Background: Socioeconomic status has been found to be associated with allergic diseases in children, but results are inconsistent. This study aimed to assess the association between household income and the development of allergic disease in children at 3 years old. Methods: We used data from 72,180 participants from the Japan Environment and Children’s Study, which is a prospective birth cohort study with participants recruited from January 2011 to March 2014. We examined the associations between household income and allergic diseases (asthma, eczema, and food allergies) in children, adjusting for covariates using multivariate logistic regression. Results: The percentages of doctor-diagnosed allergies at 3 years old were 7.5% for asthma, 7.2% for eczema, and 6.2% for food allergies. Children from households with an annual income of <2 million yen (approx. 18,000 USD) had a significantly higher risk of doctor-diagnosed asthma and eczema than those from households with an income of 4–6 million yen. The adjusted odds ratios (aORs) were 1.17 (95% confidence interval [CI] 1.03–1.34) and 1.21 (95% CI 1.06–1.39). Children from households with an income of >6 million yen tended to have an increased risk of food allergies (aOR 1.07, 95% CI 0.98–1.15). Conclusion: Low household income was a risk for doctor-diagnosed asthma and eczema, suggesting that public health professionals should recognize low-income groups as vulnerable populations for these conditions.

Keywords:
Allergic disease, Household income and socioeconomic status
1.
Uphoff E, Cabieses B, Pinart M, Valdés M, Antó JM, Wright J. A systematic review of socioeconomic position in relation to asthma and allergic diseases.
Eur Respir J
. 2015 Aug;46(2):364–74.
2.
Farfel A, Tirosh A, Derazne E, Garty BZ, Afek A. Association between socioeconomic status and the prevalence of asthma.
Ann Allergy Asthma Immunol
. 2010 Jun;104(6):490–5.
3.
Galobardes B, Granell R, Sterne J, Hughes R, Mejia-Lancheros C, Davey Smith G, et al. Childhood wheezing, asthma, allergy, atopy, and lung function: different socioeconomic patterns for different phenotypes.
Am J Epidemiol
. 2015 Nov 1;182(9):763–74.
4.
Kravitz-Wirtz N, Teixeira S, Hajat A, Woo B, Crowder K, Takeuchi D. Early-life air pollution exposure, neighborhood poverty, and childhood asthma in the United States, 1990–2014.
Int J Environ Res Public Health
. 2018 May 30;15(6):1114.
5.
Kuruvilla ME, Vanijcharoenkarn K, Shih JA, Lee FE. Epidemiology and risk factors for asthma.
Respir Med
. 2019 Mar;149:16–22.
6.
Harris JM, Cullinan P, Williams HC, Mills P, Moffat S, White C, et al. Environmental associations with eczema in early life.
Br J Dermatol
. 2001 Apr;144(4):795–802.
7.
Dom S, Droste JH, Sariachvili MA, Hagendorens MM, Bridts CH, Stevens WJ, et al. The influence of parental educational level on the development of atopic sensitization, wheezing and eczema during the first year of life.
Pediatr Allergy Immunol
. 2009 Aug;20(5):438–47.
8.
Civelek E, Sahiner UM, Yüksel H, Boz AB, Orhan F, Uner A, et al. Prevalence, burden, and risk factors of atopic eczema in schoolchildren aged 10-11 years: a national multicenter study.
J Investig Allergol Clin Immunol
. 2011;21(4):270–7.
9.
Lee KS, Rha YH, Oh IH, Choi YS, Choi SH. Socioeconomic and sociodemographic factors related to allergic diseases in Korean adolescents based on the Seventh Korea Youth Risk Behavior Web-based Survey: a cross-sectional study.
BMC Pediatr
. 2016 Jan 27;16:19.
10.
Sacotte R, Silverberg JI. Epidemiology of adult atopic dermatitis.
Clin Dermatol
. 2018 Sep–Oct;36(5):595–605.
11.
Victorino CC, Gauthier AH. The social determinants of child health: variations across health outcomes–a population-based cross-sectional analysis.
BMC Pediatr
. 2009 Aug 17;9:53.
12.
Metsälä J, Lundqvist A, Kaila M, Gissler M, Klaukka T, Virtanen SM. Maternal and perinatal characteristics and the risk of cow’s milk allergy in infants up to 2 years of age: a case-control study nested in the Finnish population.
Am J Epidemiol
. 2010 Jun 15;171(12):1310–6.
13.
Mullins RJ, Clark S, Camargo CA Jr. Socio-economic status, geographic remoteness and childhood food allergy and anaphylaxis in Australia.
Clin Exp Allergy
. 2010 Oct;40(10):1523–32.
14.
Gupta RS, Springston EE, Warrier MR, Smith B, Kumar R, Pongracic J, et al. The prevalence, severity, and distribution of childhood food allergy in the United States.
Pediatrics
. 2011 Jul;128(1):e9–17.
15.
Ben-Shoshan M, Harrington DW, Soller L, Fragapane J, Joseph L, Pierre YS, et al. Demographic predictors of peanut, tree nut, fish, shellfish, and sesame allergy in Canada.
