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Abstract
Objective To investigate if socioeconomic gradients in health reduce during adolescence (the equalisation hypothesis) in four low-income and middle-income countries (LMIC).
Setting Analysis of the Young Lives Study cohorts in Ethiopia, Peru, Vietnam and India.
Participants A total of 3395 participants (across the four cohorts) aged 6–10 years at enrolment and followed up for 11 years.
Outcomes measured Change in income-related health inequalities from mid-childhood to late adolescence. Socioeconomic status was determined by wealth index quartile. The health indicators included were self-reported health, injuries in the previous 4 years, presence of long-term health problems, low mood, alcohol use, overweight/obesity, thinness and stunting. The relative risk of each adverse health outcome between highest and lowest wealth index quartile were compared across four waves of the study within each country.
Results We found steep socioeconomic gradients across multiple health indicators in all four countries. Socioeconomic gradients remained similar across all waves of the study, with no significant decrease during adolescence.
Conclusion We found no consistent evidence of equalisation for income-related health inequalities in youth in these LMIC. Socioeconomic gradients for health in these cohorts appear to persist and be equally damaging across the early life course and during adolescence.
- paediatrics
- epidemiology
- public health
- adolescent health
- health inequalities
- equalisation
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Footnotes
Contributors JLW and RMV contributed equally to study design/conception, performing the analysis, design of figures and writing the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Disclaimer The views expressed here are those of the authors and are not necessarily those of the Young Lives project, the University of Oxford, DFID or other funders.
Competing interests None declared.
Patient consent Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Data used in this study are publicly available at www.younglives.org.uk. All authors had full access to all of the data (including statistical reports and tables) in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis.