Have health inequalities changed during childhood in the New Labour generation? Findings from the UK Millennium Cohort Study

Abstract

Objectives: To examine how population-level socioeconomic health inequalities developed during childhood, for children born at the turn of the 21st century and who grew up with major initiatives to tackle health inequalities (under the New Labour Government).

Setting: The UK.

Participants: Singleton children in the Millennium Cohort Study at ages 3 (n=15 381), 5 (n=15 041), 7 (n=13 681) and 11 (n=13 112) years.

Primary outcomes: Relative (prevalence ratios (PR)) and absolute health inequalities (prevalence differences (PD)) were estimated in longitudinal models by socioeconomic circumstances (SEC; using highest maternal academic attainment, ranging from 'no academic qualifications' to 'degree' (baseline)). Three health outcomes were examined: overweight (including obesity), limiting long-standing illness (LLSI), and socio-emotional difficulties (SED).

Results: Relative and absolute inequalities in overweight, across the social gradient, emerged by age 5 and increased with age. By age 11, children with mothers who had no academic qualifications were considerably more likely to be overweight as compared with those with degree-educated mothers (PR=1.6 (95% CI 1.4 to 1.8), PD=12.9% (9.1% to 16.8%)). For LLSI, inequalities emerged by age 7 and remained at 11, but only for children whose mothers had no academic qualifications (PR=1.7 (1.3 to 2.3), PD=4.8% (2% to 7.5%)). Inequalities in SED (observed across the social gradient and at all ages) declined between 3 and 11, although remained large at 11 (eg, PR=2.4 (1.9 to 2.9), PD=13.4% (10.2% to 16.7%) comparing children whose mothers had no academic qualifications with those of degree-educated mothers).

Conclusions: Although health inequalities have been well documented in cross-sectional and trend data in the UK, it is less clear how they develop during childhood. We found that relative and absolute health inequalities persisted, and in some cases widened, for a cohort of children born at the turn of the century. Further research examining and comparing the pathways through which SECs influence health may further our understanding of how inequalities could be prevented in future generations of children.

Keywords: CHILD HEALTH; COHORT; INEQUALITIES; LIFECOURSE EPIDEMIOLOGY; POLICY.

Figure 1

Prevalence of overweight in singletons in the Millennium Cohort Study at ages 3 (n=15 381), 5 (n=15 041), 7 (n=13 681) and 11 (n=13 112) by concurrent maternal academic attainment, weighted %. GCSE,General Certificate of Secondary Education.

Figure 2

Prevalence of LLSI in singletons in the Millennium Cohort Study at ages 3 (n=15 381), 5 (n=15 041), 7 (n=13 681) and 11 (n=13 112) by concurrent maternal academic attainment, weighted %. GCSE,General Certificate of Secondary Education; LLSI, limiting long-standing illness.

Figure 3

Prevalence of SED in the Millennium Cohort Study in singletons at ages 3 (n=15 381), 5 (n=15 041), 7 (n=13 681) and 11 (n=13 112) by concurrent maternal academic attainment, weighted %. GCSE,General Certificate of Secondary Education; SED, socio-emotional difficulties.