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From the Department of Social and Preventive Medicine and the Groupe de recherche interdisciplinaire en santé, Université de Montréal, Montréal, Que.
Correspondence to: Dr. Louise Séguin, Département de médecine sociale et préventive, Université de Montréal, CP 6128, Succursale Centre-Ville, Montréal QC H3C 3J7; fax 514 343-5645
Background: Few population-based studies have analyzed the link between poverty and infant morbidity. In this study, we wanted to determine whether inadequate income itself has an impact on infant health.
Methods: We interviewed 2223 mothers of 5-month-old children participating in the 1998 phase of the Quebec Longitudinal Study of Child Development to determine their infant's health and the sociodemographic characteristics of the household (including household income, breast-feeding and the smoking habits of the mother). Data on the health of the infants at birth were taken from medical records. We examined the effects of household income using Statistics Canada definitions of sufficient (above the low-income threshold), moderately inadequate (between 60% and 99% of the low-income threshold) and inadequate (below 60% of the low-income threshold) income on the mother's assessment of her child's overall health, her report of her infant's chronic health problems and her report of the number of times, if any, her child had been admitted to hospital since birth. In the analysis, we controlled for factors known to affect infant health: infant characteristics and neonatal health problems, the mother's level of education, the presence or absence of a partner, the duration of breast-feeding and the mother's smoking status.
Results: Compared with infants in households with sufficient incomes, those in households with lower incomes were more likely to be judged by their mothers to be in less than excellent health (moderately inadequate incomes: adjusted odds ratio [OR] 1.5, 95% confidence interval [CI] 1.1–2.1; very inadequate incomes: adjusted OR 1.8, 95% CI 1.3–2.6). Infants in households with moderately inadequate incomes were more likely to have been admitted to hospital (adjusted OR 1.8, 95% CI 1.2–2.6) than those in households with sufficient incomes, but the same was not true of infants in households with very inadequate incomes (adjusted OR 0.7, 95% CI 0.4–1.2). Household income did not significantly affect the likelihood of an infant having chronic health problems.
Interpretation: Less than sufficient household incomes are associated with poorer overall health and higher hospital admission rates among infants in the first 5 months of life, even after adjustment for factors known to affect infant health, including the mother's level of education.
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