Rabia Khalid1,2, Anita Van Zwieten3,4, Siah Kim3,4, Madeleine Didsbury3,4, Anna Francis3,4,5, Steven Mctaggart5, Amanda Walker6, Fiona E Mackie7, Chanel Prestidge8, Armando Teixeira-Pinto3,4, Belinda Barton9, Jennifer Lorenzo10, Suncica Lah11, Kirsten Howard4,12, Natasha Nassar13, Eric Au3,4, Allison Tong3,4, Katrina Blazek3,4, Jonathan C Craig3,14, Germaine Wong3,4,15. 1. Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia. Rabia.khalid@sydney.edu.au. 2. Sydney School of Public Health, The University of Sydney, Sydney, Australia. Rabia.khalid@sydney.edu.au. 3. Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia. 4. Sydney School of Public Health, The University of Sydney, Sydney, Australia. 5. Child & Adolescent Renal Service, Queensland Children's Hospital, Brisbane, Australia. 6. Department of Nephrology, The Royal Children's Hospital, Melbourne, Australia. 7. Department of Nephrology, Sydney Children's Hospital at Randwick, Sydney, Australia. 8. Department of Nephrology, Starship Children's Hospital, Auckland, New Zealand. 9. Children's Hospital Education Research Institute, The Children's Hospital at Westmead, Sydney, Australia. 10. Kids Neuroscience Centre, The Children's Hospital at Westmead, Sydney, Australia. 11. School of Psychology, The University of Sydney, Sydney, Australia. 12. Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Sydney, Australia. 13. Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, The University of Sydney, Sydney, Australia. 14. College of Medicine and Public Health, Flinders University, Adelaide, Australia. 15. Centre for Transplant and Renal Research, Westmead Hospital, Sydney, Australia.
Abstract
BACKGROUND: Lower socioeconomic status (SES) is associated with lower academic achievement; however, this relationship is understudied in children with chronic kidney disease (CKD). This study examined the relationship between SES and academic performance in children and adolescents with CKD. METHODS: A total of 377 participants aged 6-18 years with CKD stages 1-5 (n = 199), on dialysis (n = 43) or with a kidney transplant (n = 135) were recruited. Five SES measures and a composite SES index were examined for associations with parent-rated average or above average academic performance in numeracy and literacy using multivariable logistic regression. RESULTS: Participants' median age was 12.6 years (IQR 8.9-15.5). Adjusted odds ratios (aOR) (95%CI) for better performance in numeracy and literacy, respectively, were 0.71 (0.44-1.15) and 0.75 (0.45-1.23) for children whose caregivers had lower educational attainment; 0.46 (0.26-0.80) and 0.53 (0.30-0.93) for lower household income; 0.52 (0.32-0.85) and 0.44 (0.26-0.73) for caregivers who were unemployed; 0.68 (0.41-1.12) and 0.59 (0.35-1.00) for caregivers with poor self-rated financial status; and 0.93 (0.53-1.64) and 1.00 (0.56-1.79) for caregivers who did not own their own home. Compared with the highest SES index quartile, the aORs for better performance by SES quartile in descending order were 1.24 (0.60-2.54), 0.76 (0.37-1.58), and 0.39 (0.18-0.86) for numeracy and 0.88 (0.41-1.85), 0.77 (0.35-1.66), and 0.32 (0.14-0.72) for literacy. No interactions were identified between SES and CKD stage, child age, or gender. CONCLUSIONS: Across all CKD stages, children from lower SES families are less likely to perform well in literacy and numeracy than those from higher SES households. A higher resolution version of the Graphical abstract is available as Supplementary information.
BACKGROUND: Lower socioeconomic status (SES) is associated with lower academic achievement; however, this relationship is understudied in children with chronic kidney disease (CKD). This study examined the relationship between SES and academic performance in children and adolescents with CKD. METHODS: A total of 377 participants aged 6-18 years with CKD stages 1-5 (n = 199), on dialysis (n = 43) or with a kidney transplant (n = 135) were recruited. Five SES measures and a composite SES index were examined for associations with parent-rated average or above average academic performance in numeracy and literacy using multivariable logistic regression. RESULTS: Participants' median age was 12.6 years (IQR 8.9-15.5). Adjusted odds ratios (aOR) (95%CI) for better performance in numeracy and literacy, respectively, were 0.71 (0.44-1.15) and 0.75 (0.45-1.23) for children whose caregivers had lower educational attainment; 0.46 (0.26-0.80) and 0.53 (0.30-0.93) for lower household income; 0.52 (0.32-0.85) and 0.44 (0.26-0.73) for caregivers who were unemployed; 0.68 (0.41-1.12) and 0.59 (0.35-1.00) for caregivers with poor self-rated financial status; and 0.93 (0.53-1.64) and 1.00 (0.56-1.79) for caregivers who did not own their own home. Compared with the highest SES index quartile, the aORs for better performance by SES quartile in descending order were 1.24 (0.60-2.54), 0.76 (0.37-1.58), and 0.39 (0.18-0.86) for numeracy and 0.88 (0.41-1.85), 0.77 (0.35-1.66), and 0.32 (0.14-0.72) for literacy. No interactions were identified between SES and CKD stage, child age, or gender. CONCLUSIONS: Across all CKD stages, children from lower SES families are less likely to perform well in literacy and numeracy than those from higher SES households. A higher resolution version of the Graphical abstract is available as Supplementary information.
Authors: Germaine Wong; Meredith Medway; Madeleine Didsbury; Allison Tong; Robin Turner; Fiona Mackie; Steven McTaggart; Amanda Walker; Sarah White; Kirsten Howard; Siah Kim; Jonathan C Craig Journal: BMC Public Health Date: 2014-04-04 Impact factor: 3.295