Abstract
Objective
Prior research suggests that children with a low socioeconomic status (SES) background are at an increased risk for special healthcare needs. Conversely, for hypersensitivity-related diseases, many studies reported a lower risk among children with lower SES according to the hygiene hypothesis. We aimed to evaluate the association between SES and several hypersensitivity diseases and autism in a representative American sample.
Methods
We used data from the 2016, 2017 and 2018 US National Survey of Children’s Health. A total of 102,341 children aged 0–17 years were included. The dependent variables were doctor-diagnosed allergies, arthritis, asthma, diabetes, and autism. The main SES indicators were family poverty levels, highest education of the reported adults and difficulty in family income. Our analysis used logistic regression that accounted for the survey sampling design.
Results
The sample had a mean age of 9.4 ± 5.3 years. The weighted prevalence for allergies was 24.4%, 0.3% for arthritis, 11.9% for asthma, 0.5% for diabetes and 2.6% for autism. Children with adults reporting higher educational levels had greater odds of allergies (adjusted odds ratio and 95% CI: 1.48, 1.23–1.78) than those with lower educational levels. But for all other diseases, most findings suggested that a higher odds of disease was associated with lower SES instead of higher SES.
Conclusions
A low SES background remains an important risk factor for hypersensitivity diseases in children. Most of our results suggested that children with low SES were associated with a higher risk of hypersensitivity diseases and autism.
Significance
Studies have shown that children from low SES backgrounds are at a lower risk for hypersensitivity-related diseases according to the hygiene hypothesis; however, most studies only explored one type of hypersensitivity disease at a time. We analyzed data from the 2016, 2017, and 2018 National Survey of Children’s Health and examined the association of SES with allergies, arthritis, asthma, diabetes, and autism. Except for allergies, most of our findings suggested that children with lower SES backgrounds were at an increased risk of hypersensitivity diseases and autism. Our results contradicted the notion that low SES backgrounds are protective against hypersensitivity-related diseases in children.
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Data Availability
Data can be accessed at the Child and Adolescent Health Measurement Initiative’s Data Resource Center for Child and Adolescent Health.
Code Availability
Codes are available upon request.
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This project was supported by the Ministry of Health and Welfare in Taiwan. The content is solely the responsibility of the authors and does not represent the official views of the funders.
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This study was supported by the Ministry of Health and Welfare in Taiwan.
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Wong, TJ., Yu, T. Association Between Socioeconomic Status and Prevalence of Hypersensitivity Diseases and Autism: A Nationwide Study of Children. Matern Child Health J 27, 2194–2202 (2023). https://doi.org/10.1007/s10995-023-03789-z
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DOI: https://doi.org/10.1007/s10995-023-03789-z