Background
Methods
Study design and population
Data collection
Variables
Statistical analysis
Results
Boys | Girls | Total | ||||
---|---|---|---|---|---|---|
N = 746,392 | % | N = 703,424 | % | N = 1,449,816 | % | |
Age | ||||||
0–2 | 224,889 | 30.13 | 211,827 | 30.11 | 436,716 | 30.12 |
3–5 | 140,194 | 18.78 | 131,100 | 18.64 | 271,294 | 18.71 |
6–8 | 135,725 | 18.18 | 127,797 | 18.17 | 263,522 | 18.18 |
9–11 | 127,066 | 17.02 | 120,194 | 17.09 | 247,260 | 17.06 |
12–14 | 118,518 | 15.89 | 112,506 | 15.99 | 231,024 | 15.93 |
SEP | ||||||
Very low | 31,641 | 4.24 | 29,353 | 4.17 | 60,994 | 4.21 |
Low | 465,703 | 62.39 | 438,256 | 62.30 | 903,959 | 62.35 |
Medium | 243,055 | 32.57 | 230,005 | 32.70 | 473,060 | 32.63 |
High | 5993 | 0.80 | 5810 | 0.83 | 11,803 | 0.81 |
Prevalences, incidence proportions, PR and IR
PR/IR | Period prevalence/ Incidence proportion | ||||||||
---|---|---|---|---|---|---|---|---|---|
Boys vs girls | Boys | Girls | |||||||
Very low SEP | Low SEP | Medium SEP | High SEP | Very low SEP | Low SEP | Medium SEP | High SEP | ||
Disease | PR/IR (95% CI) p-value | N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | N (%) |
Infectious diseases | |||||||||
Tuberculosisa | 0.92 (0.79, 1.07) | 33 (0.10) | 243 (0.05) | 47 (0.02) | 0 (0.00) | 44 (0.15) | 229 (0.05) | 53 (0.02) | 0 (0.00) |
Meningitis (bacterial or viral)a | 1.57 (1.36, 1.80)*** | 33 (0.10) | 330 (0.07) | 142 (0.06) | 1 (0.02) | 12 (0.04) | 196 (0.04) | 97 (0.04) | 1 (0.01) |
Influenzaa | 1.05 (1.04, 1.06)*** | 3257 (10.29) | 40,304 (8.65) | 19,581 (8.06) | 234 (3.91) | 2940 (10.02) | 36,172 (8.25) | 17,580 (7.64) | 217 (3.73) |
Neoplasms | |||||||||
Cancer of the brain and nervous system | 1.09 (0.90, 1.32) | 18 (0.06) | 133 (0.03) | 75 (0.03) | 0 (0.00) | 6 (0.02) | 126 (0.03) | 58 (0.03) | 4 (0.06) |
Leukaemia | 1.26 (1.06, 1.48)** | 17 (0.05) | 196 (0.04) | 105 (0.04) | 4 (0.07) | 8 (0.03) | 157 (0.04) | 74 (0.03) | 1 (0.02) |
Malignant neoplasms | 1.08 (1.02, 1.15)* | 129 (0.41) | 1402 (0.30) | 667 (0.27) | 9 (0.15) | 107 (0.36) | 1231 (0.28) | 572 (0.259 | 8 (0.14) |
Anthropometrics | |||||||||
Overweight | 1.06 (1.05, 1.08)*** | 3809 (18.77) | 44,974 (17.52) | 20,602 (14.23) | 267 (5.93) | 3252 (17.24) | 38,425 (15.80) | 16,985 (12.30) | 228 (5.30) |
Obesity | 1.33 (1.32, 1.35)*** | 2159 (10.64) | 23,454 (9.14) | 8886 (6.14) | 78 (1.73) | 1530 (8.11) | 16,237 (6.71) | 5880 (4.27) | 57 (1.32) |
Mental health | |||||||||
Mood disorders | 0.87 (0.83, 0.91)*** | 164 (0.52) | 2144 (0.46) | 780 (0.32) | 10 (0.17) | 200 (0.68) | 2325 (0.53) | 823 (0.36) | 10 (0.17) |
