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Maternal socioeconomic position and inequity in child deaths: An analysis of 2012 South Korean birth cohort of 466,636 children
BACKGROUND: Inequalities in child mortality occur via interactions between socio-environmental factors and their constituents. Through childhood developmental stages, we can observe changing patterns of mortality. By investigating these patterns and social inequalities by cause and developmental sta...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9762189/ https://www.ncbi.nlm.nih.gov/pubmed/36544546 http://dx.doi.org/10.1016/j.ssmph.2022.101304 |
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author | Jo, Minjin Oh, Inseong Moon, Daseul Kim, Sodam Jung-Choi, Kyunghee Chung, Haejoo |
author_facet | Jo, Minjin Oh, Inseong Moon, Daseul Kim, Sodam Jung-Choi, Kyunghee Chung, Haejoo |
author_sort | Jo, Minjin |
collection | PubMed |
description | BACKGROUND: Inequalities in child mortality occur via interactions between socio-environmental factors and their constituents. Through childhood developmental stages, we can observe changing patterns of mortality. By investigating these patterns and social inequalities by cause and developmental stage, we aim to gain insights into health policies to reduce and equalize childhood mortality. METHODS: Using vital statistics, we examined the Korean birth cohort of 2012, including all children born in 2012 up to five years of age (N = 466,636). The dependent variables were all-cause and cause-specific mortality by developmental stage (i.e., neonatal, post-neonatal, and childhood). A Cox proportional hazard regression model was built to compare child mortality according to maternal education. The distribution of inequalities in cause-specific mortality by child age was calculated using the slope index of inequality (SII). RESULTS: Inequalities in child mortality due to maternal education occur during the neonatal period and increase over time. After adjusting for covariates, the Cox proportional hazard models showed that “injury and external causes” (HR = 2.178; 95% CI = [1.283–3.697]) and “unknown causes” (HR = 2.299; 95% CI = [1.572–3.363]) in the post-neonatal period, and “injury and external causes” (HR = 2.153; 95% CI = [1.347–3.440]) in the childhood period significantly contributed to socioeconomic inequalities in child mortality. For each period, the leading causes of inequality were identified as follows: “congenital” (96.7%) for the neonatal period, “unknown causes” (58.2%) and “injury and external causes” (28.4%) for the post-neonatal period, and “injury and external causes” (56.5%) for the childhood period. CONCLUSION: We confirmed that the main causes of death in mortality inequality vary according to child age, in accordance with the distinctive context of child development. Strengthening the health system and multisectoral efforts that consider families' and children's needs according to spatial contexts (e.g., home, community) may be necessary to address the social inequalities in child health. |
format | Online Article Text |
id | pubmed-9762189 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-97621892022-12-20 Maternal socioeconomic position and inequity in child deaths: An analysis of 2012 South Korean birth cohort of 466,636 children Jo, Minjin Oh, Inseong Moon, Daseul Kim, Sodam Jung-Choi, Kyunghee Chung, Haejoo SSM Popul Health Regular Article BACKGROUND: Inequalities in child mortality occur via interactions between socio-environmental factors and their constituents. Through childhood developmental stages, we can observe changing patterns of mortality. By investigating these patterns and social inequalities by cause and developmental stage, we aim to gain insights into health policies to reduce and equalize childhood mortality. METHODS: Using vital statistics, we examined the Korean birth cohort of 2012, including all children born in 2012 up to five years of age (N = 466,636). The dependent variables were all-cause and cause-specific mortality by developmental stage (i.e., neonatal, post-neonatal, and childhood). A Cox proportional hazard regression model was built to compare child mortality according to maternal education. The distribution of inequalities in cause-specific mortality by child age was calculated using the slope index of inequality (SII). RESULTS: Inequalities in child mortality due to maternal education occur during the neonatal period and increase over time. After adjusting for covariates, the Cox proportional hazard models showed that “injury and external causes” (HR = 2.178; 95% CI = [1.283–3.697]) and “unknown causes” (HR = 2.299; 95% CI = [1.572–3.363]) in the post-neonatal period, and “injury and external causes” (HR = 2.153; 95% CI = [1.347–3.440]) in the childhood period significantly contributed to socioeconomic inequalities in child mortality. For each period, the leading causes of inequality were identified as follows: “congenital” (96.7%) for the neonatal period, “unknown causes” (58.2%) and “injury and external causes” (28.4%) for the post-neonatal period, and “injury and external causes” (56.5%) for the childhood period. CONCLUSION: We confirmed that the main causes of death in mortality inequality vary according to child age, in accordance with the distinctive context of child development. Strengthening the health system and multisectoral efforts that consider families' and children's needs according to spatial contexts (e.g., home, community) may be necessary to address the social inequalities in child health. Elsevier 2022-11-29 /pmc/articles/PMC9762189/ /pubmed/36544546 http://dx.doi.org/10.1016/j.ssmph.2022.101304 Text en © 2022 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Regular Article Jo, Minjin Oh, Inseong Moon, Daseul Kim, Sodam Jung-Choi, Kyunghee Chung, Haejoo Maternal socioeconomic position and inequity in child deaths: An analysis of 2012 South Korean birth cohort of 466,636 children |
title | Maternal socioeconomic position and inequity in child deaths: An analysis of 2012 South Korean birth cohort of 466,636 children |
title_full | Maternal socioeconomic position and inequity in child deaths: An analysis of 2012 South Korean birth cohort of 466,636 children |
title_fullStr | Maternal socioeconomic position and inequity in child deaths: An analysis of 2012 South Korean birth cohort of 466,636 children |
title_full_unstemmed | Maternal socioeconomic position and inequity in child deaths: An analysis of 2012 South Korean birth cohort of 466,636 children |
title_short | Maternal socioeconomic position and inequity in child deaths: An analysis of 2012 South Korean birth cohort of 466,636 children |
title_sort | maternal socioeconomic position and inequity in child deaths: an analysis of 2012 south korean birth cohort of 466,636 children |
topic | Regular Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9762189/ https://www.ncbi.nlm.nih.gov/pubmed/36544546 http://dx.doi.org/10.1016/j.ssmph.2022.101304 |
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