Elsevier

Seminars in Pediatric Neurology

Volume 27, October 2018, Pages 16-25
Seminars in Pediatric Neurology

Socioeconomic Status and Pediatric Neurologic Disorders: Current Evidence

https://doi.org/10.1016/j.spen.2018.03.003Get rights and content

Socioeconomic status (SES) is an important risk factor for many neurological disorders and a determinant of health outcomes and quality of life, especially for individuals with neurologic disorders and developmental disabilities. This article focuses on the relationship between SES and pediatric epilepsy, cerebral palsy, autism spectrum disorder, and intellectual disability. Disparities in the prevalence and long-term impact of SES on functioning in persons with disabilities are observed worldwide. Clinicians can use the information presented in the article to target early identification and interventions for improving outcomes in populations most at risk for these disorders and for poor health, social, and economic outcomes.

Introduction

It is an interesting paradox that the more we increase our understanding of the biologic basis for disease and disability, the more we appreciate the contribution of social factors to both the occurrence and quality of life of individuals with neurologic and developmental disorders of childhood. Socioeconomic status (SES) refers to the position of persons or families in society based on a combination of occupation, income and education.1 SES is a key determinant of health among all ages, but especially among children.2 Compared to their peers of higher SES, children and adolescents of socioeconomically disadvantaged families are more than twice as likely to experience acute illnesses as well as chronic health conditions such as asthma and obesity,2 mental disorders,3 and developmental delay.4 These associations are no less pronounced for children growing up in low and middle-income countries.5 The potential associations between SES and the causes of pediatric neurologic disorders are complex, as outlined in Table.

Here we provide a review of the literature on the relationship between SES and select neurological disorders of childhood, specifically, epilepsy, cerebral palsy (CP), autism spectrum disorder (ASD), and intellectual disability (ID). We describe the prevalence of the disorders by indicators of family SES and the influence of SES on quality of life and other outcomes of children and adults with these conditions.

Section snippets

Literature Review

An online search of the English-language, peer-reviewed medical literature was conducted in 2017 using MEDLINE and PubMed to examine the relation between SES and specific pediatric neurological disorders. Search terms included socioeconomic status, social class, maternal or paternal education paternal or maternal occupation, family income, or poverty and the outcomes of epilepsy, CP, ASD, ID, mental retardation, or developmental disabilities. Additional selection criteria for studies to review

Conclusion

We found that a literature review of published studies of SES and epilepsy, CP, ASD, and ID revealed complex and important relationships between SES and these neurologic conditions. The prevalence of ID, CP, and epilepsy is with considerable consistency found to be higher in children of lower SES families. Both the consistency of this association and the steepness of the inverse SES gradient in prevalence are greatest for ID. In contrast, findings related to ASD do not follow this same pattern

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    Financial disclosures: Authors have indicated that they have no financial relationships relevant to this article to disclose.

    Conflict of interest: Authors have indicated they have no potential conflicts of interest to disclose.

    CDC disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

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