Introduction
Methods
Subjects
Linkage between ALSPAC and the GPRD
Social position data
Multimorbidity measures
Statistical methods
Grouping of socio-economic position variables
Analyses of multimorbidity measures
Exclusion criteria
Results
Socio-economic position variables
Socio-economic marker | Frequency (%) | |
---|---|---|
Maternal education (n = 460) | CSE/vocational/lower | 153 (33.3%) |
O level | 182 (39.6%) | |
A level | 85 (18.5%) | |
Degree | 40 (8.7%) | |
Paternal education (n = 376) | CSE/vocational/lower | 99 (26.3%) |
O level | 90 (23.9%) | |
A level | 127 (33.8%) | |
Degree | 60 (16.0%) | |
Occupational social class (n = 419) | I | 13 (3.1%) |
II | 91 (21.7%) | |
III non-manual | 93 (22.2%) | |
III manual | 118 (28.2%) | |
IV | 84 (20.1%) | |
V | 20 (4.8%) | |
Housing tenure during pregnancy (n = 483) | Mortgaged/owned | 320 (66.3%) |
Private rented | 33 (6.8%) | |
Council rented/housing association | 130 (26.9%) | |
Long family adversity index during pregnancy (n = 484) | 0 | 169 (34.9%) |
1 | 133 (27.5%) | |
2 | 81 (16.7%) | |
3 | 42 (8.7%) | |
4 | 17 (3.5%) | |
5 | 15 (3.1%) | |
6 | 12 (2.5%) | |
7 | 11 (2.3%) | |
8 or 9 | 4 (0.8%) | |
Townsend score (n = 620) | 1st decile (least deprived) | 63 (10.2%) |
2 | 76 (12.3%) | |
3 | 40 (6.5%) | |
4 | 57 (9.2%) | |
5 | 69 (11.1%) | |
6 | 68 (11.0%) | |
7 | 59 (9.5%) | |
8 | 86 (13.9%) | |
9 | 46 (7.4%) | |
10th (most deprived) | 56 (9.0%) |
Multimorbidity measures
ACG | Age 51 | Age 101 | Age 151 |
---|---|---|---|
Non-user | 68 (22.6%) | 119 (28.7%) | 78 (17.9%) |
No diagnoses | 19 (6.3%) | 77 (18.6%) | 99 (22.8%) |
Acute minor | 62 (20.6%) | 67 (16.2%) | 67 (15.4%) |
Acute minor and likely to recur (with or without allergies) | 58 (19.3%) | 26 (6.3%) | 23 (5.3%) |
Likely to recur (with or without allergies) | 29 (9.6%) | 38 (9.2%) | 46 (10.6%) |
Acute minor and major | 13 (4.3%) | 18 (4.4%) | 9 (2.1%) |
Acute major | 6 (2.0%) | 11 (2.7%) | 24 (5.5%) |
2–3 other ADGs | 16 (5.3%) | 16 (3.9%) | 29 (6.7%) |
Other ACGs | 30 (10.0%) | 42 (10.1%) | 60 (13.8%) |
301 | 414 | 435 | |
Resource Utilisation Band | |||
Non-user | 68 (22.6%) | 119 (28.7%) | 78 (17.9%) |
Healthy user2 | 87 (28.9%) | 150 (36.2%) | 177 (40.7%) |
Low morbidity2 | 124 (41.2%) | 131 (31.6%) | 151 (34.7%) |
Moderate morbidity2 | 22 (7.3%) | 14 (3.4%) | 28 (6.4%) |
High morbidity2 | 0 | 0 | 1 (0.2%) |
Very high morbidity2 | 0 | 0 | 0 |
301 | 414 | 435 |
Relationship between multimorbidity measures and socio-economic position
Chronic condition counts
Socio-economic marker | Number of chronic conditions while aged 0–9 years (% within SEP category) | χ2; p-value | |||
---|---|---|---|---|---|
0 | 1 | 2 or more | |||
Mother’s education | O level or lower | 35 (34.3%) | 34 (33.3%) | 33 (32.4%) | χ22 = 7.9; p = 0.02 |
