Exploring the mediating roles of parenting & relationship quality in the association between early socioeconomic disparities and healthcare utilization for childhood allergic conditions: Longitudinal evidence from linked LSAC–medicare data

Introduction: Allergic diseases are an increasing public health concern among Australian children, with notable inequalities in healthcare utilization. This study examined how early socioeconomic status (SES) influences healthcare use for childhood allergic diseases, mediated by parenting style and parental relationship quality. Methods: Using data from a nationally representative longitudinal cohort, meditational analyses were conducted with a time-lagged design. Generalized structural equation modeling with a negative binomial family and logit link estimated direct and indirect effects. Statistical significance was defined as p < 0.05 or 95% bootstrapped confidence intervals excluding zero. Results: Allergic disease prevalence was 23.3% and 55% of affected children had high healthcare utilization. Higher SES was indirectly associated with increased healthcare use through parenting style (IRR = 1.27, p < 0.05) and parental relationship quality (IRR = 1.91, p < 0.05). Sequential mediation was significant (IRR = 1.29, p < 0.05), with a strong total indirect effect (IRR = 2.07, p < 0.05) and a substantial overall total effect (IRR = 2.44, p < 0.05). Conclusion: Parenting style and parental relationship quality partially mediate the SES-healthcare utilization relationship. Strengthening family dynamics alongside addressing socioeconomic inequities will improve equitable healthcare access for children with allergic diseases.