Child mortality, socioeconomic position, and one-parent families: independent associations and variation by age and cause of death

Blakely, Tony; Atkinson, June; Kiro, Cynthia; Blaiklock, Alison; D’Souza, Amanda

doi:10.1093/ije/dyg154

Cited by 76 publications

(87 citation statements)

References 21 publications

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“…The earnings of parents seem to have no effect above and beyond education, and there is also no or minor impact of age or marital status of parents. Existing similar studies, based on smaller data sets for other countries, have not shown such a clear relationship between parental education and survival from childhood cancer, 2,5,7,26 but our results are in line with those from a recent, large Korean study. 9 No earlier investigation has addressed the possible importance of siblings.…”

supporting

confidence: 91%

“…2 Number of children in the respective categories. 3 Percentage of children in the respective categories.…”

Section: Descriptive Statisticsmentioning

confidence: 99%

“…One study from New Zealand showed that cancer survival was significantly reduced if a parent did not have a registered occupation or if a parent was unemployed, and an adverse effect of low education was also weakly indicated, while single parenthood had no impact. 2 Similarly, ethnicity did not play a role. 4 A relatively small, older study from the Netherlands concluded that educational level of parents had only a minor impact on childhood leukemia survival in the period 1973-1979.…”

mentioning

confidence: 96%

“…1 However, little is known about the impact of specific parental socioeconomic resources on childhood cancer survival. [2][3][4][5][6][7][8][9] Diagnostic procedures and treatment protocols for these diseases are largely standardized and centralized in developed countries, 10 and childhood cancer survival is therefore assumed to be fairly equal across different social groups.…”

mentioning

confidence: 99%

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Is mortality after childhood cancer dependent on social or economic resources of parents? A population‐based study

Syse

Lyngstad

Kravdal

2011

Intl Journal of Cancer

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Diagnostic and treatment protocols for childhood cancer are generally standardized, and therefore, survival ought to be fairly equal across social strata in societies with free public health care readily available. Nevertheless, our study explores whether there are disparities in mortality after childhood cancer in Norway depending on socioeconomic status of parents. Limited knowledge on differentials exists from earlier analyses. Discrete-time hazard regression models for all-cause mortality for the first 10 years after diagnosis were estimated for all Norwegian children (younger than 20 years), who were diagnosed with cancer during 1974-2007 (N 5 6,280), using data from five national registers. Mortality was reduced by about 15% for children with highly educated mothers and children without siblings. These effects were most pronounced for cancers predicted to encompass intense, long-lasting treatments resulting in chronic health problems. Neither earnings nor the marital status of parents affected children's survival. This large, registry-based study suggests that time constraints and various noneconomic rewards of parents from their education appears to have an impact on childhood cancer survival. It may be that children with resourceful parents are healthier at the outset and/or are more likely to avoid later health problems. It may also be that children of well-informed and strongly involved parents are offered better treatment or are able to make better use of what is offered, for instance, by adhering more closely to recommendations for follow-up treatment. The possibility of such differentials in offered and actual treatment should be addressed in future research.

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supporting

confidence: 91%

“…2 Number of children in the respective categories. 3 Percentage of children in the respective categories.…”

Section: Descriptive Statisticsmentioning

confidence: 99%

mentioning

confidence: 96%

mentioning

confidence: 99%

See 2 more Smart Citations

Is mortality after childhood cancer dependent on social or economic resources of parents? A population‐based study

Syse

Lyngstad

Kravdal

2011

Intl Journal of Cancer

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“…47,[95][96][97][98][99][100] This inverse association appears to be persistent across time, with some evidence of a steepening of the socioeconomic gradient in recent decades in the United States. 101 Furthermore, the relationship appears to hold regardless of whether socioeconomic status is delineated at an individual level, using measures such as income, social class or parental education, or at a more aggregated level using national or regional data on socioeconomic conditions.…”

