Increased household financial strain, the Great Recession and child health-findings from the UK Millennium Cohort Study.
Increased household financial strain, the Great Recession and child health-findings from the UK Millennium Cohort Study.
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DOI：
10.1136/bmjopen-2016-015559
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发表时间：
2017-03-09
期刊：
影响因子：
2.9
通讯作者：
Pearce A
中科院分区：
文献类型：
--
作者：
McKenna C;Law C;Pearce A
越来越多的证据表明，经济压力(FS)与健康状况不佳有关，但这项研究的大部分都是横断面的，而且是针对成年人的。在“大衰退”期间，许多英国家庭经历了FS的增加。这项研究的主要目的是确定FS增加对儿童健康的影响。我们分析了千年队列研究，这是一项对2000至2002年间在英国出生的儿童进行的纵向研究。7个 年(T1,2008)和11个 年(T2,2012)的调查跨越了“大衰退”。定义了增加FS的三个衡量标准：“变得收入差”(自我报告的家庭收入在T1和T2之间降至“贫困线”以下)；“发展中的管理困难”(父母报告在T1时“经济上舒适”，但在T2时“难以管理”)；“感觉更差”(父母报告在T2时感觉经济上比T1更差)。使用泊松回归估计6种儿童健康结局的风险比(RR)、调整后的风险比(ARR)和95%的CI：测量的超重/肥胖、父母和教师评分的问题行为、父母报告的一般健康/较差、长期患病和T2时尿床(N=13 112)。在子分析中，我们将样本限制在t2贫困线以上的人。与那些在这两个时间点上没有经济压力的人相比，那些经历了FS增加的家庭的孩子接受所有不健康结果检查的风险增加。在大多数情况下，在对混淆因素进行调整并将样本限制在贫困线以上的人之后，这些增加的风险仍然存在。FS与一系列新的或持续的不良儿童健康结局有关。在大范围的经济困难时期，例如“大衰退”，应采取措施缓冲儿童及其家庭免受金融风暴的影响，而这些措施不应仅限于收入较低的人。
There is a growing body of evidence associating financial strain (FS) with poor health but most of this research has been cross-sectional and adult-focused. During the ‘Great Recession’ many UK households experienced increased FS. The primary aim of this study was to determine the impact of increased FS on child health. We analysed the Millennium Cohort Study, a longitudinal study of children born in the UK between 2000 and 2002. Surveys at 7 years (T1, 2008) and 11 years (T2, 2012) spanned the ‘Great Recession’. Three measures of increased FS were defined; ‘became income poor’ (self-reported household income dropped below the ‘poverty line’ between T1 and T2); ‘developed difficulty managing’ (parental report of being ‘financially comfortable’ at T1 and finding it ‘difficult to manage’ at T2); ‘felt worse off’ (parental report of feeling financially ‘worse off’ at T2 compared with T1). Poisson regression was used to estimate risk ratios (RR), adjusted risk ratios (aRR) and 95% CIs for six child health outcomes: measured overweight/obesity, problematic behaviour as scored by parents and teachers, and parental reports of fair/poor general health, long-standing illness and bedwetting at T2 (N=13 112). In subanalyses we limited our sample to those who were above the poverty line at T2. Compared with those who were not financially strained at both time points, children in households which experienced increased FS were at an increased risk of all unhealthy outcomes examined. In most cases, these increased risks persisted after adjustment for confounding and when limiting the sample to those above the poverty line. FS is associated with a range of new or continued poor child health outcomes. During times of widespread economic hardship, such as the ‘Great Recession’, measures should be taken to buffer children and their families from the impact of FS, and these should not be limited to those who are income poor.