Addressing Socioeconomic Inequities in Children’s Cardiovascular Health via Positive Experiences
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Objectives
Socioeconomic disadvantage leads to poor cardiovascular health and this relationship may be mediated by positive childhood experiences. This study aimed to estimate the extent to which promoting positive experiences could reduce socioeconomic inequities in children’s cardiovascular health.
Methods
Data source: The Longitudinal Study of Australian Children Child Health CheckPoint (N=1874). Exposure: Maternal education (low/medium/high) as a key indicator of family socioeconomic position during pregnancy. Outcome: Cardiovascular health (11-12 years) (poor/good) quantified by four health behaviors and four health factors. Mediator: Multiple positive experiences (≥2/<2) indicated by positive parenting, supportive relationships, environments, and high social engagement (2-11 years). We conducted a causal mediation analysis using an interventional effects approach, adjusting for childhood adversity and other potential confounders.
Results
Children with low (risk difference=4.9%, 95% CI=-3.2%, 13.0%) or medium (risk difference=5.6%, 95% CI=-1.2%, 12.5%) maternal education had a higher risk of poor cardiovascular health compared to those with high maternal education. Causal mediation analysis estimated that increasing the levels of positive experiences in children with low or medium maternal education to be like their high maternal education peers could reduce these risk differences by 1.0% (95% CI= −0.8%,1.5%) and 0.5% (95% CI=-0.5%, 1.5%) respectively, reducing cardiovascular inequities by 20.4% and 8.9%.
Conclusions
Targeted policy interventions that promote positive experiences are potential opportunities to reduce socioeconomic inequities in children’s cardiovascular health. However, such interventions should be considered within a broader and multipronged approach that includes addressing socioeconomic disadvantage itself and other socially distributed drivers of cardiovascular diseases to achieve the maximum impact.
Article Summary
We explore the potential of positive childhood experience interventions to reduce socioeconomic inequities in children’s cardiovascular health.
What’s Known on This Subject
Socioeconomic disadvantage is associated with poor cardiovascular health. Positive childhood experiences are emerging as protective factors, but their potential to reduce socioeconomic inequities in children’s cardiovascular health remains unexplored.
What This Study Adds
Promoting positive experiences partially reduces socioeconomic inequities in children’s cardiovascular health. An integrated and multi-faceted approach that tackles the diverse drivers of cardiovascular health is essential to achieve the maximum impact.
