Social inequalities influence health in childhood

A study by the Instituto de Saúde Pública da Universidade do Porto (ISPUP), recently published in the journal “Preventive Medicine”, concluded that children from less favoured socioeconomic backgrounds present, already at the ages of 7 and 10, biological alterations that may place them in a less favourable health trajectory throughout life due to social inequalities.

According to Sara Soares, first author of the study, coordinated by Sílvia Fraga, the work evaluated “how socioeconomic conditions at birth may influence some markers of children’s cardiometabolic health, such as blood pressure, waist circumference and body mass index (BMI). In clinical practice, these indicators are used to assess the cardiovascular health of adults“.

We know that “cardiovascular disease is more common in adults who have a lower socioeconomic status. What we wanted to evaluate in this study was whether, already in childhood, children who belong to more disadvantaged socioeconomic contexts showed changes in these cardiometabolic markers”, adds the ISPUP researcher.

To assess this association, researchers used information collected from children in the Generation XXI cohort – a longitudinal study by ISPUP that has followed, since 2005, about 8600 participants who were born in public maternity hospitals in the Porto Metropolitan Area.

Cardiometabolic markers of children in the cohort were analyzed, which were assessed at both 7 and 10 years of age. BMI, waist circumference, systolic and diastolic blood pressure, percentage of lean mass, triglycerides and glucose were considered.

The study entitled Early life socioeconomic circumstances and cardiometabolic health in childhood: evidence from the Generation XXI cohort (available HERE) considered parents’ education and profession, as well as household income, to characterize children’s socioeconomic context.

There are differences in biological markers of children’s health, according to the socioeconomic conditions of the family

The study observed that “children who have less educated parents, with less differentiated occupations and who earn lower incomes, already at 7 and 10 years of age, have higher levels of BMI, waist circumference and systolic blood pressure”, says Sara Soares.

Also, children with more educated parents, with more differentiated professions and a higher income have, at the age of 10, better levels of HDL (the so-called good cholesterol) compared to children from less well-off families.

“These results show us that the socioeconomic environment in which the child is born seems to condition biological changes even in childhood. Although this does not necessarily mean that these children will develop illness later in life, this study appears to show that children from more disadvantaged backgrounds may be growing up on a worse health trajectory”, concludes the ISPUP researcher.

Higher C-reactive protein levels in children with poorer socioeconomic conditions

In another study, entitled How do early socioeconomic circumstances impact inflammatory trajectories? Findings from Generation XXI, published in the journal Psychoneuroendocrinology (available HERE), ISPUP researchers showed that socioeconomic conditions have an impact on children’s biological markers.

Parents’ socioeconomic status and the levels of inflammation of participants of Generation XXI, at 4, 7 and 10 years of age were evaluated, and the study found that children born in more disadvantaged socioeconomic contexts have the highest levels of C-reactive protein – an inflammatory marker indicating risk for the development of cardiovascular diseases – at 10 years of age.

“With this study, we realized that children, who are born to families with less favored socioeconomic conditions, have higher levels of inflammation, already in the first decade of life, something that until now has only been shown in studies carried out in adults”, says Sara Soares.

“It is unknown whether this inflammation process can be reversed during adolescence or even in adulthood, but we realize that the socioeconomic status of parents causes, in the first ten years of life, biological changes in their children. Thus, children from less favored backgrounds seem to be growing in a less favorable health trajectory”, she adds.

Cutting out socioeconomic inequalities to avoid health inequalities

Considering the evidence found, Sara Soares highlights the importance of reducing socioeconomic inequalities to prevent health inequalities.

“One of the objectives that the United Nations and the Member States have defined for 2030 in the Sustainable Development Agenda is the reduction of inequalities. With these two studies, we were able to understand that differences in the socioeconomic status of families may be translating into health inequalities in children, and that this may be happening since childhood”, she says.

For this reason, “a more egalitarian society would help to reduce health inequalities that, as we found in this article, begin to manifest very early in life”.

Image: Unsplash/Ben Wicks

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