Longitudinal associations between socioeconomic position and overall health of children with chronic kidney disease and their carers
Authors:
Rashmi Shingde, Chandana Guha, Anita van Zwieten, Siah Kim, Amanda Walker, Anna Francis, Madeleine Didsbury, Armando Teixeira-Pinto, Chanel Prestidge, Emily Lancsar, Fiona Mackie, Joseph Kwon, Kirsten Howard, Martin Howell, Allison Jaure, Alison Hayes, Rakhee Raghunandan, Stavros Petrou, Suncica Lah, Steven McTaggart, Jonathan C. Craig, Kylie-Ann Mallitt, Germaine Wong
Disadvantaged socioeconomic position (SEP) is an important predictor of poor health in children with chronic kidney disease (CKD). The time course over which SEP influences the health of children with CKD and their carers is unknown.
Methods
This prospective longitudinal study included 377 children, aged 6–18 years with CKD (stages I–V, dialysis, and transplant), and their primary carers. Mixed effects ordinal regression was performed to assess the association between SEP and carer-rated child health and carer self-rated health over a 4-year follow-up.
Results
Adjusted for CKD stage, higher family household income (adjusted odds ratio (OR) (95% CI) 3.3, 1.8–6.0), employed status of primary carers (1.7, 0.9–3.0), higher carer-perceived financial status (2.6, 1.4–4.8), and carer home ownership (2.2, 1.2–4.0) were associated with better carer-rated child health. Household income also had a differential effect on the carer’s self-rated health over time (p = 0.005). The predicted probabilities for carers’ overall health being ‘very good’ among lower income groups at 0, 2, and 4 years were 0.43 (0.28–0.60), 0.34 (0.20–0.51), and 0.25 (0.12–0.44), respectively, and 0.81 (0.69–0.88), 0.84 (0.74–0.91), and 0.88 (0.76–0.94) for carers within the higher income group.
Conclusions
Carers and their children with CKD in higher SEP report better overall child and carer health compared with those in lower SEP. Carers of children with CKD in low-income households had poorer self-rated health compared with carers in higher-income households at baseline, and this worsened over time. These cumulative effects may contribute to health inequities between higher and lower SEP groups over time.
Longitudinal associations between socioeconomic position and overall health of children with chronic kidney disease and their carers
Authors
Rashmi Shingde Chandana Guha Anita van Zwieten Siah Kim Amanda Walker Anna Francis Madeleine Didsbury Armando Teixeira-Pinto Chanel Prestidge Emily Lancsar Fiona Mackie Joseph Kwon Kirsten Howard Martin Howell Allison Jaure Alison Hayes Rakhee Raghunandan Stavros Petrou Suncica Lah Steven McTaggart Jonathan C. Craig Kylie-Ann Mallitt Germaine Wong