RT Journal Article
SR Electronic
T1 Deprivation and mortality related to pediatric respiratory tract infection: a cohort study in 3 high-income jurisdictions
JF CMAJ Open
JO CMAJ
FD Canadian Medical Association
SP E273
OP E281
DO 10.9778/cmajo.20190074
VO 8
IS 2
A1 Maximiliane L. Verfürden
A1 Tiffany Fitzpatrick
A1 Laura Holder
A1 Ania Zylbersztejn
A1 Laura Rosella
A1 Ruth Gilbert
A1 Astrid Guttmann
A1 Pia Hardelid
YR 2020
UL http://www.cmajopen.ca/content/8/2/E273.abstract
AB Background: Deaths from respiratory tract infections (RTIs) in children are preventable through timely access to public health and medical interventions. We aimed to assess whether socioeconomic disparities in mortality related to pediatric RTI persisted after accounting for health status at birth.Methods: We compared the prevalence of and risk factors for RTI-related death in singletons aged 28 days to 4 years across Ontario (Canada), Scotland and England (jurisdictions with universal health care) using linked administrative data for 2003–2013. We estimated rates of RTI-related mortality for children living in deprived areas and those born to teenage girls; we estimated both crude rates and those adjusted for health status at birth.Results: A total of 1 299 240 (Ontario), 547 556 (Scotland) and 3 910 401 (England) children were included in the study. Across all jurisdictions, children born in the most deprived areas experienced the highest rates of RTI-related mortality. After adjustment for high-risk chronic conditions and prematurity, we observed differences in mortality according to area-level deprivation in Ontario and England but not in Scotland. In Ontario, teenage motherhood was also an independent risk factor for RTI-related mortality.Interpretation: Socioeconomic disparities played a substantial role in child mortality related to RTI in all 3 jurisdictions. Context-specific investigations around the mechanisms of this increased risk and development of programs to address socioeconomic disparities are needed.