Adjustment and anxiety disorders | 1.06 (1.04, 1.08)*** | 1788 (5.65) | 21,098 (4.53) | 7596 (3.13) | 56 (0.94) | 1638 (5.58) | 18,764 (4.28) | 6682 (2.91) | 47 (0.82) |
ADHD | 2.70 (2.63, 2.76)*** | 1323 (4.18) | 16,443 (3.53) | 7790 (3.20) | 139 (2.32) | 437 (1.49) | 5863 (1.34) | 2627 (1.14) | 46 (0.79) |
ASD | 4.66 (4.39, 4.94)*** | 321 (1.01) | 4154 (0.89) | 2006 (0.83) | 21 (0.35) | 68 (0.23) | 844 (0.19) | 401 (0.17) | 2 (0.04) |
Autoimmune and respiratory diseases | |||||||||
Acute bronchitisa | 1.21 (1.20, 1.21)*** | 7014 (22.17) | 87,062 (18.60) | 41,963 (17.26) | 669 (11.16) | 5471 (18.64) | 68,208 (15.50) | 32,929 (14.30) | 476 (8.20) |
Chronic bronchitis | 1.22 (1.21, 1.23)*** | 3285 (10.38) | 40.515 (8.70) | 19,404 (7.98) | 282 (4.71) | 2560 (8.72) | 31,430 (7.17) | 14,976 (6.51) | 201 (3.46) |
Asthma | 1.47 (1.45, 1.49)*** | 2460 (7.77) | 32,359 (6.95) | 16,639 (6.85) | 232 (3.87) | 1641 (5.59) | 21,122 (4.82) | 10,298 (4.48) | 128 (2.20) |
Respiratory allergy | 1.13 (1.12, 1.14)*** | 1677 (5.30) | 22,128 (4.75) | 9797 (4.03) | 125 (2.09) | 1310 (4.46) | 15,929 (3.63) | 6640 (2.89) | 79 (1.36) |
Dermatitis | 0.94 (0.93, 0.94)*** | 7610 (24.05) | 102,065 (21.92) | 47,832 (19.68) | 668 (11.15) | 7886 (26.87) | 106,201 (24.23) | 48,956 (21.28) | 687 (11.82) |
Food allergy | 1.08 (1.06, 1.10)*** | 316 (1.00) | 5502 (1.18) | 3811 (1.57) | 58 (0.96) | 240 (0.82) | 5073 (1.16) | 3640 (1.58) | 59 (1.01) |
Cystic fibrosis | 1.00 (0.79, 1.28) | 3 (0.01) | 83 (0.02) | 46 (0.02) | 1 (0.01) | 5 (0.02) | 75 (0.02) | 44 (0.02) | 2 (0.04) |
Adverse birth outcomes | |||||||||
Short gestation, low birth weight, foetal growth retardation | 1.04 (1.01, 1.08)* | 320 (1.01) | 4795 (1.03) | 1677 (0.69) | 30 (0.50) | 310 (1.05) | 4276 (0.98) | 1568 (0.68) | 28 (0.49) |
Intrauterine hypoxia and birth asphyxia and trauma | 1.37 (1.29, 1.45)*** | 173 (0.55) | 2102 (0.45) | 746 (0.31) | 8 (0.14) | 85 (0.29) | 1480 (0.34) | 506 (0.22) | 0 (0.00) |
Congenital anomalies | 1.18 (1.16, 1.19)*** | 3343 (10.57) | 46,752 (10.04) | 21,640 (8.90) | 265 (4.42) | 2398 (8.17) | 36,981 (8.44) | 18,183 (7.91) | 232 (3.99) |
Nervous system | |||||||||
Paralysis | 1.24 (1.14, 1.36)*** | 71 (0.22) | 760 (0.16) | 306 (0.13) | 3 (0.05) | 64 (0.22) | 544 (0.12) | 252 (0.11) | 4 (0.07) |
Epilepsy | 1.16 (1.10, 1.21)*** | 217 (0.68) | 2555 (0.55) | 1139 (0.47) | 28 (0.46) | 175 (0.60) | 2024 (0.46) | 996 (0.43) | 9 (0.16) |
Circulatory system | |||||||||
Essential hypertension | 1.28 (1.18, 1.38)*** | 70 (0.22) | 1001 (0.22) | 343 (0.14) | 4 (0.06) | 56 (0.19) | 731 (0.17) | 256 (0.11) | 3 (0.05) |
