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Updated: Aug 13, 2026
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Social class inequalities in childhood mortality and morbidity in an English population
Stavros Petrou1, Emil Kupek, Christine Hockley
1National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK. stavros.petrou@npeu.ox.ac.uk
Insights
Children from lower social classes face higher mortality and morbidity risks in their first decade of life. This study highlights significant social class inequalities in child health outcomes, impacting respiratory, digestive, and injury-related conditions.
Area of Science:
- Public Health
- Epidemiology
- Social Determinants of Health
Background:
- Socioeconomic status is a known determinant of health.
- Understanding social class gradients in child health is crucial for targeted interventions.
Purpose of the Study:
- To investigate the association between head of household's social class at birth and child mortality and morbidity.
- To analyze social class gradients in health outcomes during the first 10 years of life.
Main Methods:
- Cohort study of 117,212 children born in Oxfordshire and West Berkshire (1979-1988).
- Logistic and Poisson regression models used to assess social class gradients in mortality and hospital admission rates.
- Analysis stratified by age groups and disease categories.
Main Results:
- A significant social class gradient was observed in mortality during the first 10 years of life.
- Significant social class gradients were found in hospital admission rates for 14 of 16 disease groups.
- Persistent gradients noted for respiratory diseases, digestive system diseases, and injury/poisoning throughout childhood.
Conclusions:
- Significant social class inequalities exist in a broad spectrum of adverse child health outcomes.
- Social class influences child health from birth through the first decade of life.
- Findings underscore the need for policies addressing socioeconomic disparities in child health.
Abstract:
The objective of this study was to examine the association between social class of the head of household at the time of birth and mortality and morbidity during the first 10 years of life in a cohort of all 117 212 children born to women who both lived, and delivered in hospital, in Oxfordshire or West Berkshire during the period 1 January 1979 to 31 December 1988. Logistic regression was used to estimate social class gradients, with odds ratios (OR), for mortality during the early neonatal period, late neonatal period, post-neonatal period, post-infancy period and throughout the first 10 years of life. Logistic regression was also used to estimate social class gradients, with ORs, for hospital admission rates for 16 broad groups of diseases during years 0-3, 4-6, 7-10 and throughout the first 10 years of life. Poisson regression was used to estimate social class gradients, with effect sizes, for overall hospital admission rates during years 0-3, 4-6, 7-10 and throughout the first 10 years of life. The study revealed a significant social class gradient in mortality during the first 10 years of life (adjusted OR for each decrement in social class category 1.08; [95% confidence interval 1.03, 1.14]). The study also revealed a significant adjusted social class gradient in hospital admission rates for 14 of the 16 groups of diseases during the first 10 years of life. For the majority of these, the social class gradients had attenuated somewhat by the later childhood years. However, the social class gradient persisted throughout the first 10 years of life for diseases of the respiratory system (1.07 [1.05, 1.08]), diseases of the digestive system (1.06 [1.04, 1.09]), and injury and poisoning (1.07 [1.06, 1.09]). In addition, a significant adjusted social class gradient was found in overall hospital admission rates for each age group studied. This study suggests that there are significant social class inequalities in a wide range of adverse child health outcomes.
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