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Deprivation and bronchiolitis
N Spencer1, S Logan, S Scholey
1Centre for Community and Social Paediatric Research, University of Warwick, Coventry.
Insights
Socioeconomic deprivation is linked to a higher risk of infant bronchiolitis hospital admissions. Children in deprived areas are over 1.5 times more likely to be admitted for this respiratory illness.
Area of Science:
- Pediatric respiratory health
- Social epidemiology
- Public health research
Background:
- Bronchiolitis is a common respiratory infection in infants, often requiring hospitalization.
- Socioeconomic factors are increasingly recognized as determinants of child health outcomes.
- Previous research suggests a link between deprivation and various childhood illnesses.
Purpose of the Study:
- To investigate the association between socioeconomic deprivation and the risk of hospital admission for clinically suspected bronchiolitis in infants.
- To determine if this association persists after accounting for environmental factors like parental smoking.
- To examine the relationship for both general and severe cases of bronchiolitis.
Main Methods:
- A case-control study was conducted involving infants under one year of age in Sheffield.
- Cases were infants admitted with clinically suspected bronchiolitis; controls were drawn from the Sheffield Child Development Study.
- Residential postcodes were used to determine deprivation levels via the Townsend deprivation index, and parental smoking data were collected.
Main Results:
- A significant positive correlation was found between increasing levels of socioeconomic deprivation and the risk of hospital admission for bronchiolitis.
- Infants residing in the two most deprived electoral wards were over 1.5 times more likely to be admitted (OR 1.67) or admitted with medical intervention (OR 1.74).
- These findings remained consistent even after excluding children from smoky households, indicating the robustness of the deprivation effect.
Conclusions:
- Living in socioeconomically deprived areas significantly increases an infant's risk of hospital admission for bronchiolitis.
- This association is independent of parental smoking and holds true even when considering only more severe cases.
- Public health strategies should address socioeconomic disparities to mitigate the burden of infant bronchiolitis.
Objective:
To test the hypothesis that socioeconomic deprivation is associated with an increased risk of admission with clinically suspected bronchiolitis.
Design:
Case-control study.
Setting:
Children under 1 year living in Sheffield in 1989-90.
Subjects:
307 children resident in Sheffield admitted to Sheffield hospitals with clinically suspected bronchiolitis between 1 October 1989 and 28 February 1990.
Methods:
Children admitted with clinically suspected bronchiolitis were ascertained from laboratory records of nasopharyngeal aspirates cultured for respiratory syncytial virus. Case notes were examined to determine whether these children had required medical intervention and postcode of residence was recorded. Controls were selected from the Sheffield child development study (SCDS) data. Postcodes were converted to electoral wards which were assigned Townsend deprivation index scores. Electoral wards were then categorised by Townsend score into five levels of deprivation. Data on family smoking for cases and controls were extracted from the SCDS.
Results:
Of the 307 children admitted with suspected bronchiolitis during the study period, 127 required one or more medical intervention. The risk of admission with clinically suspected bronchiolitis and with bronchiolitis requiring medical intervention rose with increasing level of deprivation score of electoral ward of residence. Children living in electoral wards in the two more deprived groups were more than 1.5 times as likely to be admitted (odds ratio (OR) 1.67, 95% confidence interval (CI) 1.25 to 2.24) or admitted requiring a medical intervention (OR 1.74, 95% CI 1.16 to 2.62) than children living in other parts of the city. Similar results were obtained after exclusion of children living in homes classified as smoky by the health visitor.
Conclusion:
Residence in an area of social and material deprivation increases the risk of admission with bronchiolitis even after taking account of parental smoking and when only more severe cases were considered.