Social disadvantage and infection in childhood.

Although the literature on health inequalities in childhood is extensive, relatively little has been written about social differences in infectious disease. This is despite the strong association between poverty and infection noted historically, the continuing importance of infection as a cause of childhood mortality and morbidity, the resurgence of infectious disease as a public health problem and the increasing proportions of children living in poverty. This paper reviews the evidence, mainly from the United Kingdom, which shows that wide inequalities continue to occur in most types of infectious disease in childhood and the consequences stretch into adulthood. Possible reasons for the continuing association of poverty and infection in an age of high standards of hygiene, sanitation, and health care are discussed. Environmental and material factors are likely to have a stronger influence than social differences in behaviour, attitudes and lifestyle, and they can affect susceptibility to infection at the level of individuals, family, and community, and in access to health care. More emphasis needs to be placed on structural and community wide interventions than those directed at changing individual behaviour if a reduction in inequalities in childhood infection is to be achieved. [ABSTRACT FROM AUTHOR]