Do socioeconomic inequalities contribute to the high prevalence of child developmental risk in an ethnically diverse, socioeconomically disadvantaged population? A Born in Bradford’s Better Start (BiBBS) study

BACKGROUND: Socioeconomic inequalities in child development are pervasive; however, less is known regarding the impacts of socioeconomic factors within and across ethnically diverse and socioeconomically disadvantaged populations. This study (1) describes the prevalence of children at risk of poor overall early child development; (2) investigates the relationship between individual indicators of socioeconomic position and early child development; and (3) investigates if the relationship between indicators of socioeconomic position and early child development varies by ethnic group. METHODS: This study uses data from a prospective birth cohort study, Born in Bradford's Better Start (BiBBS). Child development was measured with the Ages and Stages Questionnaire (ASQ) during routine health visiting appointments at age 2-years-old. Binary logistic regression investigated child development by key maternal socioeconomic indicators: maternal education, financial security, social status (measured via the MacArthur Scale of Subjective Social Status), and social support (measured via number of people to count on). RESULTS: 22% of the 2003 children with a valid developmental assessment were at risk of poor child development. Mothers who had a degree (OR=1.95, 95% CI 1.28 to 2.99), reported 'living comfortably' in financial security (OR=1.78, 95% CI 1.03 to 3.07) and had higher social status (OR=1.11, 1.02 to 1.22); all had higher odds of their child having a good development. Though socioeconomic gradients in maternal education and financial security were consistent across White British, South Asian and Other ethnic groups, both social support and social status had weaker relationships with child development for South Asian parents. CONCLUSION: A high proportion of children are at risk of poor development in this diverse, socioeconomically disadvantaged population. Higher socioeconomic position may protect against poor early development, and the mechanisms underlying this may differ by ethnicity. The findings underline the need for proportionate universal strategies to improve child development in such communities.