Heart valve disorders | 1.18 (1.16, 1.20)*** | 1054 (3.33) | 15,078 (3.24) | 7584 (3.12) | 97 (1.61) | 899 (3.06) | 11,970 (2.73) | 6075 (2.64) | 83 (1.43) |
Acute cerebrovascular disease | 1.39 (1.23, 1.57)*** | 32 (0.10) | 413 (0.09) | 173 (0.07) | 3 (0.06) | 22 (0.07) | 269 (0.06) | 130 (0.06) | 3 (0.06) |
Others | |||||||||
Injuriesa | 1.18 (1.17, 1.18)*** | 13,453 (42.52) | 16,4317 (35.28) | 78,687 (32.37) | 1292 (21.57) | 10,493 (35.75) | 130,995 (29.89) | 63,419 (27.57) | 990 (17.04) |
Poisoninga | 0.99 (0.92, 1.06) | 123 (0.39) | 1094 (0.23) | 438 (0.18) | 10 (0.17) | 119 (0.41) | 1089 (0.25) | 372 (0.16) | 15 (0.27) |
Inequality measures
Disease | SII (95% CI) | RII (95% CI) | ||||
---|---|---|---|---|---|---|
Boys | Girls | p-value* | Boys | Girls | p-value* | |
Infectious diseases | ||||||
Tuberculosis | 0.08 (−0.04, 0.21) | 0.11 (−0.13, 0.35) | 0.675 | 8.13 (4.83, 13.71) | 9.62 (5.70, 16.26) | 0.656 |
Meningitis (bacterial or viral) | 0.06 (−0.03, 0.15) | 0.02 (− 0.03, 0.08) | 0.144 | 1.89 (1.31, 2.72) | 1.23 (0.77, 1.95) | 0.153 |
Influenza | 5.00 (−2.68, 12.67) | 4.90 (− 2.47, 12.26) | 0.969 | 1.29 (1.25, 1.33) | 1.33 (1.28, 1.37) | 0.286 |
Neoplasms | ||||||
Cancer of the brain and nervous system | 0.04 (−0.04, 0.12) | − 0.03 (− 0.11, 0.05) | 0.019 | 1.28 (0.75, 2.19) | 1.13 (0.64, 2.02) | 0.765 |
Leukaemia | −0.01 (− 0.07, 0.04) | 0.01 (− 0.03, 0.05) | 0.103 | 1.01 (0.65, 1.58) | 1.16 (0.69, 1.94) | 0.695 |
Malignant neoplasms | 0.20 (−0.11, 0.50) | 0.17 (− 0.06, 0.41) | 0.793 | 1.37 (1.15, 1.62) | 1.44 (1.19, 1.73) | 0.696 |
Anthropometrics | ||||||
Overweight | 11.36 (−0.81, 23.53) | 10.69 (1.30, 20.08) | 0.858 | 1.63 (1.58, 1.67) | 1.78 (1.73, 1.84) | < 0.001 |
Obesity | 7.98 (2.52, 13.43) | 6.09 (2.35, 9.82) | 0.261 | 2.37 (2.27, 2.48) | 2.68 (2.54, 2.82) | < 0.001 |
Mental health | ||||||
Mood disorders | 0.31 (0.14, 0.48) | 0.44 (0.08, 0.81) | 0.205 | 1.92 (1.65, 2.23) | 2.09 (1.81, 2.41) | 0.424 |
Adjustment and anxiety disorders | 4.03 (0.66, 7.41) | 4.03 (0.47, 7.60) | 0.998 | 2.17 (2.07, 2.27) | 2.24 (2.13, 2.36) | 0.346 |
ADHD | 1.48 (−0.39, 3.34) | 0.60 (0.07, 1.13) | 0.090 | 1.21 (1.15, 1.27) | 1.31 (1.20, 1.43) | 0.112 |
ASD | 0.53 (−0.31, 1.37) | 0.15 (−0.09, 0.40) | 0.107 | 1.29 (1.16, 1.42) | 1.36 (1.09, 1.71) | 0.636 |
Autoimmune and respiratory diseases | ||||||
Acute bronchitis | 8.62 (−3.28, 20.52) | 8.19 (−3.40, 19.77) | 0.915 | 1.35 (1.33, 1.38) | 1.39 (1.36, 1.42) | 0.090 |
Chronic bronchitis | 4.46 (−1.75, 10.67) | 4.13 (−1.62, 9.89) | 0.874 | 1.37 (1.33, 1.41) | 1.43 (1.38, 1.49) | 0.064 |
