Atul K Sharma1, Kristine Kroeker2, Dan Chateau3, Marni Brownell3, Celia J Rodd4. 1. Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada. 2. Centre for Healthcare Innovation, University of Manitoba, Winnipeg, MB, Canada. 3. Manitoba Centre for Health Policy and Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada. 4. Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada. crodd@hsc.mb.ca.
Abstract
BACKGROUND: Socioeconomic gradients in health exist in Canada. Although multiple Canadian area-based socioeconomic measures (ABSM) have been developed, none have been specifically validated against pediatric outcomes. Our objective was to compare the strength of association between key pediatric health outcomes and a number of ABSM, including income quintile. METHODS: This was a retrospective cross-sectional assessment of the association between socioeconomic status (SES) measured by ABSM and 20 specific pediatric health outcomes. Data from the Manitoba Population Research Data Repository were used for residents aged 0-19 years from 2010 to 2015. Outcomes included birth-related events (e.g. mortality), vaccination uptake, hospitalizations, and teen pregnancy. Regression goodness of fit was used to assess the strength of individual associations. Inequality was measured by slope index of inequality (SII) and relative index of inequality (RII). RESULTS: Overall, 19 of 20 outcomes had socioeconomic gradients identified by SII and RII. The multidimensional CAN-Marg indices had the best explanatory power in standard regression models. The simplest ABSM-income quintile-detected 16 of 19 confirmed inequalities, more than any other single measure. CONCLUSIONS: At all ages, many pediatric health outcomes in Manitoba were associated with significant socioeconomic inequalities; while income quintile detected most, CAN-Marg composite indices had the best explanatory power.
BACKGROUND: Socioeconomic gradients in health exist in Canada. Although multiple Canadian area-based socioeconomic measures (ABSM) have been developed, none have been specifically validated against pediatric outcomes. Our objective was to compare the strength of association between key pediatric health outcomes and a number of ABSM, including income quintile. METHODS: This was a retrospective cross-sectional assessment of the association between socioeconomic status (SES) measured by ABSM and 20 specific pediatric health outcomes. Data from the Manitoba Population Research Data Repository were used for residents aged 0-19 years from 2010 to 2015. Outcomes included birth-related events (e.g. mortality), vaccination uptake, hospitalizations, and teen pregnancy. Regression goodness of fit was used to assess the strength of individual associations. Inequality was measured by slope index of inequality (SII) and relative index of inequality (RII). RESULTS: Overall, 19 of 20 outcomes had socioeconomic gradients identified by SII and RII. The multidimensional CAN-Marg indices had the best explanatory power in standard regression models. The simplest ABSM-income quintile-detected 16 of 19 confirmed inequalities, more than any other single measure. CONCLUSIONS: At all ages, many pediatric health outcomes in Manitoba were associated with significant socioeconomic inequalities; while income quintile detected most, CAN-Marg composite indices had the best explanatory power.
Authors: Abbas M Hassan; Huan T Nguyen; Joseph P Corkum; Jun Liu; Sahil K Kapur; Carrie K Chu; Nina Tamirisa; Anaeze C Offodile Journal: Ann Surg Oncol Date: 2022-09-09 Impact factor: 4.339