A level or degree | 20 (58.8%) | 10 (27.4%) | 4 (11.8%) | ||
Father’s education | O level or lower | 23 (31.5%) | 27 (37.0%) | 23 (31.5%) | χ22 = 4.3; p = 0.1 |
A level or degree | 32 (50.8%) | 17 (27.0%) | 14 (22.2%) | ||
Family social class | I, II, III non-manual | 31 (49.2%) | 18 (28.6%) | 14 (22.2%) | χ22 = 3.8; p = 0.1 |
III manual, IV V | 24 (32.9%) | 26 (35.6%) | 23 (31.5%) | ||
Housing tenure (in pregnancy) | Owned/mortgaged | 48 (42.9%) | 35 (31.3%) | 29 (25.9%) | χ22 = 1.0; p = 0.5 |
Other | 7 (29.2%) | 9 (37.5%) | 8 (33.3%) | ||
Family adversity index | 0 | 25 (44.6%) | 18 (32.1%) | 13 (23.2%) | χ62 = 4.4; p = 0.6 |
1 | 17 (42.5%) | 13 (32.5%) | 10 (25.0%) | ||
2 | 6 (30.0%) | 5 (25.0%) | 9 (45.0%) | ||
≥3 | 7 (35.0%) | 8 (40.0%) | 5 (25.0%) | ||
Townsend score (quintile) | 1st (least deprived) | 18 (40.9%) | 15 (34.1%) | 11 (25.0%) | χ62 = 2.1; p = 0.9 |
2 | 11 (40.7%) | 7 (25.9%) | 9 (33.3%) | ||
3 | 8 (33.3%) | 10 (41.7%) | 6 (25.0%) | ||
4th & 5th (most deprived)1 | 18 (43.9%) | 12 (29.3%) | 11 (26.8%) | ||
Number of chronic conditions while aged 10–18 years (% within SEP category) | |||||
0 | 1 | 2 or more | |||
Mother’s education | O level or lower | 121 (58.7%) | 60 (29.1%) | 25 (12.1%) | χ22 = 9.2; p = 0.01 |
A level or degree | 45 (45.5%) | 29 (29.3%) | 25 (25.3%) | ||
Father’s education | O level or lower | 85 (54.1%) | 49 (31.2%) | 23 (14.7%) | χ22 = 1.1; p = 0.6 |
A level or degree | 81 (54.7%) | 40 (27.0%) | 27 (18.2%) | ||
Family social class | I, II, III non-manual | 79 (49.7%) | 48 (30.2%) | 32 (20.1%) | χ22 = 4.3; p = 0.1 |
III manual, IV V | 87 (59.6%) | 41 (28.1%) | 18 (12.3%) | ||
Housing tenure | Mortgaged/owned | 118 (51.5%) | 70 (30.6%) | 41 (17.9%) | χ22 = 3.3; p = 0.2 |
Other | 48 (63.2%) | 19 (25.0%) | 9 (11.8%) | ||
Family adversity index | 0 | 60 (49.6%) | 43 (35.5%) | 18 (14.9%) | χ62 = 4.5; p = 0.6 |
1 | 53 (56.4%) | 25 (26.6%) | 16 (17.0%) | ||
2 | 29 (61.7%) | 10 (21.3%) | 8 (17.0%) | ||
≥3 | 24 (55.8%) | 11 (25.6%) | 8 (18.6%) | ||
Townsend score (quintile) | 1st (least deprived) | 51 (58.0%) | 25 (28.4%) | 12 (13.6%) | χ82 = 4.1; p = 0.8 |
2 | 31 (55.4%) | 16 (28.6%) | 9 (16.1%) | ||
3 | 35 (48.0%) | 21 (28.8%) | 17 (23.3%) | ||
4 | 33 (55.0%) | 18 (30.0%) | 9 (15.0%) | ||
5th (most deprived) | 16 (57.1%) | 9 (32.1%) | 3 (10.7%) |
Drug counts
Socio-economic marker | Drug counts age 0-9 | |||
---|---|---|---|---|
Number of drugs/person | Rate ratio (95% CI) | p-value | ||
Mother’s education | O level or lower | 1107/69 = 16.0 | 1.00 | p = 0.4 |
A level or degree | 195/14 = 13.9 | 0.87 (0.64, 1.18) | ||
Father’s education | O level or lower | 902/53 = 17.0 | 1.00 | p = 0.04 |
A level or degree | 400/30 = 13.3 | 0.78 (0.62, 0.99) | ||
Family social class | I, II, III non-manual | 506/33 = 15.3 | 1.00 | p = 0.8 |
