Understanding income-related differences in distribution of child growth, behaviour and development using a cross-sectional sample of a clinical cohort study. Issue 2 (15th February 2022)

• Record Type: Journal Article
• Authors: Fuller, Anne; Siddiqi, Arjumand; Shahidi, Faraz V; Anderson, Laura N; Hildebrand, Vincent; Keown-Stoneman, Charles D G; Maguire, Jonathon L; Birken, Catherine
• Other Names: author non-byline.; Birken Catherine S. author non-byline.; Maguire Jonathon L. author non-byline.; Cohn Ronald author non-byline.; Lau Eddy author non-byline.; Laupacis Andreas author non-byline.; Parkin Patricia C. author non-byline.; Salter Michael author non-byline.; Szatmari Peter author non-byline.; Weir-Seeley Shannon author non-byline.; Anderson Laura N. author non-byline.; Borkhoff Cornelia M. author non-byline.; Keown-Stoneman Charles author non-byline.; Kowal Christine author non-byline.; Mason Dalah author non-byline.; Abdurrahman Murtala author non-byline.; Anderson Kelly author non-byline.; Arbess Gordon author non-byline.; Baker Jillian author non-byline.; Barozzino Tony author non-byline.; Bergeron Sylvie author non-byline.; Bhagat Dimple author non-byline.; Bloch Gary author non-byline.; Bonifacio Joey author non-byline.; Bowry Ashna author non-byline.; Calpin Caroline author non-byline.; Campbell Douglas author non-byline.; Cheema Sohail author non-byline.; Cheng Elaine author non-byline.; Chisamore Brian author non-byline.; Constantin Evelyn author non-byline.; Danayan Karoon author non-byline.; Das Paul author non-byline.; Derocher Mary Beth author non-byline.; Do Anh author non-byline.; Doukas Kathleen author non-byline.; Egger Anne author non-byline.; Farber Allison author non-byline.; Freedman Amy author non-byline.; Freeman Sloane author non-byline.; Gazeley Sharon author non-byline.; Guiang Charlie author non-byline.; Ha Dan author non-byline.; Handford Curtis author non-byline.; Hanson Laura author non-byline.; LeahHarrington Sheila Jacobson author non-byline.; Jagiello Lukasz author non-byline.; Jansz Gwen author non-byline.; Kadar Paul author non-byline.; Kim Florence author non-byline.; Kiran Tara author non-byline.; Knowles Holly author non-byline.; Kwok Bruce author non-byline.; Lakhoo Sheila author non-byline.; Lam-Antoniades Margarita author non-byline.; Lau Eddy author non-byline.; Leduc Denis author non-byline.; Leung Fok-Han author non-byline.; Li Alan author non-byline.; Li Patricia author non-byline.; Malach Jessica author non-byline.; Male Roy author non-byline.; Mascoll Vashti author non-byline.; Meret Aleks author non-byline.; EliseMok Rosemary Moodie author non-byline.; Nader Maya author non-byline.; Nash Katherine author non-byline.; Naymark Sharon author non-byline.; Owen James author non-byline.; Peer Michael author non-byline.; Pena Kifi author non-byline.; Perlmutar Marty author non-byline.; Persaud Navindra author non-byline.; Pinto Andrew author non-byline.; Porepa Michelle author non-byline.; Qi Vikky author non-byline.; NasreenRamji Noor Ramji author non-byline.; Raza Danyaal author non-byline.; Rosenthal Alana author non-byline.; Rouleau Katherine author non-byline.; Ruderman Caroline author non-byline.; JanetSaunderson Vanna Schiralli author non-byline.; Sgro Michael author non-byline.; Shuja Hafiz author non-byline.; Shepherd Susan author non-byline.; Smiltnieks Barbara author non-byline.; CinnthaSrikanthan Carolyn Taylor author non-byline.; Treherne Stephen author non-byline.; Turner Suzanne author non-byline.; Uddin Fatima author non-byline.; Heuvel Meta van den author non-byline.; Vaughan Joanne author non-byline.; Weisdorf Thea author non-byline.; Wijayasinghe Sheila author non-byline.; Wong Peter author non-byline.; Yaremko John author non-byline.; Ying Ethel author non-byline.; Young Elizabeth author non-byline.; Zajdman Michael author non-byline.; Bazeghi Farnaz author