Asthma | 3.00 (−2.63, 8.64) | 2.68 (− 1.42, 6.78) | 0.848 | 1.08 (1.05, 1.12) | 1.23 (1.18, 1.29) | < 0.001 |
Respiratory allergy | 2.71 (−0.33, 5.75) | 2.58 (−0.03, 5.18) | 0.889 | 1.26 (1.22, 1.29) | 1.37 (1.33, 1.41) | < 0.001 |
Dermatitis | 10.68 (−3.47, 24.84) | 12.55 (−2.75, 27.86) | 0.713 | 1.32 (1.30, 1.35) | 1.41 (1.38, 1.43) | < 0.001 |
Food allergy | −0.06 (−1.80, 1.67) | −0.23 (−2.15, 1.68) | 0.791 | 0.86 (0.82, 0.90) | 0.87 (0.83, 0.92) | 0.655 |
Cystic fibrosis | 0.00 (−0.03, 0.02) | −0.02 (− 0.05, 0.02) | 0.113 | 0.79 (0.40, 1.55) | 0.77 (0.38, 1.55) | 0.963 |
Adverse birth outcomes | ||||||
Short gestation, low birth weight, foetal growth retardation. | 0.53 (0.42, 0.65) | 0.54 (0.39, 0.70) | 0.788 | 2.20 (1.99, 2.43) | 2.14 (1.92, 2.38) | 0.704 |
Intrauterine hypoxia and birth asphyxia and trauma | 0.36 (0.11, 0.61) | 0.28 (−0.09, 0.65) | 0.453 | 2.31 (1.98, 2.69) | 2.31 (1.93, 2.78) | 0.978 |
Congenital anomalies | 5.21 (−2.26, 12.69) | 3.59 (−3.77, 10.96) | 0.530 | 1.38 (1.34, 1.42) | 1.23 (1.19, 1.27) | < 0.001 |
Nervous system | ||||||
Paralysis | 0.14 (−0.02, 0.30) | 0.11 (− 0.12, 0.33) | 0.654 | 1.89 (1.48, 2.41) | 1.66 (1.26, 2.2) | 0.501 |
Epilepsy | 0.18 (−0.17, 0.53) | 0.34 (−0.21, 0.88) | 0.312 | 1.47 (1.29, 1.68) | 1.30 (1.13, 1.50) | 0.203 |
Circulatory system | ||||||
Essential hypertension | 0.15 (0.07, 0.24) | 0.13 (0.06, 0.19) | 0.284 | 2.14 (1.72, 2.68) | 2.16 (1.66, 2.79) | 0.978 |
Heart valve disorders | 1.40 (−1.40, 4.20) | 1.27 (−0.96, 3.50) | 0.885 | 1.17 (1.11, 1.23) | 1.21 (1.15, 1.29) | 0.318 |
Acute cerebrovascular disease | 0.04 (0.01, 0.06) | 0.01 (−0.02, 0.05) | 0.039 | 1.72 (1.23, 2.38) | 1.26 (0.85, 1.86) | 0.232 |
Others | ||||||
Injuries | 16.35 (−5.98, 38.67) | 14.63 (− 5.84, 35.10) | 0.815 | 1.31 (1.29, 1.33) | 1.29 (1.28, 1.31) | 0.242 |
Poisoning | 0.16 (−0.23, 0.56) | 0.11 (− 0.43, 0.65) | 0.741 | 2.02 (1.65, 2.48) | 2.51 (2.03, 3.10) | 0.150 |
Population SEP impact measures
Disease | PAF% (95% CI) | PAFa (95% CI) | ||
---|---|---|---|---|
Boys | Girls | Boys | Girls | |
Infectious diseases | ||||
Tuberculosis | 56.26 (43.03, 66.41) | 51.95 (38.51, 62.45) | 181 (139, 214) | 171 (127, 205) |
Meningitis (bacterial or viral) | 18.32 (5.88, 29.11) | 7.69 (−9.09, 21.90) | 93 (30, 148) | 24 (−28, 67) |
Influenza | 7.17 (6.13, 8.20) | 7.83 (6.73, 8.91) | 4540 (3882, 5191) | 4450 (3827, 5065) |
Neoplasms | ||||
Cancer of the brain and nervous system | 0.54 (−19.66, 17.34) | 6.69 (−14.89, 24.21) | 1 (−44, 39) | 13 (−29, 47) |
Leukaemia | −1.77 (− 18.54, 12.63) | 5.93 (− 13.30, 21.90) | − 6 (− 60, 41) | 14 (− 32, 53) |
Malignant neoplasms | 7.51 (1.57, 13.10) | 9.18 (2.85, 15.10) | 166 (35, 290) | 177 (55, 291) |
