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Is socioeconomic position associated with bronchiolitis seasonality? A cohort study

Lewis, K; De Stavola, B; Hardelid, P; (2020) Is socioeconomic position associated with bronchiolitis seasonality? A cohort study. Journal of Epidemiology & Community Health 10.1136/jech-2019-213056. (In press). Green open access

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Abstract

BACKGROUND: Understanding differences in the seasonality of bronchiolitis can help to plan the timing of interventions. We quantified the extent to which seasonality in hospital admissions for bronchiolitis is modified by socioeconomic position. METHODS: Using Hospital Episode Statistics, we followed 3 717 329 infants born in English National Health Service hospitals between 2011 and 2016 for 1 year. We calculated the proportion of all infant admissions due to bronchiolitis and the incidence rate of bronchiolitis admissions per 1000 infant-years, according to year, month, age, socioeconomic position and region. We used harmonic Poisson regression analysis to assess whether socioeconomic position modified bronchiolitis seasonality. RESULTS: The admission rate for bronchiolitis in England increased from 47.4 (95% CI 46.8 to 47.9) to 58.9 per 1000 infant-years (95% CI 58.3 to 59.5) between 2012 and 2016. We identified some variation in the seasonality of admissions by socioeconomic position: increased deprivation was associated with less seasonal variation and a slightly delayed epidemic peak. At week 50, the risk of admission was 38% greater (incidence rate ratios 1.38; 95% CI 1.35 to 1.41) for infants in the most deprived socioeconomic group compared with the least deprived group. CONCLUSION: These results do not support the need for differential timing of prophylaxis or vaccination by socioeconomic group but suggest that infants born into socioeconomic deprivation should be considered a priority group for future interventions. Further research is needed to establish if the viral aetiology of bronchiolitis varies by season and socioeconomic group, and to quantify risk factors mediating socioeconomic deprivation and bronchiolitis rates.

Type: Article
Title: Is socioeconomic position associated with bronchiolitis seasonality? A cohort study
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/jech-2019-213056
Publisher version: http://dx.doi.org/10.1136/jech-2019-213056
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.
Keywords: Infection, child health, inequalities, respiratory DI, social epidemiology
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10111352
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