Parental income gradients in adult health: a national cohort study
Abstract Background Disparities in health by adult income are well documented, but we know less about the childhood origins of health inequalities, and it remains unclear how the shape of the gradient varies across health conditions. This study examined the association between parental income in chi...
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doaj-7c408ead3f274589af8622a4750a2ba12021-07-04T11:20:45ZengBMCBMC Medicine1741-70152021-07-0119111410.1186/s12916-021-02022-4Parental income gradients in adult health: a national cohort studyMiriam Evensen0Søren Toksvig Klitkou1Mette C. Tollånes2Simon Øverland3Torkild Hovde Lyngstad4Stein Emil Vollset5Jonas Minet Kinge6Centre for Disease Burden, Norwegian Institute of Public HealthCentre for Disease Burden, Norwegian Institute of Public HealthNorwegian Organization for Quality Improvement of Laboratory Examinations, Haraldsplass Deaconess HospitalCentre for Disease Burden, Norwegian Institute of Public HealthDepartment of Sociology and Human Geography, University of OsloDepartment of Health Metrics Sciences and Institute for Health Metrics and Evaluation, University of WashingtonCentre for Disease Burden, Norwegian Institute of Public HealthAbstract Background Disparities in health by adult income are well documented, but we know less about the childhood origins of health inequalities, and it remains unclear how the shape of the gradient varies across health conditions. This study examined the association between parental income in childhood and several measures of morbidity in adulthood. Methods We used administrative data on seven complete Norwegian birth cohorts born in 1967–1973 (N = 429,886) to estimate the association between parental income from birth to age 18, obtained from tax records available from 1967, linked with administrative registries on health. Health measures, observed between ages 39 and 43, were taken from registry data on consultations at primary health care services based on diagnostic codes from the International Classification of Primary Care (ICPC-2) and hospitalizations and outpatient specialist consultations registered in the National Patient Registry (ICD-10). Results Low parental income during childhood was associated with a higher risk of being diagnosed with several chronic and pain-related disorders, as well as hospitalization, but not overall primary health care use. Absolute differences were largest for disorders related to musculoskeletal pain, injuries, and depression (7–9 percentage point difference). There were also differences for chronic disorders such as hypertension (8%, CI 7.9–8.5 versus 4%, CI 4.1–4.7) and diabetes (3.2%, CI 3.0–3.4 versus 1.4%, CI 1.2–1.6). There was no difference in consultations related to respiratory disorders (20.9%, CI 20.4–21.5 versus 19.7%, CI 19.2–20.3). Childhood characteristics (parental education, low birth weight, and parental marital status) and own adult characteristics (education and income) explained a large share of the association. Conclusions Children growing up at the bottom of the parental income distribution, compared to children in the top of the income distribution, had a two- to threefold increase in somatic and psychological disorders measured in adulthood. This shows that health inequalities by socioeconomic family background persist in a Scandinavian welfare-state context with universal access to health care.https://doi.org/10.1186/s12916-021-02022-4Health inequalitiesChildhoodParental incomeCohort study |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Miriam Evensen Søren Toksvig Klitkou Mette C. Tollånes Simon Øverland Torkild Hovde Lyngstad Stein Emil Vollset Jonas Minet Kinge |
spellingShingle |
Miriam Evensen Søren Toksvig Klitkou Mette C. Tollånes Simon Øverland Torkild Hovde Lyngstad Stein Emil Vollset Jonas Minet Kinge Parental income gradients in adult health: a national cohort study BMC Medicine Health inequalities Childhood Parental income Cohort study |
author_facet |
Miriam Evensen Søren Toksvig Klitkou Mette C. Tollånes Simon Øverland Torkild Hovde Lyngstad Stein Emil Vollset Jonas Minet Kinge |
author_sort |
Miriam Evensen |
title |
Parental income gradients in adult health: a national cohort study |
title_short |
Parental income gradients in adult health: a national cohort study |
title_full |
Parental income gradients in adult health: a national cohort study |
title_fullStr |
Parental income gradients in adult health: a national cohort study |
title_full_unstemmed |
Parental income gradients in adult health: a national cohort study |
title_sort |
parental income gradients in adult health: a national cohort study |
publisher |
BMC |
series |
BMC Medicine |
issn |
1741-7015 |
publishDate |
2021-07-01 |
description |
Abstract Background Disparities in health by adult income are well documented, but we know less about the childhood origins of health inequalities, and it remains unclear how the shape of the gradient varies across health conditions. This study examined the association between parental income in childhood and several measures of morbidity in adulthood. Methods We used administrative data on seven complete Norwegian birth cohorts born in 1967–1973 (N = 429,886) to estimate the association between parental income from birth to age 18, obtained from tax records available from 1967, linked with administrative registries on health. Health measures, observed between ages 39 and 43, were taken from registry data on consultations at primary health care services based on diagnostic codes from the International Classification of Primary Care (ICPC-2) and hospitalizations and outpatient specialist consultations registered in the National Patient Registry (ICD-10). Results Low parental income during childhood was associated with a higher risk of being diagnosed with several chronic and pain-related disorders, as well as hospitalization, but not overall primary health care use. Absolute differences were largest for disorders related to musculoskeletal pain, injuries, and depression (7–9 percentage point difference). There were also differences for chronic disorders such as hypertension (8%, CI 7.9–8.5 versus 4%, CI 4.1–4.7) and diabetes (3.2%, CI 3.0–3.4 versus 1.4%, CI 1.2–1.6). There was no difference in consultations related to respiratory disorders (20.9%, CI 20.4–21.5 versus 19.7%, CI 19.2–20.3). Childhood characteristics (parental education, low birth weight, and parental marital status) and own adult characteristics (education and income) explained a large share of the association. Conclusions Children growing up at the bottom of the parental income distribution, compared to children in the top of the income distribution, had a two- to threefold increase in somatic and psychological disorders measured in adulthood. This shows that health inequalities by socioeconomic family background persist in a Scandinavian welfare-state context with universal access to health care. |
topic |
Health inequalities Childhood Parental income Cohort study |
url |
https://doi.org/10.1186/s12916-021-02022-4 |
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