Anthropometrics | ||||
Overweight | 15.63 (14.74, 16.52) | 18.44 (17.46, 19.40) | 10,905 (10,280, 11,524) | 10,872 (10,299, 1438) |
Obesity | 27.14 (25.86, 28.39) | 30.31 (28.77, 31.80) | 9407 (8694, 9841) | 7204 (6840, 7560) |
Mental health | ||||
Mood disorders | 20.11 (15.29, 24.65) | 21.54 (16.96, 25.86) | 619 (471, 759) | 718 (565, 862) |
Adjustment and anxiety disorders | 22.88 (21.42, 24.31) | 23.30 (21.76, 24.81) | 6964 (6520, 7400) | 6290 (5873, 6699) |
ADHD | 4.01 (2.31, 5.68) | 7.34 (4.46, 10.13) | 1031 (595, 1459) | 658 (399, 908) |
ASD | 7.04 (3.63, 10.33) | 8.57 (0.84, 15.69) | 459 (237, 673) | 113 (11, 207) |
Autoimmune and respiratory diseases | ||||
Acute bronchitis | 10.30 (9.63, 10.96) | 11.11 (10.35, 11.87) | 14,082 (13,174, 14,983) | 11,905 (11,091, 12,713) |
Chronic bronchitis | 10.30 (9.27, 11.32) | 11.52 (10.35, 12.68) | 6540 (5887, 7187) | 5665 (5089, 6234) |
Asthma | 1.15 (0.03, 2.31) | 5.16 (3.69, 6.61) | 594 (16, 1196) | 1714 (1225, 2194) |
Respiratory allergy | 6.93 (6.01, 7.83) | 9.59 (8.59, 10.58) | 2335 (2026, 2641) | 2295 (2056, 2532) |
Dermatitis | 9.69 (9.13, 10.25) | 11.61 (11.06, 12.15) | 15,345 (14,457, 16,227) | 19,027 (18,128, 19,921) |
Food allergy | −5.42 (−7.07, −3.80) | −4.46 (−6.22, −2.73) | − 524 (− 683, − 367) | − 401 (− 559, − 246) |
Cystic fibrosis | −5.12 (− 32.35, 16.51) | −8.90 (− 37.10, 13.50) | −7 (− 43, 22) | −11 (− 47, 17) |
Adverse birth outcomes | ||||
Short gestation, low birth weight,foetal growth retardation | 29.83 (26.78, 32.75) | 28.21 (24.98, 31.29) | 2053 (1843, 2254) | 1757 (1556, 1949) |
Intrauterine hypoxia and birth asphyxia and trauma | 30.04 (25.40, 34.39) | 32.10 (26.54, 37.24) | 915 (774, 1048) | 675 (558, 783) |
Congenital anomalies | 11.51 (10.55, 12.45) | 8.19 (7.10, 9.26) | 8305 (7615, 8988) | 4742 (4115, 5362) |
Nervous system | ||||
Paralysis | 18.50 (10.39, 25.88) | 11.37 (1.81, 20.00) | 211 (118, 295) | 98 (16, 173) |
Epilepsy | 11.22 (6.86, 15.38) | 6.11 (1.21, 10.78) | 443 (270, 607) | 196 (39, 346) |
Circulatory system | ||||
Essential hypertension | 24.81 (17.73, 31.28) | 24.64 (16.36, 32.10) | 351 (251, 443) | 257 (171, 335) |
Heart valve disorders | 5.62 (3.87, 7.34) | 6.39 (4.43, 8.31) | 1340 (921, 1750) | 1218 (844, 1584) |
Acute cerebrovascular disease | 17.09 (5.93, 26.93) | 7.09 (−6.98, 19.31) | 107 (37, 169) | 30 (−30, 82) |
Others | ||||
Injuries | 7.54 (7.10, 7.98) | 7.17 (6.67, 7.68) | 19,432 (18,303, 20,555) | 14,758 (13,714, 15,796) |
Poisoning | 20.81 (14.22, 26.90) | 27.82 (21.26, 33.84) | 347 (237, 449) | 442 (337, 537) |