Child mortality, socioeconomic position, and one-parent families: independent associations and variation by age and cause of death
Child mortality, socioeconomic position, and one-parent families: independent associations and variation by age and cause of death
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DOI：
10.1093/ije/dyg154
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发表时间：
2003-06-01
影响因子：
7.7
通讯作者：
D'Souza, A
中科院分区：
文献类型：
--
作者：
Blakely, T;Atkinson, J;D'Souza, A
虽然儿童死亡率和社会经济地位之间的关系已经得到了很好的建立，但目前还不清楚是否所有年龄段的儿童死亡率都存在社会经济地位的差异。单亲家庭与死亡率的关联，以及任何这种关联是否是由于相关的低社会经济地位，也不清楚。方法在所有，480 693（69%）0-14岁的死亡在1991年至1994年与1991年人口普查记录。分析加权调整潜在的联动bias.Results之间的死亡率最低的最高的社会经济类别的教育，收入，汽车的访问，和邻里剥夺约两倍。职业阶层的差异较弱。这些死亡率的社会经济差异在婴儿中最大（特别是婴儿猝死综合征[SIDS]死亡率），但在其他年龄组（1-4岁，5-9岁和10- 1 - 4岁）中相似。在意外伤害、癌症、先天性和其他死亡方面，社会经济差异的幅度相似。多变量分析表明，教育，收入，汽车使用和邻里剥夺与死亡率的持续独立关联。单亲家庭与双亲或其他家庭相比，全因和意外伤害死亡率的比率（经年龄和种族调整）分别为1.2（95% CI：1.0，1.5）和1.8（95% CI：1.2，2.5）。社会经济因素的进一步调整，这些协会减少到0.8（95%CI：0.6，1.2）和1.2（95%CI：0.7，2.2），respectively.Conclusions似乎没有显着的变化，在儿童死亡率的年龄或死因的社会经济差异的相对风险。单亲家庭与儿童死亡率的任何联系都是由于其社会经济地位低下。
Background Although the association between child mortality and socioeconomic status is well established, it is unclear whether child mortality differences by socioeconomic position are present at all ages. The association of one-parent families with mortality, and whether any such association is due to associated low socioeconomic position, is also not clear.Methods In all, 480 of 693 (69%) 0-14 year old deaths during 1991-1994 were linked to 1991 census records. Analyses were weighted to adjust for potential linkage bias.Results There was approximately twofold higher mortality among the lowest compared with the highest socioeconomic categories of education, income, car access, and neighbourhood deprivation. Occupational class differences were weaker. These socioeconomic differences in mortality were strongest among infants (particularly sudden infant death syndrome [SIDS] mortality), but similar across other age groups (1-4, 5-9, and 10-14 years). The socioeconomic differences were of a similar magnitude for unintentional injury, cancer, congenital, and other deaths. Multivariable analyses demonstrated persistent independent associations of education, income, car access, and neighbourhood deprivation with mortality. Rate ratios (adjusted for age and ethnicity) for one-parent families compared with two-parent or other families were 1.2 (95% CI: 1.0, 1.5) and 1.8 (95% CI: 1.2, 2.5) for all-cause and unintentional injury mortality, respectively. Further adjustment for socioeconomic factors reduced these associations to 0.8 (95% CI: 0.6, 1.2) and 1.2 (95% CI: 0.7, 2.2), respectively.Conclusions There does not appear to be notable variation in relative risk terms of socioeconomic differences in child mortality by age or cause of death. Any association of one-parent families with child mortality is due to associated low socioeconomic position.