RT Journal Article
SR Electronic
T1 Household income and maternal education in early childhood and activity-limiting chronic health conditions in late childhood: findings from birth cohort studies from six countries
JF Journal of Epidemiology and Community Health
JO J Epidemiol Community Health
FD BMJ Publishing Group Ltd
SP jech-2022-219228
DO 10.1136/jech-2022-219228
A1 Nicholas James Spencer
A1 Johnny Ludvigsson
A1 Yueyue You
A1 Kate Francis
A1 Yara Abu Awad
A1 Wolfgang Markham
A1 Tomas Faresjö
A1 Jeremy Goldhaber-Fiebert
A1 Pär Andersson White
A1 Hein Raat
A1 Fiona Mensah
A1 Lise Gauvin
A1 Jennifer J McGrath
A1 ,
YR 2022
UL http://jech.bmj.com/content/early/2022/07/21/jech-2022-219228.abstract
AB Background We examined absolute and relative relationships between household income and maternal education during early childhood (<5 years) with activity-limiting chronic health conditions (ALCHC) during later childhood in six longitudinal, prospective cohorts from high-income countries (UK, Australia, Canada, Sweden, Netherlands, USA).Methods Relative inequality (risk ratios, RR) and absolute inequality (Slope Index of Inequality) were estimated for ALCHC during later childhood by maternal education categories and household income quintiles in early childhood. Estimates were adjusted for mother ethnicity, maternal age at birth, child sex and multiple births, and were pooled using meta-regression.Results Pooled estimates, with over 42 000 children, demonstrated social gradients in ALCHC for high maternal education versus low (RR 1.54, 95% CI 1.28 to 1.85) and middle education (RR 1.24, 95% CI 1.11 to 1.38); as well as for high household income versus lowest (RR 1.90, 95% CI 1.66 to 2.18) and middle quintiles (RR 1.34, 95% CI 1.17 to 1.54). Absolute inequality showed decreasing ALCHC in all cohorts from low to high education (range: −2.85% Sweden, −13.36% Canada) and income (range: −1.8% Sweden, −19.35% Netherlands).Conclusion We found graded relative risk of ALCHC during later childhood by maternal education and household income during early childhood in all cohorts. Absolute differences in ALCHC were consistently observed between the highest and lowest maternal education and household income levels across cohort populations. Our results support a potential role for generous, universal financial and childcare policies for families during early childhood in reducing the prevalence of activity limiting chronic conditions in later childhood.Data are available on reasonable request. Data may be obtained from a third party and are not publicly available. Data underlying the results presented in this EPOCH study are available from the primary data sources. Data from the UK Millennium Cohort Study is available in a public open-access repository (https://cls.ucl.ac.uk/cls-studies/millennium-cohort-study/). Data from the Longitudinal Study of Australian Children (LSAC) is available in a public, open-access repository (https://growingupinaustralia.gov.au/data-and-documentation). Data from the US NLSY-79 is available in a public open-access repository (https://www.nlsinfo.org/content/cohorts/nlsy79-children). Data from the Rotterdam, Netherlands Generation R are available to request from (https://generationr.nl/researchers/); authors do not have permission to share their data. Data from Alla Barn I Sydöstra Sverige/All Babies in Southeast Sweden (ABIS) are available to request from (http://www.abis- studien.se); authors do not have permission to share their data.