Section: Socio-economic Statusmentioning

confidence: 99%

Understanding why children die in high-income countries

et al. 2014

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Copyright and reuse:The Warwick Research Archive Portal (WRAP) makes this work of researchers of the University of Warwick available open access under the following conditions. Copyright © and all moral rights to the version of the paper presented here belong to the individual author(s) and/or other copyright owners. To the extent reasonable and practicable the material made available in WRAP has been checked for eligibility before being made available.Copies of full items can be used for personal research or study, educational, or not-forprofit purposes without prior permission or charge. Provided that the authors, title and full bibliographic details are credited, a hyperlink and/or URL is given for the original metadata page and the content is not changed in any way. AbstractThrough a structured narrative review of the literature, we have identified a wide range of factors influencing child and adolescent mortality in high income countries. These can be conceptualised within the four domains of intrinsic factors, the physical environment, the social environment, and service delivery factors. The most prominent factors in the literature are socio-economic gradients, although the mechanisms through which these gradients exert their effects are complex, affecting all four domains, and often poorly understood. While some factors are relatively fixed, including the child's gender, age, ethnicity and inherent genetic make-up, some parental characteristics, and some wider 3 environmental conditions, others may be amenable to interventions that could lessen risks and help to prevent future child deaths. A number of examples of systemic health service factors that may impact child survival are given, along with interventions such as modifications to the physical or social environmental that may impact more distal factors.

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Quantification of Neighborhood-Level Social Determinants of Health in the Continental United States

et al. 2020

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IMPORTANCE An association between social and neighborhood characteristics and health outcomes has been reported but remains poorly understood owing to complex multidimensional factors that vary across geographic space. OBJECTIVES To quantify social determinants of health (SDOH) as multiple dimensions across the continental United States (the 48 contiguous states and the District of Columbia) at a small-area resolution and to examine the association of SDOH with premature mortality within Chicago, Illinois. DESIGN, SETTING, AND PARTICIPANTS In this cross-sectional study, census tracts from the US Census Bureau from 2014 were used to develop multidimensional SDOH indices and a regional typology of the continental United States at a small-area level (n = 71 901 census tracts with approximately 312 million persons) using dimension reduction and clustering machine learning techniques (unsupervised algorithms used to reduce dimensions of multivariate data). The SDOH indices were used to estimate age-adjusted mortality rates in Chicago (n = 789 census tracts with approximately 7.5 million persons) with a spatial regression for the same period, while controlling for violent crime. MAIN OUTCOMES AND MEASURES Fifteen variables, measured as a 5-year mean, were selected to characterize SDOH as small-area variations for demographic characteristics of vulnerable groups, economic status, social and neighborhood characteristics, and housing and transportation availability at the census-tract level. This SDOH data matrix was reduced to 4 indices reflecting advantage, isolation, opportunity, and mixed immigrant cohesion and accessibility, which were then clustered into 7 distinct multidimensional neighborhood typologies. The association between SDOH indices and premature mortality (defined as death before age 75 years) in Chicago was measured by years of potential life lost and aggregated to a 5-year mean. Data analyses were conducted between July 1, 2018, and August 30, 2019. RESULTS Among the 71 901 census tracts examined across the continental United States, a median (interquartile range) of 27.2% (47.1%) of residents had minority status, 12.1% (7.5%) had disabilities, 22.9% (7.6%) were 18 years and younger, and 13.6% (8.1%) were 65 years and older. Among the 789 census tracts examined in Chicago, a median (interquartile range) of 80.4% (56.3%) of residents had minority status, 10.2% (8.2%) had disabilities, 23.2% (10.9%) were 18 years and younger, and 9.5% (7.1%) were 65 years and older. Four SDOH indices accounted for 71% of the variance across all census tracts in the continental United States in 2014. The SDOH neighborhood typology of extreme poverty, which is of greatest concern to health care practitioners and policy advocates, comprised only 9.6% of all census tracts across the continental United States but characterized small areas of known public health crises. An association was observed between all SDOH indices and age-adjusted premature mortality rates in Chicago (R 2 = 0.63; P < .001), even after accounting for vio...

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Child mortality, socioeconomic position, and one-parent families: independent associations and variation by age and cause of death

Abstract: There does not appear to be notable variation in relative risk terms of socioeconomic differences in child mortality by age or cause of death. Any association of one-parent families with child mortality is due to associated low socioeconomic position.

Cited by 76 publications

References 21 publications

Is mortality after childhood cancer dependent on social or economic resources of parents? A population‐based study

Is mortality after childhood cancer dependent on social or economic resources of parents? A population‐based study

Understanding why children die in high-income countries

Quantification of Neighborhood-Level Social Determinants of Health in the Continental United States

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