European Comparative Cohort Study of Social Inequalities in Child Health and Development: Findings from the DRIVERS Birth Cohorts
European Comparative Cohort Study of Social Inequalities in Child Health and Development: Findings from the DRIVERS Birth Cohorts
Tuesday, 19 August 2014
Exhibit hall (Dena'ina Center)
INTRODUCTION: Healthy growth in early childhood has become a major priority to reduce health inequalities across Europe. It is now increasingly recognised that the first years of life may provide children with lasting benefits throughout the life course. Investigation of social inequalities in early childhood health has important implications for the health of future generations, but it is not readily known how inequalities in early childhood health and development vary across the region of Europe.
METHODS: Longitudinal data from thirteen birth cohorts across the European region participating in the DRIVERS for Health Equity – Early Childhood Development research programme were used. Mother’s level of education was collected at the time of birth and health and confounding data were measured prospectively at subsequent follow-ups to the age of 8. Regression models were estimated within each cohort and meta-analyses were conducted to assess the extent of heterogeneity between regions of Europe.
RESULTS: The association between low maternal education and increased risk of poor child health were not entirely consistent across Europe. Social inequalities in preterm births, estimated by the Relative Index of Inequality (RII), were generally unobserved in Southern and Central Europe, but were strong in the Netherlands, Sweden and the UK: 1.72 (1.15 – 2.60), 1.57 (1.14 – 2.15), and 1.49 (1.07 – 2.01). A similar pattern arose for children born small for gestational age. Social inequalities in asthma were identified in the Western countries alone, namely France, 2.01 (1.09 – 3.71), the Netherlands, 1.65 (1.01 – 2.72) and the UK, 1.71 (1.42 – 2.06). Overweight and obesity among preschool children were inversely associated with high maternal education in Northern and Western Europe, but gradients were steeper in the West.
CONCLUSIONS: This work highlights the value of comparative cohort analysis in early childhood to better understand how social inequalities in health emerge in different settings across Europe.
METHODS: Longitudinal data from thirteen birth cohorts across the European region participating in the DRIVERS for Health Equity – Early Childhood Development research programme were used. Mother’s level of education was collected at the time of birth and health and confounding data were measured prospectively at subsequent follow-ups to the age of 8. Regression models were estimated within each cohort and meta-analyses were conducted to assess the extent of heterogeneity between regions of Europe.
RESULTS: The association between low maternal education and increased risk of poor child health were not entirely consistent across Europe. Social inequalities in preterm births, estimated by the Relative Index of Inequality (RII), were generally unobserved in Southern and Central Europe, but were strong in the Netherlands, Sweden and the UK: 1.72 (1.15 – 2.60), 1.57 (1.14 – 2.15), and 1.49 (1.07 – 2.01). A similar pattern arose for children born small for gestational age. Social inequalities in asthma were identified in the Western countries alone, namely France, 2.01 (1.09 – 3.71), the Netherlands, 1.65 (1.01 – 2.72) and the UK, 1.71 (1.42 – 2.06). Overweight and obesity among preschool children were inversely associated with high maternal education in Northern and Western Europe, but gradients were steeper in the West.
CONCLUSIONS: This work highlights the value of comparative cohort analysis in early childhood to better understand how social inequalities in health emerge in different settings across Europe.