Associations of Parental Education With Children’s Infectious Diseases and Their Mediating Factors: The Japan Environment and Children’s Study (JECS)

Background: Parents’ educational background is presumed to influence the incidence of vaccine-preventable diseases in children through their decisions about vaccinations and other family lifestyle choices. Regarding voluntary vaccination, a household’s economic situation may also be associated with non-vaccination. Therefore, this study investigated the association between parental education and vaccine-preventable diseases (varicella, mumps, influenza [flu], pertussis, measles, and rubella) in children, which currently remains elusive. Methods: We used datasets from the Japan Environment and Children’s Study, which included 104,062 fetal records; our study population comprised 80,930 children up to the age of 3 years. The associations between parental educational background and children’s infectious diseases were examined using binomial logistic regression analysis. The mediating effects of household income, vaccination, and smoking were examined using a path analysis. Results: For varicella, mumps, and influenza covered by voluntary vaccination, a higher education level of the father was associated with a lower incidence of infection. The association between mothers’ education and children’s infection was limited. There were both income-mediated and non-income-mediated pathways between parental education and voluntary vaccination. For pertussis, measles, and rubella, which are covered by routine vaccines, there was no association between parental education and the child’s infection. Conclusion: An association between parental education and childhood infections was observed. Providing financial support for vaccination and communicating the benefits of vaccination in a way that parents at all levels of education can understand may help reduce the incidence of infectious diseases among children.