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Socioeconomic inequality profiles in physical and developmental health from 0–7 years: Australian National Study
  1. Jan M Nicholson1,2,
  2. Nina Lucas1,
  3. Donna Berthelsen2,
  4. Melissa Wake1,3,4
  1. 1Murdoch Childrens Research Institute, Melbourne, Australia
  2. 2Centre for Learning Innovation, Queensland University of Technology, Brisbane Australia
  3. 3Royal Children's Hospital and Centre for Community Child Health, Melbourne, Australia
  4. 4Department of Paediatrics, The University of Melbourne, Melbourne, Australia
  1. Correspondence to Jan M Nicholson, Murdoch Childrens Research Institute, Royal Childrens Hospital, Flemington Road, Parkville, Melbourne, VIC 3052, Australia; jan.nicholson{at}


Background Early and persistent exposure to socioeconomic disadvantage impairs children's health and wellbeing. However, it is unclear at what age health inequalities emerge or whether these relationships vary across ages and outcomes. We address these issues using cross-sectional Australian population data on the physical and developmental health of children at ages 0–1, 2–3, 4–5 and 6–7 years.

Methods 10 physical and developmental health outcomes were assessed in 2004 and 2006 for two cohorts each comprising around 5000 children. Socioeconomic position was measured as a composite of parental education, occupation and household income.

Results Lower socioeconomic position was associated with increased odds for poor outcomes. For physical health outcomes and socio-emotional competence, associations were similar across age groups and were consistent with either threshold effects (for poor general health, special healthcare needs and socio-emotional competence) or gradient effects (for illness with wheeze, sleep problems and injury). For socio-emotional difficulties, communication, vocabulary and emergent literacy, stronger socioeconomic associations were observed. The patterns were linear or accelerated and varied across ages.

Conclusions From very early childhood, social disadvantage was associated with poorer outcomes across most measures of physical and developmental health and showed no evidence of either strengthening or attenuating at older compared to younger ages. Findings confirm the importance of early childhood as a key focus for health promotion and prevention efforts.

  • Health inequalities
  • early childhood
  • socioeconomic status
  • physical health
  • emotional health
  • child health
  • inequalities SI
  • mental health DI
  • physical function
  • social class

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  • Funding This work was supported by the National Health and Medical Research Council (Career Development Awards 390136 to JN, 546405 and 284556 to MW) and the Australian Research Council (DP0774439).

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Australian Institute of Family Studies Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.