Deprivation linked to childhood asthma hospitalization
medwireNews: Swedish data show that children living in deprived areas have a significantly higher risk for hospitalization for asthma than do children from wealthier neighborhoods.
The study included all 864,468 children aged 2-11 years from singleton births in Sweden between 1995 and 2006. Overall, 17,672 (2.0%) children were diagnosed with asthma in hospital.
The authors, Xinjun Li (Lund University, Sweden) and colleagues, report that rates of hospitalization varied according to deprivation, ranging from 1.9% in neighborhoods with low deprivation, to 2.0% in those with moderate deprivation, and to 2.3% in those with high deprivation.
And, after accounting for confounders, including gender, age, and maternal socio-demographic variables, living in a high deprivation area was associated with a significant 8% increase in the odds for asthma hospitalization compared with living in a low deprivation area.
Writing in Clinical & Experimental Allergy, the researchers also note that the risk for childhood asthma was highest in children whose mothers were never married, had the lowest educational attainment, had a history of asthma, or were smokers.
And, within each of these risk categories, there was a gradient according to neighborhood deprivation. For example, among children whose mothers had 9 or fewer years of compulsory education, 2.7% of those living in an area of high deprivation were admitted to hospital compared with 2.4% of those who lived in an area of low deprivation. Corresponding values of 1.8% and 1.7% were observed in children whose mothers went to high school and/or college.
"Our finding that neighbourhood deprivation exerts an independent effect on risk of childhood asthma is consistent with the findings of a small, but growing number of studies that have provided evidence of an association between neighbourhood-level, socio-economic factors and childhood asthma," comment Li et al.
They write that, "it is noteworthy that this effect was found in a country with a comparatively strong system of universal health care and social welfare," adding that access to healthcare is unlikely to have played a role in their findings.
Instead, they suggest that multiple general mechanisms in high deprivation areas may influence asthma risk, such as "unfavourable health-related behaviours, neighbourhood social disintegration (i.e. criminality, high mobility or unemployment), low social capital and neighbourhood stress mediated by factors that can influence immunological and/or hormonal stress reaction."
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By Kirsty Oswald, medwireNews Reporter