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Social gradients in ADHD by household income and maternal education exposure during early childhood : findings from birth cohort studies across six countries
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Spencer, Nicholas James, Ludvigsson, Johnny, Bai, Guannan, Gauvin, Lise, Clifford, Susan A., Abu Awad, Yara, Goldhaber-Fiebert, Jeremy D., Markham, Wolfgang A., Faresjö, Åshild, White, Pär Andersson, Raat, Hein, Jansen, Pauline, Nikiema, Béatrice, Mensah, Fiona K. and McGrath, Jennifer J. (2022) Social gradients in ADHD by household income and maternal education exposure during early childhood : findings from birth cohort studies across six countries. PLoS ONE, 17 (3). e0264709. doi:10.1371/journal.pone.0264709
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Official URL: https://doi.org/10.1371/journal.pone.0264709
Abstract
Objective:
This study aimed to examine social gradients in ADHD during late childhood (age 9–11 years) using absolute and relative relationships with socioeconomic status exposure (household income, maternal education) during early childhood (<5 years) in seven cohorts from six industrialised countries (UK, Australia, Canada, The Netherlands, USA, Sweden).
Methods:
Secondary analyses were conducted for each birth cohort. Risk ratios, pooled risk estimates, and absolute inequality, measured by the Slope Index of Inequality (SII), were estimated to quantify social gradients in ADHD during late childhood by household income and maternal education measured during early childhood. Estimates were adjusted for child sex, mother age at birth, mother ethnicity, and multiple births.
Findings:
All cohorts demonstrated social gradients by household income and maternal education in early childhood, except for maternal education in Quebec. Pooled risk estimates, relating to 44,925 children, yielded expected gradients (income: low 1.83(CI 1.38,2.41), middle 1.42(1.13,1.79), high (reference); maternal education: low 2.13(1.39,3.25), middle 1.42(1.13,1.79)). Estimates of absolute inequality using SII showed that the largest differences in ADHD prevalence between the highest and lowest levels of maternal education were observed in Australia (4% lower) and Sweden (3% lower); for household income, the largest differences were observed in Quebec (6% lower) and Canada (all provinces: 5% lower).
Conclusion:
Findings indicate that children in families with high household income or maternal education are less likely to have ADHD at age 9–11. Absolute inequality, in combination with relative inequality, provides a more complete account of the socioeconomic status and ADHD relationship in different high-income countries. While the study design precludes causal inference, the linear relation between early childhood social circumstances and later ADHD suggests a potential role for policies that promote high levels of education, especially among women, and adequate levels of household income over children’s early years in reducing risk of later ADHD.
| Item Type: | Journal Article | ||||||||||||||||||||||||||||||||||||||||||||||||
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| Subjects: | R Medicine > RJ Pediatrics | ||||||||||||||||||||||||||||||||||||||||||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| SWORD Depositor: | Library Publications Router | ||||||||||||||||||||||||||||||||||||||||||||||||
| Library of Congress Subject Headings (LCSH): | Attention-deficit hyperactivity disorder , Attention-deficit-disordered children , Parents of attention-deficit-disordered children -- Economic conditions | ||||||||||||||||||||||||||||||||||||||||||||||||
| Journal or Publication Title: | PLoS ONE | ||||||||||||||||||||||||||||||||||||||||||||||||
| Publisher: | Public Library of Science | ||||||||||||||||||||||||||||||||||||||||||||||||
| ISSN: | 1932-6203 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Official Date: | 16 March 2022 | ||||||||||||||||||||||||||||||||||||||||||||||||
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| Volume: | 17 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Number: | 3 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Article Number: | e0264709 | ||||||||||||||||||||||||||||||||||||||||||||||||
| DOI: | 10.1371/journal.pone.0264709 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Status: | Peer Reviewed | ||||||||||||||||||||||||||||||||||||||||||||||||
| Publication Status: | Published | ||||||||||||||||||||||||||||||||||||||||||||||||
| Access rights to Published version: | Open Access | ||||||||||||||||||||||||||||||||||||||||||||||||
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