Addressing Socioeconomic Inequities in Children's Cardiovascular Health via Positive Experiences

Socioeconomic disadvantage often leads to high rates of poor cardiovascular health and this relationship may be mediated by positive experiences. This study estimated the extent to which promoting positive experiences could reduce socioeconomic inequities in children's cardiovascular health.

Data source: The Longitudinal Study of Australian Children (N = 1874).

Maternal education (low/medium/high) as a key indicator of family socioeconomic position during pregnancy.

Cardiovascular health (11-12 years) (poor/good) quantified by four health behaviors (diet, physical activity, nicotine exposure, sleep) and four health factors (body mass index, blood lipids, blood glucose. Blood pressure). Mediator: Multiple positive experiences (2-11 years) (≥2) indicated by positive parenting, supportive relationships, environments, and high social engagement. We conducted a causal mediation analysis using an interventional effects approach, adjusting for childhood adversity and other confounders.

Children with low (risk difference = 4.9%, 95% CI = -3.2%, 13.0%) or medium (risk difference = 5.6%, 95% CI = -1.2%, 12.5%) maternal education had a higher risk of poor cardiovascular health compared to those with high maternal education. Increasing the levels of multiple positive experiences in children with low or medium maternal education to be like their high maternal education peers could reduce these risk differences by 1.0% (95% CI = -0.8%, 2.8%) and 0.5% (95% CI = -0.5%, 1.5%) respectively, reducing cardiovascular inequities by 20.4% and 8.9%.

Targeted interventions promoting positive experiences can reduce socioeconomic inequities in children's cardiovascular health. Such interventions should be considered within a broader and multipronged approach that includes addressing socioeconomic disadvantage itself and other socially distributed drivers to achieve the maximum impact.