Poster #42 - Do lower socio-economic status neighbourhoods have a higher prevalence of kindergarten children with health disorders?

• In Event: 3-206 - Poster Session 13
  In Poster Session: PS 13 Section - Developmental Disabilities

Integrative Statement

Background: Having a health disorder early in life often impacts trajectories of development through childhood, adolescence, and adulthood. It has long been recognized that socioeconomic status (SES), typically conceptualized as some combination of income, education, and employment indicators, is strongly associated with health, with lower SES related to both higher mortality and morbidity (Adler et al., 1993; Marmot et al., 1991). The disparities in health across SES are referred to as the socioeconomic gradient (Marmot et al., 1991), where individuals living in poverty have poorer outcomes compared to those with the highest SES, and each increase in income is associated with an increase in positive outcomes. Thus far, research on children with health disorders has explored the association of SES factors with prevalence or with outcomes (such as academic achievement or behaviour) and usually for no more than one disorder/diagnosis at a time. To our knowledge, the relationship between neighbourhood-level SES and health disorders in young children at the population-level has not been explored to date.
Purpose: One of the goals of the Canadian Children’s Health in Context Study (CCHICS) was to examine the prevalence of health disorders in kindergarten children in relation to the SES of the neighbourhoods they live in. Using population-level data for 2,038 custom neighbourhoods from 12 of Canada’s 13 provinces and territories (Guhn et al., 2016), the study investigated whether neighbourhoods with lower SES had a higher prevalence of children with health disorders compared to higher SES neighbourhoods.
Methods: Data collected for 990,502 children from 2004 to 2015 using the Early Development Instrument (EDI; Janus & Offord, 2007), a population-based measure of children’s developmental health at school entry, were linked with neighbourhood sociodemographic data from the 2006 Canadian Census and the 2005 Taxfiler. We examined the relationship between neighbourhood-level SES and the prevalence of health disorders, as reported on the EDI, using linear regression. The reported disorders included an identification of special needs, having a functional impairment limiting child’s ability to participate in classroom activities, or diagnosed conditions (i.e. physical or mental health disorder).
Results: The prevalence of childhood health disorders in Canadian neighbourhoods, excluding those with fewer than 10 children, ranged from 1.9 to 49.3%, with an average of 16.8% (SD = 5.99). Results of a linear regression demonstrated a significant association between neighbourhood-level SES and the prevalence of health disorders (F(1, 2036) = 386.89, p < .001), with an R2 of .16(Figure 1). For one standard deviation decrease in neighbourhood-level SES, the prevalence of health disorders increased by 2.4 percent. This relationship remained significant even after adding province/territory to the model (F(32, 2035) = 284.04, p < .001, R2 = .22).
Conclusion: This study offers an important opportunity to investigate the prevalence of health disorders that impact child development. Our study has established a population-based prevalence of health disorders by jurisdictions which underlines the importance of considering children’s health and development in the context of their neighbourhoods.

Authors

• Caroline Reid-Westoby, McMaster University
  Non-Presenting Author

• Molly Pottruff, McMaster University
  Presenting Author

• Magdalena Janus, McMaster University
  Non-Presenting Author

• Marni Brownell, Manitoba Centre for Health Policy, Department of Community Health Sciences, University of Manitoba
  Non-Presenting Author