Poverty and health-related functional status of first-grade children in a Quebec birth cohort

Objective: To examine the effect of chronic poverty on health-related functional status among first-grade children, controlling for other family and neighborhood level explanatory variables. Methods: We used the first seven waves of the Quebec Longitudinal Study of Child Development which followed up annually a representative birth cohort of 2120 singletons since they were 5 months old. Functional status was assessed at age 6 by the number of days during which a child was too ill to play or attend school, as reported by the mother. Exposure to chronic poverty was operationalized as household income being on average below the yearly Canadian low-income cut-offs (LICO), over the 7-year follow-up period. We used logistic regression to predict accumulation of at least seven activity-restricted days. Results: Among the 1492 children followed until age 6, 16% grew up in chronic poverty. Seven or more activity-restricted days were accumulated by 18% of the poor children (sample average: 13%). Significant predictors of functional status were the number of asthma attacks (OR=2.0 [1.1-4.1] for 1-2 attacks, OR=4.0 [2.0-9.2] for more attacks), acute health problems (OR=1.9 [1.4-2.6]), social support, and use of daycare. Even after controlling for these factors, poor children remained more likely (OR=1.7 [1.1-3.0]) to have accumulated one week of activity-restriction, compared to those with a household averaging 300% or more of LICO. Conclusion: Poverty continues to compromise many children's health-related quality of life in Quebec. Acknowledgement: Canadian Institutes of Health Research #200309MOP-123079 and the Institut de la Statistique du Québec, Direction Santé Québec.