Measuring socioeconomic adversity in early life

Abstract

Aim Early life adversity leads to enduring effects on physical and mental health, school performance and other outcomes. We sought to identify potentially modifiable factors associated with socioeconomic adversity in early life. Methods We enrolled 1503 pregnant women aged 16–40 years, without pregnancy complications or pre‐existing conditions from Shelby County, Tennessee. Social, familial and economic variables were analysed using principal components (PCs) analyses to generate the Socioeconomic Adversity Index (SAI). This was replicated using the National Survey of Children's Health (NSCH). Health and social outcomes were compared across the quintile groups defined by SAI values at the county, state and national levels. Results Significant differences occurred across the SAI Quintile‐1 to Quintile‐5 groups in marital status, household structure, annual income, education and health insurance. Significantly worse health and social outcomes occurred in the lower versus higher SAI quintiles, including maternal depression, parental incarceration, child's birthweight and potential for child abuse. Maternal age and race also differed significantly across the SAI quintiles. Conclusion Modifiable factors contributing to socioeconomic adversity in early life included marital status, household structure, annual income, education and health insurance. Those exposed to greater socioeconomic adversity as defined by SAI values had significantly worse maternal and child outcomes.

The price of inequality—Inequality in wealth and health

“…It showed that marital status, household structure, annual income, education and health insurance contributed to socio‐economic adversity in early life. It was notable that females who were exposed to greater socio‐economic adversity had significantly worse maternal outcomes and so did their children . Anand et al.…”

Socioeconomic adversity: making sense of measures used for child health research

“…Proposed SAI score and similar composite measures of SES can be used to monitor patterns of socioeconomic adversity and compare populations and trends over time, given that common risk factors are of relevance. For example, lower SAI scores were more common in the population of Shelby County than those for the state of Tennessee or the United States, indicating higher deprivation . However, since one of the components of the score included the type of health insurance, SAI would not be replicable or meaningful in settings where health care is universal, such as the Nordic countries or the UK.…”

“…In the current issue of Acta Paediatrica , Anand et al. present a new measure of socioeconomic adversity in the population, the Socioeconomic Adversity Index (SAI) which can be used to describe inequalities in child health. What other measures are commonly used for research and how does SAI compare?…”

Highlights in this issue

“…The socio‐economic adversity index developed by Anand et al. is a new measure that can be used to describe inequalities in child health. Instead of focusing on poverty, the authors considered more broad measures of socio‐economic adversity based on social, family and economic factors.…”