III manual, IV V | 796/50 = 15.9 | 1.04 (0.82, 1.32) | ||
Housing tenure (in pregnancy) | Owned/mortgaged | 1096/69 = 15.9 | 1.00 | p = 0.3 |
Other | 206/14 = 14.7 | 0.93 (0.68, 1.26) | ||
Family adversity index | 0 | 498/31 = 16.1 | 1.00 | p = 0.6 |
1 | 404/25 = 16.2 | } 0.97 (0.88, 1.09) | ||
2 | 199/14 = 14.2 | |||
≥3 | 201/13 = 15.5 | |||
Townsend score (quintile) | 1st (least deprived) | 404/25 = 16.2 | 1.00 | p = 0.9 |
2 | 250/18 = 13.9 | } 1.00 (0.95, 1.04)2 | ||
3 | 309/18 = 17.2 | |||
4 & 5th (most deprived)1 | 339/22 = 15.4 | |||
Drug counts age 10-18 | ||||
Number of drugs/person | Rate ratio | p-value | ||
Mother’s education | O level or lower | 758/95 = 8.0 | 1.00 | p = 1.0 |
A level or degree | 410/51 = 8.0 | 1.01 (0.79, 1.28) | ||
Father’s education | O level or lower | 634/75 = 8.5 | 1.00 | p = 0.3 |
A level or degree | 534/71 = 7.5 | 0.89 (0.71, 1.12) | ||
Family social class | I, II, III non-manual | 601/80 = 7.5 | 1.00 | p = 0.3 |
III manual, IV V | 567/66 = 8.6 | 1.14 (0.91, 1.44) | ||
Housing tenure | Mortgaged/owned | 922/113 =8.2 | 1.00 | p = 0.5 |
Other | 246/33 = 7.5 | 0.91 (0.69, 1.21) | ||
Family adversity index | 0 | 452/63 = 7.2 | 1.00 | p = 0.2 |
1 | 430/49 = 8.8 | } 1.07 (0.96, 1.21) | ||
2 | 151/19 = 7.9 | |||
≥3 | 135/15 = 9.0 | |||
Townsend score (quintile) | 1st (least deprived) | 414/54 = 7.7 | 1.00 | p = 0.6 |
2 | 152/23 = 6.6 | } 1.01 (0.97, 1.05)2 | ||
3 | 335/36 = 9.3 | |||
4 | 176/22 = 8.0 | |||
5th (most deprived) | 91/11 = 8.3 |
Resource utilisation bands
Socio-economic marker | Resource Utilisation Band at age 5 (% within SEP category) | ||||
---|---|---|---|---|---|
Non-user | Healthy user | Low or moderate morbidity | χ2; p-value | ||
Mother’s education | O level or lower | 24 (22.0%) | 32 (29.4%) | 53 (48.6%) | χ22 = 2.9; p = 0.2 |
A level or degree | 14 (35.9%) | 9 (23.1%) | 16 (41.0%) | ||
Father’s education | O level or lower | 20 (26.0%) | 23 (29.9%) | 34 (44.2%) | χ22 = 0.5; p = 0.8 |
A level or degree | 18 (25.4%) | 18 (25.4%) | 35 (49.3%) | ||
Family social class | I, II, III non-manual | 23 (31.1%) | 20 (27.0%) | 31 (41.9%) | χ22 = 2.4; p = 0.3 |
III manual, IV V | 15 (20.3%) | 21 (28.4%) | 38 (51.4%) | ||
Housing tenure (in pregnancy) | Owned/mortgaged | 27 (22.5%) | 38 (31.7%) | 55 (45.8%) | χ22 = 6.2; p = 0.05 |
Other | 11 (39.3%) | 3 (10.7%) | 14 (50.0%) | ||
Family adversity index | 0 | 18 (28.1%) | 19 (29.7%) | 27 (42.2%) | χ62 = 9.8; p = 0.1 |
1 | 11 (26.2%) | 6 (14.3%) | 25 (59.5%) | ||
2 | 4 (19.1%) | 6 (28.6%) | 11 (52.4%) | ||
≥3 | 5 (23.8%) | 10 (47.6%) | 6 (28.6%) | ||
Townsend score (quintile) | 1st (least deprived) | 9 (18.0%) | 16 (32.0%) | 25 (50.0%) | χ62 = 4.2; p = 0.6 |
2 | 11 (37.9%) | 6 (20.7%) | 12 (41.4%) | ||
