ESICRI · Effects of Socio-economic Inequalities in Childhood Respiratory Infections

Effects of Socio-economic Inequalities in Childhood Respiratory Infections

Respiratory infections (RIs) are the most common health problem in childhood, yet substantial inequalities in their burden persist across Europe. Children from disadvantaged socio-economic circumstances experience higher risks of severe RI outcomes, including hospitalisation, but the causal pathways underlying these inequalities remain poorly understood. Addressing this knowledge gap is essential for designing effective and equitable public health interventions. The Effects of Socio-economic Inequalities in Childhood Respiratory Infections (ESICRI) project aims to quantify and explain socio-economic inequalities in childhood RIs across Europe using the EU Child Cohort Network (EUCCN), which includes harmonised data on more than 200,000 children from 16 birth cohorts. Leveraging recent advances in federated analysis through DataSHIELD, ESICRI will conduct privacy-preserving multi-cohort analyses to investigate how social conditions and early-life risk factors jointly shape infection risk. The project has two main research objectives: (1) to characterise social and geographic patterns in childhood respiratory infections across Europe, and (2) to determine whether early-life environmental, behavioural, and psychosocial factors mediate the relationship between socio-economic circumstances and RI outcomes. ESICRI will address these objectives through three integrated work packages. First, large-scale federated epidemiological analyses will quantify inequalities in upper and lower respiratory tract infections and test interactions between socio-economic indicators and early-life exposures. Second, the project will develop dsMediation, a novel open-source DataSHIELD package enabling privacy-preserving multi-cohort causal mediation analysis. Third, the new functionality will be used to identify and quantify mediating pathways linking socio-economic disadvantage to childhood RIs. Methodologically, ESICRI goes beyond the state of the art by combining life-course epidemiology, causal inference, and federated analytics in a uniquely large European dataset. The project will implement both one-stage and two-stage individual participant data meta-analyses and apply counterfactual mediation methods within a secure distributed computing environment. Gender differences will be explicitly examined through adjustment and stratified analyses. ESICRI will deliver the first large-scale European evidence on mechanisms driving socio-economic inequalities in childhood respiratory infections and will provide the research community with a reusable open-source tool for federated mediation analysis. The findings could potentially be used to inform European policies aimed at reducing child health inequalities and improving early-life infection prevention strategies.

Data: CORDIS, © European Union