Impact of poverty and family adversity on adolescent health: a multi-trajectory analysis using the UK Millennium Cohort Study.
Impact of poverty and family adversity on adolescent health: a multi-trajectory analysis using the UK Millennium Cohort Study.
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DOI：
10.1016/j.lanepe.2021.100279
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发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
ORACLE consortium
中科院分区：
文献类型：
--
作者：
Adjei NK;Schlüter DK;Straatmann VS;Melis G;Fleming KM;McGovern R;Howard LM;Kaner E;Wolfe I;Taylor-Robinson DC;ORACLE consortium
暴露在贫困和家庭逆境中的儿童，包括家庭暴力、父母精神疾病和父母酗酒，在一生中可能会经历糟糕的结果。然而，童年时期这些暴露之间的复杂相互关系尚不清楚。因此，我们评估了家庭贫困和家庭逆境的轨迹及其对青少年健康结果的影响。我们使用了英国千年队列研究的纵向数据，该研究对11564名14岁以下的儿童进行了跟踪调查。家庭逆境包括父母报告的家庭暴力和虐待、精神健康状况不佳和频繁饮酒。我们使用基于群体的多轨迹集群模型来识别儿童的贫困和家庭逆境的轨迹。我们使用多变量Logistic回归来评估这些轨迹与14岁儿童生理、心理和行为结果的相关性，并对混杂因素进行了调整。结果显示：低贫困和家庭逆境(43.2%)、父母持续饮酒(7.7%)、持续的家庭暴力和虐待(3.4%)、持续的不良父母心理健康(11.9%)、持续的贫困(22.6%)和持续的贫困和不良的父母心理健康(11.1%)。与低贫困和低逆境儿童相比，持续逆境轨迹组儿童的结局更差；那些暴露在父母心理健康和贫困持续不佳的儿童特别容易出现社会情绪行为问题(调整后的优势比6·4；95%CI 5·0-8·3)、认知障碍(AOR 2·1；CI 1·5-2·8)、药物试验(AOR 2·8；CI 1·8-4·2)和肥胖(AOR 1·8；CI 1·3-2·5)。在当代英国的一个队列中，持续的贫困和/或持续的糟糕的父母心理健康影响着超过四分之四的儿童。两者的组合影响十分之一的儿童，并与儿童不良结局密切相关，特别是儿童心理健康状况不佳。国家卫生研究院(NIHR)政策研究计划、伦敦南部NIHR应用研究合作(ARC South London)、国王学院医院NHS基金会信托基金和医学研究理事会(MRC)。
Children exposed to poverty and family adversities including domestic violence, parental mental ill health and parental alcohol misuse may experience poor outcomes across the life course. However, the complex interrelationships between these exposures in childhood are unclear. We therefore assessed the clustering of trajectories of household poverty and family adversities and their impacts on adolescent health outcomes. We used longitudinal data from the UK Millennium Cohort study on 11564 children followed to age 14 years. Family adversities included parent reported domestic violence and abuse, poor mental health and frequent alcohol use. We used a group-based multi-trajectory cluster model to identify trajectories of poverty and family adversity for children. We assessed associations of these trajectories with child physical, mental and behavioural outcomes at age 14 years using multivariable logistic regression, adjusting for confounders. Six trajectories were identified: low poverty and family adversity (43·2%), persistent parental alcohol use (7·7%), persistent domestic violence and abuse (3·4%), persistent poor parental mental health (11·9%), persistent poverty (22·6%) and persistent poverty and poor parental mental health (11·1%). Compared with children exposed to low poverty and adversity, children in the persistent adversity trajectory groups experienced worse outcomes; those exposed to persistent poor parental mental health and poverty were particularly at increased risk of socioemotional behavioural problems (adjusted odds ratio 6·4; 95% CI 5·0 – 8·3), cognitive disability (aOR 2·1; CI 1·5 – 2·8), drug experimentation (aOR 2·8; CI 1·8 – 4·2) and obesity (aOR 1·8; CI 1·3 – 2·5). In a contemporary UK cohort, persistent poverty and/or persistent poor parental mental health affects over four in ten children. The combination of both affects one in ten children and is strongly associated with adverse child outcomes, particularly poor child mental health. The National Institute for Health Research (NIHR) Policy Research Programme, NIHR Applied Research Collaboration South London (ARC South London) at King's College Hospital NHS Foundation Trust and the Medical Research Council (MRC).
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影响因子：
2.3
作者：
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通讯作者：
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