Background and aims Coeliac Disease (CD) comprises an auto-immune enteropathy triggered by gluten. Population screening studies suggest a prevalence of 1% although many remain clinically undetected. It is a genetically determined disease but environment may play a role. The Aim of this study was to establish whether there is a relationship between socio-economic status and diagnosis of CD in childhood.
Methods Bristol Children’s Hospital is the single regional centre where children from Bristol and SW of England with suspected CD are referred. Prospective data on all children undergoing diagnostic endoscopy is kept and includes postcode of residence. Data on children between 1997 and 2011 and aged 16 years or younger at diagnosis has been analysed. The post code was used to determine index of multiple deprivation (IMD IO) score and rank. The score is a nationally consistent measure of how deprived an area is, pulling together individual indicators chosen to cover a range of economic, social and housing issues to provide an overall measure of socio-economic deprivation.
Results 467 children (293 females and 174 males) were diagnosed with endoscopy proven CD. The mean age at diagnosis was 89 months. 73 had a postcode within Bristol City. The study found a strong independent graded association between the incidence rate of CD and socio-economic status. The incidence rate of CD in SW of England was twice as high in the least deprived quintile compared to the most deprived, and in Bristol City it was three times as high.
Conclusion There is a strong association between the incidence rate of CD in children and socio economic status with a higher incidence in those who are least deprived suggesting environmental factors may be important.