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Lower respiratory illness in infants and low socioeconomic status
P A Margolis1, R A Greenberg, L L Keyes
1Department of Pediatrics, University of North Carolina, Chapel Hill 27599-7490.
Insights
Infants in low socioeconomic status families face a higher risk of persistent respiratory symptoms. Environmental factors contribute to this risk and can be modified.
Area of Science:
- Pediatric respiratory health
- Environmental health
- Socioeconomic determinants of health
Background:
- Lower respiratory illness is common in infants.
- Infants from low socioeconomic status (SES) families are anecdotally reported to have higher rates of lower respiratory illness.
- This assertion requires rigorous examination.
Purpose of the Study:
- To investigate the frequency and determinants of lower respiratory illness in infants across different socioeconomic statuses.
- To identify specific environmental risk factors contributing to infant respiratory illness.
Main Methods:
- Community-based cohort study of 393 infants during their first year of life in central North Carolina.
- Analysis of lower respiratory illness incidence and prevalence of persistent respiratory symptoms.
- Statistical control for environmental risk factors and assessment of day care enrollment impact.
Main Results:
- Lower respiratory illness incidence was highest in the low socioeconomic group (1.41) compared to middle (1.26) and high (0.67) groups.
- Prevalence of persistent respiratory symptoms was significantly higher in low (39%) and middle (24%) socioeconomic groups compared to the high group (14%).
- Environmental risk factors partially explained the increased odds of persistent symptoms in low and middle SES infants; day care increased risk for high SES infants.
Conclusions:
- Infants from low socioeconomic status backgrounds are at a demonstrably increased risk for persistent respiratory symptoms.
- Environmental exposures are significant contributors to this elevated risk.
- Interventions targeting modifiable environmental factors hold potential for mitigating respiratory illness in vulnerable infant populations.
Objectives:
Infants from families of low socioeconomic status are said to suffer higher rates of lower respiratory illness, but this assertion has not been carefully examined.
Methods:
We studied the frequency and determinants of lower respiratory illness in infants of different socioeconomic status (n = 393) by analyzing data from a community-based cohort study of respiratory illness during the first year of life in central North Carolina.
Results:
The incidence of lower respiratory illness was 1.41 in the low socioeconomic group, 1.26 in the middle group, and 0.67 in the high group. The prevalence of persistent respiratory symptoms was 39% in infants in the low socioeconomic group, 24% in infants in the middle group, and 14% in infants in the high group. The odds of persistent respiratory symptoms in infants of low and middle socioeconomic status were reduced after controlling for environmental risk factors for lower respiratory illness. Enrollment in day care was associated with an increased risk of persistent symptoms among infants of high but not low socioeconomic status.
Conclusions:
Infants of low socioeconomic status are at increased risk of persistent respiratory symptoms. This risk can be partly attributed to environmental exposures, most of which could be changed.