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Impact of social disadvantage on cerebral palsy severity
Author(s) -
Woolfenden Sue,
Galea Claire,
SmithersSheedy Hayley,
Blair Eve,
Mcintyre Sarah,
Reid Sue,
Delacy Michael,
Badawi Nadia
Publication year - 2019
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.14026
Subject(s) - cerebral palsy , disadvantage , neighbourhood (mathematics) , psychology , socioeconomic status , epilepsy , disadvantaged , medicine , pediatrics , psychiatry , political science , environmental health , population , mathematical analysis , mathematics , law
Aim To investigate the impact of socio‐economic disadvantage on indicators of cerebral palsy ( CP ) severity – motor impairment, intellectual disability, and the presence of severe comorbidities – in children with CP in Australia. Method Data from the Australian Cerebral Palsy Register were analysed. Socio‐economic disadvantage was assessed using maternal age, maternal country of birth, and a measure of neighbourhood socio‐economic status ( SES ) at the time of the child's birth. Descriptive bivariate analysis, trend analysis, risk ratios, and mediation analysis were undertaken to examine the impact of disadvantage on the indicators of CP severity. Results A socio‐economic gradient was demonstrated with an increasing proportion of children with non‐ambulant status, at least moderate intellectual disability, and the presence of severe comorbidities (having epilepsy, functional blindness, bilateral deafness, and/or no verbal communication) with decreasing neighbourhood SES , adolescent motherhood, and maternal minority ethnicity. Interpretation In Australia, socio‐economic disadvantage at birth impacts adversely on CP severity at age 5 years. By identifying that socio‐economically disadvantaged children with CP are at greater risk of more severe functional outcomes, we can inform targeted interventions at the family and neighbourhood level to reduce these inequities for children with CP . What this paper adds Socio‐economic disadvantage is associated with increased severity of cerebral palsy functional outcomes. This encompasses low neighbourhood socio‐economic status, adolescent motherhood, and maternal minority ethnicity.