Socioeconomic inequalities in health problems in the first two years of life: 2015 Pelotas Birth Cohort

Background: Brazil is characterized by an unfinished agenda of health inequalities which could cause greater occurrence of concomitant health problems in the childhood. Objective the aim of this study was to evaluate the socioeconomic inequalities of health problems in the early childhood (up to 24 months of age) in the 2015 Pelotas Birth Cohort. Methods: : Prospective cohort study, including all births that occurred in the city of Pelotas/RS between January 1 and December 31, 2015. The outcomes were health problems presented by the children at 12 and 24 months: cough, difficult breathing, diarrhea, ear pain, pneumonia, urinary infection, hospitalization, and other health problems. Socioeconomic inequalities were measured applying Slope Index of Inequality (SII) and Concentration Index (CIX) and using wealth index and maternal schooling as socioeconomic variables. Poisson regression was used to evaluate the association between the number of health problems and socioeconomic variables. Results: : The perinatal sample was comprised of 4275 children. At 12 and 24 months, approximately 74% and 44% presented 1 or more and 2 or more health problems, respectively. For all period, the average number of health problems was 2.9 (sd 2.0). Higher frequencies were observed for children belonging to the poorest income quintile and with lower maternal education, except for 1 or more health problems at 24 months. The greatest absolute and relative inequality was observed for 2 or more health problems at 12 months (SII -.23, CI95% -.29; -.18 and CIX -.19, CI95% -.25; -.14). Inequalities were smaller (2 or more problems) and absent (1 or more problems) at 24 months. There is an opposite dose-response relationship for the accumulation of health problems. Conclusion: The study confirms inequalities due to health problems in Brazilian children, especially in the first year of life.