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Cited by 137Health disparities and outcomesHealth and Medical StudiesChild and Adolescent Health

Disabling chronic conditions in childhood and socioeconomic disadvantage: a systematic review and meta-analyses of observational studies

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Spencer, Nicholas J, Blackburn, Clare M, Read, Janet M·2015·BMJ Open
DOI 10.1136/bmjopen-2014-007062PMC PMC4563224
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Abstract

Objective: To determine the association of socioeconomic disadvantage with the prevalence of childhood disabling chronic conditions in high-income countries. Study design: Systematic review and meta-analyses. Data sources: 6 electronic databases, relevant websites, reference lists and experts in the field. Study selection: 160 observational studies conducted in high-income countries with data on socioeconomic status and disabling chronic conditions in childhood, published between 1 January 1991 and 31 December 2013. Data extraction and synthesis: Abstracts were reviewed, full papers obtained, and papers identified for inclusion by 2 independent reviewers. Inclusion decisions were checked by a third reviewer. Where reported, ORs were extracted for low versus high socioeconomic status. For studies reporting raw data but not ORs, ORs were calculated. Narrative analysis was undertaken for studies without data suitable for meta-analysis. Results: 126 studies had data suitable for meta-analysis. ORs for risk estimates were: all-cause disabling chronic conditions 1.72 (95% CI 1.48 to 2.01); psychological disorders 1.88 (95% CI 1.68 to 2.10); intellectual disability 2.41 (95% CI 2.03 to 2.86); activity-limiting asthma 2.20 (95% CI 1.87 to 2.85); cerebral palsy 1.42 (95% CI 1.26 to 1.61); congenital abnormalities 1.41 (95% CI 1.24 to 1.61); epilepsy 1.38 (95% CI 1.20 to 1.59); sensory impairment 1.70 (95% CI 1.39 to 2.07). Heterogeneity was high across most estimates (I 2 >75%). Of the 34 studies without data suitable for meta-analysis, 26 reported results consistent with increased risk associated with low socioeconomic status. Conclusions: The findings indicate that, in high-income countries, childhood disabling chronic conditions are associated with social disadvantage. Although evidence of an association is consistent across different countries, the review provides limited evidence to explain the association; future research, using longitudinal data, will be required to distinguish low socioeconomic status as the cause or consequence of childhood disabling chronic conditions and the aetiological pathways and mechanisms.

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  • Prevalence of other childhood disabilities, including intellectual disability, is consistently higher among lower SES groups.

    “Paradoxically, prevalence of other childhood disabilities, including ID, is consistently higher among lower SES groups (Spencer et al., 2015).”

    From Global prevalence of autism: A systematic review update (2022) · cites this paper as Spencer et al., 2015

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Cited by

Sorted by citations

Authors
Spencer, N. J., Blackburn, C. M., & Read, J. M.
Affiliations
University of Warwick (GB)
Corresponding author
Spencer, Nicholas J
ORCID
Venue
BMJ Open
Publisher
BMJ
Published
2015-09
Volume
5
Issue
9
Pages
e007062
ISSN
2044-6055 (ISSN-L)
DOI
10.1136/bmjopen-2014-007062
PMC
PMC4563224
OpenAlex
W2229313429
Cited by
137
References
3
Citations by year
2026: 9 · 2025: 8 · 2024: 16 · 2023: 6 · 2022: 22 · 2021: 10 · 2020: 21 · 2019: 25 · 2018: 8 · 2017: 5 · 2016: 7
FWCI
1.31
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • BMJ Open (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Warwick Research Archive Portal (University of Warwick) (acceptedVersion)
Funders
Economic and Social Research Council (RES-062-23-, ES/I007954/1)
Topics
  • Social Sciences › Health › Health disparities and outcomes
  • Health Sciences › Health Professions › General Health Professions › Health and Medical Studies
  • Health Sciences › Health Professions › General Health Professions › Child and Adolescent Health
Keywords
socioeconomic deprivation, socioeconomic status, disability, mental illness, intellectual disability, asthma, cerebral palsy, congenital malformations, epilepsy, sensory impairment, high-income countries, health disparities, social determinants of health, developmental disabilities
MeSH terms
Child, Chronic Disease, Humans, Poverty, Social Class, Models, Statistical, Odds Ratio, Developed Countries, Disabled Children, Children with Disabilities, Health Status Disparities, Observational Studies as Topic

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