Socioeconomic Status and Pediatric Neurologic Disorders: Current Evidence
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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