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Intersectional inequalities in paediatric infectious diseases: a national cohort study in Sweden
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.ORCID iD: 0000-0002-1468-5771
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.ORCID iD: 0000-0002-3606-3797
Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.ORCID iD: 0000-0002-3972-5362
2024 (English)In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background: It is well known that socially deprived children are more likely to be hospitalised for infections. Less is known about how different social disadvantages interact. Therefore, we examine intersectional inequalities in overall, upper respiratory, lower respiratory, enteric and genitourinary infections in the first 5 years of life.

Methods: We conducted a population-based retrospective cohort study of Swedish children born between 1998 and 2015. Inequalities were examined using analysis of individual heterogeneity and discriminatory accuracy as the analytical framework. A variable with 60 intersectional strata was created by combining information on maternal education, household income, sex/gender and maternal migration status. We estimated the incidence rates of infectious disease hospitalisation for each intersectional strata and the associations between intersectional strata and infectious disease hospitalisations using logistic regression models. We furthermore quantified the discriminatory ability of the intersectional strata with respect to infectious disease hospitalisation.

Results: The study included 1785 588 children and 318 080 hospital admissions. The highest overall incidence of hospitalisations for infections was found in boys born to low-educated mothers who lived in families with the lowest household income. The overall incidence of infections was unrelated to household income in children born to highly educated mothers. The ability of the intersectional strata to discriminate between children with and without infections was poor.

Conclusion: We found that inequalities in paediatric infectious diseases were shaped by the intersections of different social disadvantages. These inequalities should be addressed by public health policies that reach all children.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2024.
National Category
Public Health, Global Health, Social Medicine and Epidemiology Pediatrics Infectious Medicine
Identifiers
URN: urn:nbn:se:umu:diva-223202DOI: 10.1136/jech-2023-220593Scopus ID: 2-s2.0-85190140973OAI: oai:DiVA.org:umu-223202DiVA, id: diva2:1850814
Funder
Region Västerbotten, RV-933162Umeå UniversityAvailable from: 2024-04-11 Created: 2024-04-11 Last updated: 2024-04-22

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Videholm, SamuelSilfverdal, Sven-ArneGustafsson, Per E.

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Videholm, SamuelSilfverdal, Sven-ArneGustafsson, Per E.
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Journal of Epidemiology and Community Health
Public Health, Global Health, Social Medicine and EpidemiologyPediatricsInfectious Medicine

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