non-byline.; Bouchard Vincent author non-byline.; Bustos Marivic author non-byline.; Camacho Charmaine author non-byline.; Dalwadi Dharma author non-byline.; Flores Pamela Ruth author non-byline.; Jaleel Mateenah author non-byline.; Koroshegyi Christine author non-byline.; Malhi Tarandeep author non-byline.; Malick Ataat author non-byline.; Mitchell Michelle author non-byline.; Ogwuru Martin author non-byline.; Ong Frank author non-byline.; Rajendran Rejina author non-byline.; Thadani Sharon author non-byline.; Thompson Julia author non-byline.; Thompson Laurie author non-byline.; Aglipay Mary author non-byline.; Bayoumi Imaan author non-byline.; Carsley Sarah author non-byline.; Cost Katherine author non-byline.; Eny Karen author non-byline.; Kinlin Laura author non-byline.; Omand Jessica author non-byline.; Vanderhout Shelley author non-byline.; Vanderloo Leigh author non-byline.; Allen Christopher author non-byline.; Boodhoo Bryan author non-byline.; Chan Olivia author non-byline.; Dai David W.H. author non-byline.; Hall Judith author non-byline.; Juni Peter author non-byline.; Lakhanpal Gurpreet author non-byline.; Lebovic Gerald author non-byline.; KarenPope Audra Stitt author non-byline.; Thorpe Kevin author non-byline.; Kandel Rita author non-byline.; Rodrigues Michelle author non-byline.; Vandenberghe Hilde author non-byline.; Janus Magdalena author non-byline.; Duku Eric author non-byline.; Reid-Westoby Caroline author non-byline.; Raso Patricia author non-byline.; Offord Amanda author non-byline.;
• Is Part Of: BMJ open. Volume 12:Issue 2(2022)
• Publication Date: 2022-02-15
• Subjects: paediatrics -- social medicine -- epidemiology -- community child health; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2021-056991
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: Children from low-income households are at an increased risk of social, behavioural and physical health problems. Prior studies have generally relied on dichotomous outcome measures. However, inequities may exist along the range of outcome distribution. Our objective was to examine differences in distribution of three child health outcomes by income categories (high vs low): body mass index (BMI), behaviour difficulties and development. Design and setting: This was a cross-sectional study using data from a primary care-based research network with sites in three Canadian cities, and 15 practices enrolling participants. Participants, independent variable and outcomes: The independent variable was annual household income, dichotomised at the median income for Toronto (<$C80 000 or ≥$C80 000). Outcomes were: (1) growth (BMI z-score (zBMI) at 5 years, 1628 participants); (2) behaviour (Strengths and Difficulties Questionnaire (SDQ) at 3–5 years, 649 participants); (3) development (Infant Toddler Checklist (ITC) at 18 months, 1405 participants). We used distributional decomposition to compare distributions of these outcomes for each income group, and then to construct a counterfactual distribution that describes the hypothetical distribution of the low-income group with the predictor profile of the higher-income group. Results: We included data from 1628 (zBMI), 649 (SDQ) and 1405 (ITC) children. Children with lower family income had a higher risk distribution for all outcomes. For all outcomes, thecounterfactual distribution, which represented the distribution of children with lower-income who were assigned the predictor profile of the higher-income group, was more favourable than their observed distributions. Conclusion: Comparing the distributions of child health outcomes and understanding different risk profiles for children from higher-income and lower-income groups can offer a deeper understanding of inequities in child health outcomes. These methods may offer an approach that can be implemented in larger datasets to inform future interventions.