Hostname: page-component-76fb5796d-qxdb6 Total loading time: 0 Render date: 2024-04-25T15:44:41.277Z Has data issue: false hasContentIssue false
  • English
  • Français

Socioeconomic status and child health: what is the role of health care, health conditions, injuries and maternal health?

Published online by Cambridge University Press:  26 January 2012

Sara Allin  and
Mark Stabile
Sara Allin*
Affiliation:
School of Public Policy & Governance, University of Toronto, Canada
Mark Stabile
Affiliation:
School of Public Policy & Governance, University of Toronto, Canada
*
Correspondence to: Sara Allin, School of Public Policy & Governance, University of Toronto, Canadiana Building, 3rd floor, 14 Queen's Park Crescent West, Toronto, ON M5S 3K9, Canada. Email: Sara.allin@utoronto.ca
Get access Rights & Permissions [Opens in a new window]

Abstract

There is a persistent relationship between socioeconomic status and health that appears to have its roots in childhood. Not only do children in families with lower income and with mothers with lower levels of education have worse health on average than those with greater socioeconomic advantage, but also the gradient appears to steepen with age. This study contributes to the literature on the relationship between socioeconomic status and child health by testing the hypothesis that the increasing effect of family income on children's health with age relates to the children's use of health care services. It also investigates the role of specific health conditions, injuries or maternal health in explaining the steepening gradient. Drawing on a nationally representative survey from Canada, the National Longitudinal Survey of Children and Youth from the period 1994/95–2008/09, this study provides further evidence of a steepening socioeconomic gradient in child health with age. It finds that accounting for health care use does not explain the steepening gradient and that the protective effect of income appears to be greater for those who had contact with the health system, in particular with regard to physician care and prescription drug use.