J Allergy
. 2012;2012:858306.
16.
Civelek E, Cakir B, Orhan F, Yuksel H, Boz AB, Uner A, et al. Risk factors for current wheezing and its phenotypes among elementary school children.
Pediatr Pulmonol
. 2011 Feb;46(2):166–74.
17.
Miyake Y, Tanaka K, Sasaki S, Hirota Y. Parental employment, income, education and allergic disorders in children: a prebirth cohort study in Japan.
Int J Tuberc Lung Dis
. 2012 Jun;16(6):756–61.
18.
Sasaki M, Yoshida K, Adachi Y, Furukawa M, Itazawa T, Odajima H, et al. Environmental factors associated with childhood eczema: findings from a national web-based survey.
Allergol Int
. 2016 Oct;65(4):420–4.
19.
Nishioka D, Saito J, Ueno K, Kondo N. Single-parenthood and health conditions among children receiving public assistance in Japan: a cross-sectional study. 2020.
20.
Kawamoto T, Nitta H, Murata K, Toda E, Tsukamoto N, Hasegawa M, et al. Rationale and study design of the Japan environment and children’s study (JECS).
BMC public health
. 2014 Jan 10;14:25.
21.
Iwai-Shimada M, Nakayama SF, Isobe T, Michikawa T, Yamazaki S, Nitta H, et al. Questionnaire results on exposure characteristics of pregnant women participating in the Japan Environment and Children Study (JECS).
Environ Health Prev Med
. 2018 Sep 15;23(1):45.
22.
Yamamoto-Hanada K, Pak K, Saito-Abe M, Yang L, Sato M, Irahara M, et al. Allergy and immunology in young children of Japan: the JECS cohort.
World Allergy Organ J
. 2020 Nov;13(11):100479.
23.
Weiland SK, Björkstén B, Brunekreef B, Cookson WO, von Mutius E, Strachan DP. Phase II of the International Study of Asthma and Allergies in Childhood (ISAAC II): rationale and methods.
Eur Respir J
. 2004 Sep;24(3):406–12.
24.
Ellwood P, Asher MI, Beasley R, Clayton TO, Stewart AW. The international study of asthma and allergies in childhood (ISAAC): phase three rationale and methods.
Int J Tuberc Lung Dis
. 2005 Jan;9(1):10–6.
25.
Asher MI, Keil U, Anderson HR, Beasley R, Crane J, Martinez F, et al. International Study of Asthma and Allergies in Childhood (ISAAC): rationale and methods.
Eur Respir J
. 1995 Mar;8(3):483–91.
26.
Bager P, Wohlfahrt J, Westergaard T. Caesarean delivery and risk of atopy and allergic disease: meta-analyses.
Clin Exp Allergy
. 2008 Apr;38(4):634–42.
27.
Burke H, Leonardi-Bee J, Hashim A, Pine-Abata H, Chen Y, Cook DG, et al. Prenatal and passive smoke exposure and incidence of asthma and wheeze: systematic review and meta-analysis.
Pediatrics
. 2012 Apr;129(4):735–44.
28.
Nutten S. Atopic dermatitis: global epidemiology and risk factors.
Ann Nutr Metab
. 2015;66 Suppl 1:8–16.
29.
Castro-Rodriguez JA, Forno E, Rodriguez-Martinez CE, Celedón JC. Risk and protective factors for childhood asthma: what is the evidence?
J Allergy Clin Immunol Pract
. 2016 Nov–Dec;4(6):1111–22.
30.
Mitselou N, Hallberg J, Stephansson O, Almqvist C, Melén E, Ludvigsson JF. Cesarean delivery, preterm birth, and risk of food allergy: Nationwide Swedish cohort study of more than 1 million children.
J Allergy Clin Immunol
. 2018 Nov;142(5):1510–4.e2.
31.
Suzuki E, Shinozaki T, Yamamoto E. Causal diagrams: pitfalls and tips.
J Epidemiol
. 2020 Apr 5;30(4):153–62.
32.
Saijo Y, Yoshioka E, Sato Y, Miyamoto T, Azuma H, Tanahashi Y, et al. Parental educational level and childhood wheezing and asthma: a prospective cohort study from the Japan environment and children’s study.
PLoS One
. 2021 Apr;16(4):e0250255.
33.
van Tilburg Bernardes E, Arrieta MC. Hygiene hypothesis in asthma development: is hygiene to blame?
Arch Med Res
. 2017 Nov;48(8):717–26.
34.
Nakamura S. Parental income and child health in Japan.
J Japn Int Econ
. 2014;32:42–55.
35.
Lack G. Epidemiologic risks for food allergy.
J Allergy Clin Immunol
. 2008 Jun;121(6):1331–6.
36.
Brown SJ, Asai Y, Cordell HJ, Campbell LE, Zhao Y, Liao H, et al. Loss-of-function variants in the filaggrin gene are a significant risk factor for peanut allergy.
J Allergy Clin Immunol
. 2011 Mar;127(3):661–7.
© 2021 S. Karger AG, Basel
2021
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.