Childhood eczema: disease of the advantaged?

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Abstract
Objective: To determine whether the increased prevalence of childhood eczema inadvantaged socioeconomic groups is due to increased parental reporting. Design: Comparison of parental reports of eczema with visible eczema recorded by medical officers during a detailed physical examination. Setting: National birth cohort study. Subjects: 8279 children from England, Wales, and Scotland born during 3-9 March 1958 and followed up at the ages of 7, 11, and 16. Main outcome measures: Prevalence of eczema according to parental report compared with medical officer's examination at the ages of 7, 11, and 16. Results: Prevalence of both reported and examined eczema increased with rising social class at the ages of 7, 11, and 16 years. The point prevalence of examined eczema at age 7 was 4.8%, 3.6%, 3.6%, 2.4%, 2.2%, and 2.4% in social classes I, II, III non-manual, III manual, IV, and V respectively (X2 value for linear trend 12.6, PConclusions: Eczema is more prevalent among British schoolchildren in social classes I and II than those in lower classes. Exposures associated with social class are probably at least as important as genetic factors in the expression of childhood eczema.