Type
Articles
Information
Health Economics, Policy and Law , Volume 7 , Issue 2 , 02 March 2012 , pp. 227 - 242
Copyright
Copyright © Cambridge University Press 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Agha, M. M., Glazier, R. H.Guttmann, A. (2007), ‘Relationship between social inequalities and ambulatory care-sensitive hospitalizations persists for up to 9 years among children born in a major Canadian urban center’, Ambulatory Pediatrics: the Official Journal of the Ambulatory Pediatric Association, 7(3): 258–262.CrossRefGoogle Scholar
Allin, S. (2008), ‘Does equity in healthcare use vary across Canadian provinces?’, Healthcare Policy, 3(4): 83–99.Google ScholarPubMed
Amre, D. K., Infante-Rivard, C., Gautrin, D.Malo, J. L. (2002), ‘Socioeconomic status and utilization of health care services among asthmatic children’, The Journal of Asthma: Official Journal of the Association for the Care of Asthma, 39(7): 625–631.CrossRefGoogle ScholarPubMed
Bor, W., Najman, J. M., Andersen, M., Morrison, J.Williams, G. (1993), ‘Socioeconomic disadvantage and child morbidity: an Australian longitudinal study’, Social Science & Medicine, 36(8): 1053–1061.CrossRefGoogle ScholarPubMed
Brownell, M., Kozyrkyj, A., Roos, N., Friesen, D., Mayer, T.Sullivan, K. (2002), ‘Health service utilization by Manitoba children’, Canadian Journal of Public Health (Revue Canadienne de Sante Publique), 93(Supplement 2): S57–S62.CrossRefGoogle ScholarPubMed
Case, A., Lubotsky, D.Paxson, C. (2002), ‘Economic status and health in childhood: the origins of the gradient’, The American Economic Review, 92(5): 1308–1334.CrossRefGoogle ScholarPubMed
Case, A., Fertig, A.Paxson, C. (2005), ‘The lasting impact of childhood health and circumstance’, Journal of Health Economics, 24(2): 365–389.CrossRefGoogle ScholarPubMed
Case, A., Lee, D.Paxson, C. (2008), ‘The income gradient in children's health: a comment on Currie, Shields, and Wheatley Price’, Journal of Health Economics, 27: 801–807.CrossRefGoogle ScholarPubMed
Chatterji, P., Lahiri, K.Song, J. (2011), The Dynamics of Income-related Health Inequality among US Children, CESIFO Working Paper No. 3572. Albany, NY: CESIFO.CrossRefGoogle Scholar
Condliffe, S.Link, C. R. (2008), ‘The relationship between economic status and child health: evidence from the United States’, American Economic Review, 98(4): 1605–1618.CrossRefGoogle ScholarPubMed
Contoyannis, P.Dooley, M. (2010), ‘The role of child health and economic status in educational, health, and labour market outcomes in young adulthood’, Canadian Journal of Economics, 43: 323–346.CrossRefGoogle Scholar
Contoyannis, P.Li, J. (2011), ‘The evolution of health outcomes from childhood to adolescence’, Journal of Health Economics, 30(1): 11–32.CrossRefGoogle ScholarPubMed
Cope, S. F., Ungar, W. J.Glazier, R. H. (2008), ‘Socioeconomic factors and asthma control in children’, Pediatric Pulmonology, 43(8): 745–752.CrossRefGoogle ScholarPubMed
Currie, J. (1995), ‘Socio-economic status and child health: does public health insurance narrow the gap?’, The Scandinavian Journal of Economics, 97(4, The Future of the Welfare State): 603–620.CrossRefGoogle Scholar
Currie, J. (2009), ‘Healthy, wealthy, and wise: socioeconomic status, poor health in childhood, and human capital development’, Journal of Economic Literature, 47(1): 87–122.CrossRefGoogle Scholar
Currie, J.Hyson, R. (1999), ‘Is the impact of health shocks cushioned by socioeconomic status? The case of low birthweight’, The American Economic Review, 89(2, Papers and Proceedings of the 111th Annual Meeting of the American Economic Association): 245–250.CrossRefGoogle Scholar
Currie, J.Lin, W. (2007), ‘Chipping away at health: more on the relationship between income and child health’, Health Affairs, 26(2): 331–344.CrossRefGoogle ScholarPubMed
Currie, J.Stabile, M. (2003), ‘Socioeconomic status and child health: Why is the relationship stronger for older children?’, American Economic Review, 93(5): 1813–1823.CrossRefGoogle ScholarPubMed
Currie, J., Stabile, M., Manivong, P.Roos, L.L. (2010), ‘Child health and young adult outcomes’, Journal of Human Resources, 45(3): 517–548.CrossRefGoogle Scholar
Curtis, L. J., Dooley, M. D., Lipman, E. L.Feeny, D. H. (2001), ‘The role of permanent income and family structure in the determination of child health in Canada’, Health Economics, 10(4): 287–302.CrossRefGoogle ScholarPubMed
Dearden, L., Sibieta, L.Sylva, K. (2011), The Socio-Economic Gradient in Early Child Outcomes: Evidence from the Millennium Cohort Study, Institute for Fiscal Studies, IFS Working Papers: W11/03. London: Institute for Fiscal Studies.Google Scholar
