; EXPOSURES; EDUCATION; CHILDREN; ASTHMA; INCOME; RISK