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Is socioeconomic position associated with bronchiolitis seasonality? A cohort study
  1. Kate Lewis,
  2. Bianca De Stavola,
  3. Pia Hardelid
  1. Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
  1. Correspondence to Kate Lewis, Department of Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK; kate.lewis.14{at}


Background Understanding differences in the seasonality of bronchiolitis can help to plan the timing of interventions. We quantified the extent to which seasonality in hospital admissions for bronchiolitis is modified by socioeconomic position.

Methods Using Hospital Episode Statistics, we followed 3 717 329 infants born in English National Health Service hospitals between 2011 and 2016 for 1 year. We calculated the proportion of all infant admissions due to bronchiolitis and the incidence rate of bronchiolitis admissions per 1000 infant-years, according to year, month, age, socioeconomic position and region. We used harmonic Poisson regression analysis to assess whether socioeconomic position modified bronchiolitis seasonality.

Results The admission rate for bronchiolitis in England increased from 47.4 (95% CI 46.8 to 47.9) to 58.9 per 1000 infant-years (95% CI 58.3 to 59.5) between 2012 and 2016. We identified some variation in the seasonality of admissions by socioeconomic position: increased deprivation was associated with less seasonal variation and a slightly delayed epidemic peak. At week 50, the risk of admission was 38% greater (incidence rate ratios 1.38; 95% CI 1.35 to 1.41) for infants in the most deprived socioeconomic group compared with the least deprived group.

Conclusion These results do not support the need for differential timing of prophylaxis or vaccination by socioeconomic group but suggest that infants born into socioeconomic deprivation should be considered a priority group for future interventions. Further research is needed to establish if the viral aetiology of bronchiolitis varies by season and socioeconomic group, and to quantify risk factors mediating socioeconomic deprivation and bronchiolitis rates.

  • Infection
  • inequalities
  • respiratory DI
  • social epidemiology
  • child health

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  • Contributors All authors designed the study and revised the paper. KL cleaned and analysed the data, and drafted the paper. PH supervised the study.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. KL is funded by a UK Medical Research Council doctoral training studentship (MR/N013867/1).

  • Competing interests None declared.

  • Patient consent for publication Not required.

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

  • Date availability statement Data may be obtained from a third party and are not publicly available. This study uses NHS hospital episode statistics data and was provided within the terms of a data sharing agreement (NIC-393510-D6H1D-v3.2) to the researchers by the Health and Social Care Information Centre (‘NHS Digital’). The data do not belong to the authors and may not be shared by the authors, except in aggregate form for publication. Data can be obtained by submitting a data request through the NHS Digital Data Access Request Service.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.