Researchers conducted a population-based study of children with epilepsy from Nova Scotia, Canada, each of whom had access to universal health care. The findings suggest that those who came from poorer economic backgrounds had the same medical course and readmission rate as their wealthier counterparts, but they had less favorable social outcomes growing up.
The study, “Poor versus rich children with epilepsy have the same clinical course and remission rates but a less favorable social outcome: A population-based study with 25 years of follow-up,” was published in the latest issue of Epilepsia, the official journal of the International League Against Epilepsy (ILAE). Dr. Carol Camfield is the lead author of the published paper.
The objective of the study was to explore how a series of estimates of family socioeconomic status influenced the long-term clinical course and social outcomes of children with epilepsy.
Researchers analyzed 421 children with new onset epilepsy diagnosed between 1977 and 1985 in Nova Scotia. At the time of epilepsy onset, information was gathered on parental income, education, and home ownership. Patients were followed for an average of 26 years to assess long-term outcomes.
At the onset of a seizure, the researchers assessed total family income and classified patients into three categories: poor (first quintile), adequate (second to third quintiles), and well-off (fourth to fifth quintiles).
They found that remission of epilepsy happened in 65 percent of poor patients, in 61 percent of adequate patients, and in 61 percent of well-off patients. All groups recorded similar intractable epilepsy, number of antiepileptic drugs used, and number of seizures.
Poorer children suffered from adverse social outcomes more frequently, including failing to graduate from high school, getting inadvertently pregnant, or facing unemployment or personal challenges, as well as psychiatric diagnoses.
The study found that home ownership did not predict remission and neither paternal nor maternal education was associated with remission.
“In Nova Scotia, with access to universal health care, children with epilepsy who come from either a poor or more affluent family have a similar clinical course and long-term seizure outcome of childhood epilepsy. Unfortunately, children who come from poor families are less likely to have a good social outcome, and they often experience significant social difficulties in later adulthood,” Camfield said in a press release.