Dooley, M.Curtis, L. (1998), Child Health and Family Socioeconomic Status in the Canadian National Longitudinal Survey of Children and Youth, Canadian International Labour Network Working Papers. Hamilton: McMaster University.Google Scholar
Dowd, J. B. (2007), ‘Early childhood origins of the income/health gradient: the role of maternal health behaviors’, Social Science & Medicine, 65(6): 1202–1213.CrossRefGoogle ScholarPubMed
Dowd, J. B., Zajacova, A.Aiello, A. (2009), ‘Early origins of health disparities: burden of infection, health, and socioeconomic status in U.S. children’, Social Science & Medicine, 68(4): 699–707.CrossRefGoogle ScholarPubMed
Faelker, T., Pickett, W.Brison, R. J. (2000), ‘Socioeconomic differences in childhood injury: a population based epidemiologic study in Ontario, Canada’, Injury Prevention, 6(3): 203–208.CrossRefGoogle ScholarPubMed
Guttmann, A., Shipman, S. A., Lam, K., Goodman, D. C.Stukel, T. A. (2010), ‘Primary care physician supply and children's health care use, access, and outcomes: findings from Canada’, Pediatrics, 125(6): 1119–1126.CrossRefGoogle ScholarPubMed
Jiménez-Rubio, D., Smith, P. C.van Doorslaer, E. (2008), ‘Equity in health and health care in a decentralised context: evidence from Canada’, Health Economics, 17: 377–392.CrossRefGoogle Scholar
Khanam, R., Nghiem, H. S.Connelly, L. B. (2009), ‘Child health and the income gradient: evidence from Australia’, Journal of Health Economics, 28(4): 805–817.CrossRefGoogle ScholarPubMed
Leininger, L. J., Ryan, R. M.Kalil, A. (2009), ‘Low-income mothers’ social support and children's injuries’, Social Science & Medicine, 68(12): 2113–2121.CrossRefGoogle ScholarPubMed
Murasko, J. E. (2008), ‘An evaluation of the age-profile in the relationship between household income and the health of children in the United States’, Journal of Health Economics, 27(6): 1489–1502.CrossRefGoogle ScholarPubMed
Oreopoulos, P., Stabile, M., Roos, L.Walld, R. (2008), ‘The short, medium, and long term effects of poor infant health’, Journal of Human Resources, 43(1): 88–138.CrossRefGoogle Scholar
Owens, P. L., Zodet, M. W., Berdahl, T., Dougherty, D., McCormick, M. C.Simpson, L. A. (2008), ‘Annual report on health care for children and youth in the United States: focus on injury-related emergency department utilization and expenditures’, Ambulatory Pediatrics, 8(4): 219–240.e217.CrossRefGoogle Scholar
Poulos, R., Hayen, A., Finch, C.Zwi, A. (2007), ‘Area socioeconomic status and childhood injury morbidity in New South Wales, Australia’, Injury Prevention, 13(5): 322–327.CrossRefGoogle ScholarPubMed
Propper, C., Rigg, J.Burgess, S. (2007), ‘Child health: evidence on the roles of family income and maternal mental health from a UK birth cohort’, Health Economics, 16: 1245–1269.CrossRefGoogle ScholarPubMed
Roberts, I.Power, C. (1996), ‘Does the decline in child injury mortality vary by social class? A comparison of class specific mortality in 1981 and 1991’, British Medical Journal (Clinical research ed.), 313(7060): 784–786.CrossRefGoogle ScholarPubMed
Simpson, K., Janssen, I., Craig, W. M.Pickett, W. (2005), ‘Multilevel analysis of associations between socioeconomic status and injury among Canadian adolescents’, Journal of Epidemiology and Community Health, 59(12): 1072–1077.CrossRefGoogle ScholarPubMed
Spencer, N. (1996), Poverty and Child Health, Oxford: Radford Medical Press.Google Scholar
To, T., Dell, S., Tassoudki, M.Wang, C. (2009), ‘Health outcomes in low-income children with current asthma’, Chronic Diseases in Canada, 29(2): 49–55.CrossRefGoogle ScholarPubMed
Ungar, W. J., Daniels, C., McNeill, T.Seyed, M. (2003), ‘Children in need of Pharmacare: medication funding requests at the Toronto Hospital for Sick Children’, Canadian Journal of Public Health (Revue Canadienne de Sante Publique), 94(2): 121–126.CrossRefGoogle ScholarPubMed
van Doorslaer E., C. Masseria and the OECD Health Equity Research Group Members (2004), Income-Related Inequality in the Use of Medical Care in 21 OECD Countries, Paris: OECD.Google Scholar
Violato, M., Petrou, S.Gray, R. (2009), ‘The relationship between household income and childhood respiratory health in the United Kingdom’, Social Science & Medicine, 69(6): 955–963.CrossRefGoogle ScholarPubMed
Wang, C., Guttmann, A., To, T.Dick, P. T. (2009), ‘Neighborhood income and health outcomes in infants: how do those with complex chronic conditions fare?’, Archives of Pediatrics & Adolescent Medicine, 163(7): 608–615.CrossRefGoogle ScholarPubMed