Socioeconomic position, bronchiolitis and asthma in children: counterfactual disparity measures from a national birth cohort study.
Socioeconomic position, bronchiolitis and asthma in children: counterfactual disparity measures from a national birth cohort study.
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DOI：
10.1093/ije/dyac193
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发表时间：
2023-04-19
影响因子：
7.7
通讯作者：
中科院分区：
文献类型：
--
作者：
早期严重呼吸道合胞病毒（RSV）感染与哮喘之间有争议的联系尚未从社会不平等的角度进行调查。我们估计了儿童哮喘的社会经济差异程度，如果没有儿童在婴儿期因毛细支气管炎（通常由呼吸道合胞病毒引起）住院，这种差异仍将存在。该队列根据国家行政卫生数据集构建，包括2007年1月1日至2008年6月31日期间在苏格兰出生的83853名儿童。苏格兰多重剥夺指数（SIMD）用于捕捉社会经济地位。从医院记录中确定1岁前毛细支气管炎的急诊入院情况。使用配药数据和住院记录创建了2至9岁儿童哮喘/喘息年度指标。通过潜在类别增长分析，我们确定了哮喘/喘息的四种轨迹：早期短暂性（占队列的2.2%）、早期持续性（2.0%）、中期发病（1.8%）和无哮喘/喘息（94.0%）。慢性哮喘（包括早期持续性和中发病组）的估计边际风险因SIMD而异，相对于低剥夺组，中等和高度剥夺组的风险差异分别为7.0%（95%置信区间：3.7-10.3）和13.0%（9.6-16.4）。使用反事实差异测量，我们估计消除需要住院的毛细支气管炎可以将这些风险差异分别降低21.2%（4.9-37.5）和17.9%（10.4-25.4）。慢性哮喘患病率的大多数差异仍未得到解释。我们的论文提供了一个指南，使用因果推理方法来研究其他合理的途径，不公平的哮喘使用复杂的，相关的行政数据。
The debated link between severe respiratory syncytial virus (RSV) infection in early life and asthma has yet to be investigated within a social inequity lens. We estimated the magnitude of socioeconomic disparity in childhood asthma which would remain if no child were admitted to hospital for bronchiolitis, commonly due to RSV, during infancy. The cohort, constructed from national administrative health datasets, comprised 83853 children born in Scotland between 1 January 2007 and 31 June 2008. Scottish Index for Multiple Deprivation (SIMD) was used to capture socioeconomic position. Emergency admissions for bronchiolitis before age 1 year were identified from hospital records. Yearly indicators of asthma/wheeze from ages 2 to 9 years were created using dispensing data and hospital admission records. Using latent class growth analysis, we identified four trajectories of asthma/wheeze: early-transient (2.2% of the cohort), early-persistent (2.0%), intermediate-onset (1.8%) and no asthma/wheeze (94.0%). The estimated marginal risks of chronic asthma (combining early-persistent and intermediate-onset groups) varied by SIMD, with risk differences for the medium and high deprivation groups, relative to the low deprivation group, of 7.0% (95% confidence interval: 3.7–10.3) and 13.0% (9.6–16.4), respectively. Using counterfactual disparity measures, we estimated that the elimination of bronchiolitis requiring hospital admission could reduce these risk differences by 21.2% (4.9–37.5) and 17.9% (10.4–25.4), respectively. The majority of disparity in chronic asthma prevalence by deprivation level remains unexplained. Our paper offers a guide to using causal inference methods to study other plausible pathways to inequities in asthma using complex, linked administrative data.
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影响因子：
5.2
作者：
Gill, Peter J.;Goldacre, Michael J.;Harnden, Anthony
通讯作者：
Harnden, Anthony
影响因子：
7.7
作者：
Ferguson, Karl D.;McCann, Mark;Lewsey, James D.
通讯作者：
Lewsey, James D.
影响因子：
6.3
作者：
Lewis, Kate;De Stavola, Bianca;Hardelid, Pia
通讯作者：
Hardelid, Pia
影响因子：
5
作者：
Galobardes B;Granell R;Sterne J;Hughes R;Mejia-Lancheros C;Davey Smith G;Henderson J
通讯作者：
Henderson J
DOI：
10.1111/j.1751-9004.2007.00054.x
发表时间：
2008-01-01
影响因子：
4.6
作者：
Jung, Tony;Wickrama, K. A. S.
通讯作者：
Wickrama, K. A. S.