Citation

Ward JL, Viner RM. BMJ Open 2018; 8(9): e022114.

Affiliation

UCL GOS Institute of Child Health, University College London, London, UK.

Copyright

(Copyright © 2018, BMJ Publishing Group)

DOI

10.1136/bmjopen-2018-022114

PMID

30185573

Abstract

OBJECTIVE: To investigate if socioeconomic gradients in health reduce during adolescence (the equalisation hypothesis) in four low-income and middle-income countries (LMIC). SETTING: Analysis of the Young Lives Study cohorts in Ethiopia, Peru, Vietnam and India. PARTICIPANTS: A total of 3395 participants (across the four cohorts) aged 6-10 years at enrolment and followed up for 11 years. OUTCOMES MEASURED: Change in income-related health inequalities from mid-childhood to late adolescence. Socioeconomic status was determined by wealth index quartile. The health indicators included were self-reported health, injuries in the previous 4 years, presence of long-term health problems, low mood, alcohol use, overweight/obesity, thinness and stunting. The relative risk of each adverse health outcome between highest and lowest wealth index quartile were compared across four waves of the study within each country.

RESULTS: We found steep socioeconomic gradients across multiple health indicators in all four countries. Socioeconomic gradients remained similar across all waves of the study, with no significant decrease during adolescence.

CONCLUSION: We found no consistent evidence of equalisation for income-related health inequalities in youth in these LMIC. Socioeconomic gradients for health in these cohorts appear to persist and be equally damaging across the early life course and during adolescence.

© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Language: en

Keywords

adolescent health; epidemiology; equalisation; health inequalities; paediatrics; public health