Moustgaard Heta, Moore Elina, Malmberg Satu, Tarkiainen Lasse, Martikainen Pekka
The Social Insurance Institution of Finland, Helsinki, Finland
Helsinki Institute for Demography and Population Health, University of Helsinki, Helsinki, Finland.
J Epidemiol Community Health. 2025 May 9;79(6):424-430. doi: 10.1136/jech-2024-222129.
Low family socioeconomic position is a well-established determinant of poor health in youth. Much less is known about the social patterning of youth medication use, and the current evidence is mixed. Furthermore, previous studies have not assessed important confounders of the associations. We analyse differences in youth medication use by childhood family income and medication type.
Administrative register data on full Finnish cohorts born in 1979-2003 (n=1 490 666) and survival analysis were used to assess the risk of using common prescription medications between ages 16 and 20 according to mean household income in ages 11-15, accounting for several observed familial characteristics including parental health. We also compared siblings with discordant childhood income exposures to assess whether any differences are explained by unobserved familial confounding.
For each 10% increase in childhood family income, there was a 0.6%-1.7% increase in the probability of using the most common prescription medications: antibiotics, painkillers, and allergy and asthma medications. In contrast, a 10% increase in childhood income was related to a 2.5% decrease in the probability of psychotropic medication use. In sibling comparisons, childhood income was not associated with any type of medication use.
Apart from psychotropics, the results may indicate medication underuse among youth from low-income families. The sibling comparisons suggest that moderate differences in childhood income are unlikely to cause differences in youth medication use and thus, in contexts of relative income equality, income differences in medication use are likely to reflect other, unobserved, family factors shared by siblings.
家庭社会经济地位低下是青少年健康状况不佳的一个公认决定因素。关于青少年药物使用的社会模式，人们了解得要少得多，而且目前的证据也参差不齐。此外，先前的研究并未评估这些关联的重要混杂因素。我们分析了童年家庭收入和药物类型对青少年药物使用的差异。
利用1979 - 2003年出生的芬兰全队列行政登记数据（n = 1490666）和生存分析，根据11 - 15岁时的家庭平均收入，评估16至20岁之间使用常见处方药的风险，同时考虑包括父母健康状况在内的几个观察到的家庭特征。我们还比较了童年收入暴露情况不一致的兄弟姐妹，以评估是否可以用未观察到的家庭混杂因素来解释任何差异。
童年家庭收入每增加10%，使用最常见处方药（抗生素、止痛药以及过敏和哮喘药物）的概率就增加0.6% - 1.7%。相比之下，童年收入增加10%与使用精神药物的概率降低2.5%有关。在兄弟姐妹的比较中，童年收入与任何类型的药物使用均无关联。
除了精神药物外，研究结果可能表明低收入家庭的青少年存在药物使用不足的情况。兄弟姐妹的比较表明，童年收入的适度差异不太可能导致青少年药物使用的差异，因此，在相对收入平等的情况下，药物使用方面的收入差异可能反映了兄弟姐妹共有的其他未观察到的家庭因素。
