Inequality and childrens health [Editorial]

The link between poverty and poor health in children is well recognized. Children living in poor countries are at a hugely increased risk of dying early and of suffering devastating illness. Even within developed countries children from the poorest social groups have substantially increased risks of death and illness. They are also less likely to obtain good results in secondary education to proceed to tertiary education or to get secure employment leaving their children at risk of poorer health. What is perhaps less widely appreciated is that these differences are found not simply between the poorest and the rest of society but that there is a gradient of risk of adverse outcome across social groups whichever measure of socioeconomic status (SES) is examined. For instance we have demonstrated that there is a virtually linear relationship between SES defined on the basis of the Townsend score of the ED where a woman lives and her risk of having a baby weighing less than 2500 g or less than 1500. In this study in the West Midlands around 30% of low birthweight and about 30% of perinatal deaths was statistically attributable to social inequality. Although the most deprived decile showed the highest risks of adverse outcome the increase was seen across all groups when compared with the richest. Where sensitive measures of SES are employed this gradient across groups is seen for virtually all adverse outcomes in children. (excerpt)