3 | 8 (28.6%) | 8 (28.6%) | 12 (42.9%) | ||
4th or 5th (most deprived)1 | 10 (24.4%) | 11 (26.8%) | 20 (48.8%) |
Socio-economic marker | Resource Utilisation Band at age 10 (% within SEP category) | ||||
---|---|---|---|---|---|
Non-user | Healthy user | Low or moderate morbidity | χ2; p-value | ||
Mother’s education | O level or lower | 45 (35.4%) | 37 (29.1%) | 45 (35.4%) | χ22 = 2.3; p = 0.3 |
A level or degree | 20 (29.4%) | 27 (39.7%) | 21 (30.9%) | ||
Father’s education | O level or lower | 32 (32.7%) | 30 (30.6%) | 36 (36.7%) | χ22 = 0.8; p = 0.7 |
A level or degree | 33 (34.0%) | 34 (35.1%) | 30 (30.9%) | ||
Family social class | I, II, III non-manual | 35 (34.3%) | 31 (30.4%) | 36 (35.3%) | χ22 = 0.6; p = 0.7 |
III manual, IV V | 30 (32.3%) | 33 (35.5%) | 30 (32.3%) | ||
Housing tenure (in pregnancy) | Owned/mortgaged | 47 (31.3%) | 54 (36.0%) | 49 (32.7%) | χ22 = 3.0; p = 0.2 |
Other | 18 (40.0%) | 10 (22.2%) | 17 (37.8%) | ||
Family adversity index | 0 | 31 (36.9%) | 27 (32.1%) | 26 (31.0%) | χ62 = 3.1; p = 0.8 |
1 | 17 (29.3%) | 19 (32.8%) | 22 (37.9%) | ||
2 | 12 (40.0%) | 9 (30.0%) | 9 (30.0%) | ||
≥3 | 5 (21.7%) | 9 (39.1%) | 9 (39.1%) | ||
Townsend score (quintile) | 1st (least deprived) | 19 (28.8%) | 24 (36.4%) | 23 (34.9%) | χ62 = 13.5; p = 0.04 |
2 | 10 (28.6%) | 17 (48.6%) | 8 (22.9%) | ||
3 | 17 (38.6%) | 6 (13.6%) | 21 (47.7%) | ||
4th and 5th (most deprived)1 | 19 (38.0%) | 17 (34.0%) | 14 (28.0%) |
Socio-economic marker | Resource Utilisation Band at age 15 (% within SEP category) | ||||
---|---|---|---|---|---|
Non-user | Healthy user | Low or moderate morbidity | χ2; p-value | ||
Mother’s education | O level or lower | 28 (20.3%) | 56 (40.6%) | 54 (39.1%) | χ22 = 5.4; p = 0.07 |
A level or degree | 7 (9.3%) | 29 (38.7%) | 39 (52.0%) | ||
Father’s education | O level or lower | 17 (15.6%) | 47 (43.1%) | 45 (41.3%) | χ22 = 1.0; p = 0.6 |
A level or degree | 18 (17.3%) | 38 (36.5%) | 48 (46.2%) | ||
Family social class | I, II, III non-manual | 16 (13.6%) | 46 (39.0%) | 56 (47.5%) | χ22 = 2.3; p = 0.3 |
III manual, IV V | 19 (20.0%) | 39 (41.1%) | 37 (39.0%) | ||
Housing tenure (in pregnancy) | Owned/mortgaged | 27 (16.5%) | 67 (40.9%) | 70 (42.7%) | χ22 = 0.3; p = 0.9 |
Other | 8 (16.3%) | 18 (36.7%) | 23 (46.9%) | ||
Family adversity index | 0 | 16 (18.8%) | 32 (37.7%) | 37 (43.5%) | χ62 = 3.2; p = 0.8 |
1 | 10 (14.9%) | 27 (40.3%) | 30 (44.8%) | ||
2 | 7 (18.9%) | 17 (46.0%) | 13 (35.1%) | ||
≥3 | 2 (8.3%) | 9 (37.5%) | 13 (54.2%) | ||
Townsend score (quintile) | 1st (least deprived) | 10 (15.4%) | 26 (40.0%) | 29 (44.6%) | χ62 = 2.8; p = 0.8 |
2 | 9 (21.4%) | 19 (45.2%) | 14 (33.3%) | ||
3 | 8 (16.7%) | 17 (35.4%) | 23 (47.9%) | ||
4th and 5th (most deprived)1 | 8 (13.8%) | 23 (39.7%) | 27 (46.6%) |