Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Department of Public Health and Primary Care, Centre Environment & Health, KU Leuven, Leuven, Belgium.
Eur J Public Health. 2023 Apr 1;33(2):179-183. doi: 10.1093/eurpub/ckad028.
Parental health literacy may explain the relationship between parental socioeconomic status (SES) and paediatric metabolic syndrome (MetS). For this reason, we assessed to what extent parental health literacy mediates the relationships between parental SES and paediatric MetS.
We used data from the prospective multigenerational Dutch Lifelines Cohort Study. Our sample consisted of 6683 children with an average follow-up of 36.2 months (SD 9.3) and a mean baseline age of 12.8 years (SD 2.6). We used natural effects models to assess the natural direct, natural indirect and total effects of parental SES on MetS.
On average, an additional 4 years of parental education, e.g. university instead of secondary school, would lead to continuous MetS (cMetS) scores that were 0.499 (95% confidence interval (CI): 0.364-0.635) units lower, which is a small effect (d: 0.18). If parental income and occupational level were 1 SD higher, on average cMetS scores were 0.136 (95% CI: 0.052-0.219) and 0.196 (95% CI: 0.108-0.284) units lower, respectively; these are both small effects (d: 0.05 and 0.07, respectively). Parental health literacy partially mediated these pathways; it accounted for 6.7% (education), 11.8% (income) and 8.3% (occupation) of the total effect of parental SES on paediatric MetS.
Socioeconomic differences in paediatric MetS are relatively small, the largest being by parental education. Improving parental health literacy may reduce these inequalities. Further research is needed into the mediating role of parental health literacy on other socioeconomic health inequalities in children.
父母的健康素养可能解释了父母社会经济地位（SES）与儿科代谢综合征（MetS）之间的关系。出于这个原因，我们评估了父母健康素养在多大程度上中介了父母 SES 与儿科 MetS 之间的关系。
我们使用了前瞻性多代荷兰 Lifelines 队列研究的数据。我们的样本包括 6683 名儿童，平均随访时间为 36.2 个月（SD9.3），基线平均年龄为 12.8 岁（SD2.6）。我们使用自然效应模型来评估父母 SES 对 MetS 的直接、间接和总效应。
平均而言，父母受教育年限增加 4 年，例如从中学到大学，连续 MetS（cMetS）评分将降低 0.499 个单位（95%置信区间[CI]：0.364-0.635），这是一个较小的效应（d：0.18）。如果父母的收入和职业水平提高一个标准差，平均 cMetS 评分将分别降低 0.136（95% CI：0.052-0.219）和 0.196（95% CI：0.108-0.284）个单位，这两个效应都较小（d：0.05 和 0.07）。父母的健康素养部分中介了这些途径；它占父母 SES 对儿科 MetS 的总效应的 6.7%（教育）、11.8%（收入）和 8.3%（职业）。
儿科 MetS 中的社会经济差异相对较小，最大的是父母的教育程度。提高父母的健康素养可能会减少这些不平等。需要进一步研究父母健康素养在儿童其他社会经济健康不平等方面的中介作用。
