Income inequalities and self-reported maternal health status: cross-sectional national survey

The objective of this study was to examine income inequalities in the self-reported health status of women during the postnatal period. We analysed data from a cohort of 18,523 birth mothers of children who participated in the Millennium Cohort Study. Data on income and self-reported health status were collected during face-to-face interviews conducted at 9 months postpartum. Total take-home household income from employment, government and other sources was estimated and equivalised to reflect household composition, while self-reported health status was converted into a dichotomous measure. Complex survey logistic regression models were used to explore the association between equivalised household income and fair or poor self-reported health status. Compared with mothers with equivalised household income in the first quintile (bottom 20%) of the income distribution, mothers in the third (OR 0.69; 95% CI 0.59-0.81), fourth (OR 0.43; 95% CI 0.38-0.50) and fifth (OR 0.32; 95% CI 0.27-0.37) quintiles had a decreased likelihood of reporting fair or poor health status (P < 0.001). However, following adjustment for other predictors of postnatal health status, only mothers with equivalised household income in the fifth quintile (top 20%) had a decreased likelihood of reporting fair or poor health status (OR 0.72; 95% CI 0.58-0.90; P = 0.004). We conclude that this study provides support for the existence of an income gradient for postnatal health status. Efforts to reduce income inequalities in adverse maternal health outcomes are likely to require macro and microeconomic initiatives.