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Socioeconomic variation in the incidence of childhood coeliac disease in the UK.

Zingone, F and West, J and Crooks, CJ and Fleming, KM and Card, TR and Ciacci, C and Tata, LJ (2015) Socioeconomic variation in the incidence of childhood coeliac disease in the UK. Archives of Disease in Childhood., 100 (5). pp. 466-473. ISSN 1469-2052

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Abstract

BACKGROUND: Serological studies indicate that evidence of coeliac disease (CD) exists in about 1% of all children, but we lack estimates of current diagnostic patterns among children and how they vary by socioeconomic group. METHODS: We identified all children aged 0-18 years between 1993 and 2012 who were registered with general practices across the UK that contribute to a large population-based general practice database. The incidence of CD was evaluated in each quintile of the Townsend index of deprivation and stratified by age, sex, country and calendar year. RESULTS: Among 2,063,421 children, we identified 1247 CD diagnoses, corresponding to an overall CD incidence of 11.9 per 100,000 person-years, which was similar across the UK countries and higher in girls than in boys. We found a gradient of CD diagnosis across socioeconomic groups, with the rate of diagnosis being 80% higher in children from the least-deprived areas than in those from the most-deprived areas (incident rate ratio 1.80, 95% CI 1.45 to 2.22). This pattern held for both boys and girls and across all ages. Across all four countries of the UK, we found similar associations between CD and socioeconomic status. While CD incidence up to age 2 remained stable over the study period, diagnoses at older ages have almost tripled over the past 20 years. CONCLUSIONS: Children living in less socioeconomically deprived areas in the UK are more likely to be diagnosed with CD. Increased implementation of diagnostic guidelines could result in better case identification in more-deprived areas.

Item Type: Article
Uncontrolled Keywords: 1103 Clinical Sciences, 1114 Paediatrics And Reproductive Medicine, 1117 Public Health And Health Services
Subjects: R Medicine > RJ Pediatrics
R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
Divisions: Public Health Institute
Publisher: BMJ
Related URLs:
Date Deposited: 19 May 2016 10:30
Last Modified: 19 May 2016 10:30
DOI or Identification number: 10.1136/archdischild-2014-307105
URI: http://researchonline.ljmu.ac.uk/id/eprint/3623

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