The impact of multidimensional disadvantage over childhood on developmental outcomes in Australia
The impact of multidimensional disadvantage over childhood on developmental outcomes in Australia
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DOI：
10.1093/ije/dyy087
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发表时间：
2018-10-01
影响因子：
7.7
通讯作者：
Badland, Hannah
中科院分区：
文献类型：
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作者：
Goldfeld, Sharon;O'Connor, Meredith;Badland, Hannah
背景资料：了解长期不利处境的不同方面与儿童发展领域之间的关系，将有助于制定更准确的政策反应。我们研究了暴露于不利方面的儿童时期（从0-9岁）和儿童发展之间的关联在10-11 years.Methods：我们使用的数据来自全国代表性的出生队列的纵向研究澳大利亚儿童（n = 4979）。广义线性模型与log-Poisson链接被用来估计先前推导出的不利轨迹（在社会人口，地理环境，健康状况和风险因素，以及这些的复合四个镜头）和儿童发育不良的风险之间的关联。人口归因分数进行了计算，以量化的潜在利益，为所有儿童提供最佳条件，为每个发展outcome.Results：轨迹的不利与发展outcomes：儿童在最不利的复合轨迹有7倍的风险差的结果，在两个或更多的发展领域，相比，那些最容易。在不同的镜头的不利轨迹变化与儿童发展领域的社会情绪调节，身体功能和学习能力。暴露于所有镜片中最易受影响的轨迹可以减少70%的不良发育结果。结论：随着时间的推移，暴露于不利环境与儿童不良发育结果相关。发展成果因所经历的不利条件的不同而不同，突出了更精确的政策反应的潜在目标。调查结果提供了证据，以刺激宣传和行动，以减少儿童不平等。
Background: Understanding the relationship between different aspects of disadvantage over time and domains of child development will facilitate the formulation of more precise policy responses. We examined the association between exposure to aspects of disadvantage over the childhood period (from 0-9 years) and child development at 10-11 years.Methods: We used data from the nationally representative birth cohort of the Longitudinal Study of Australian Children (n = 4979). Generalized linear models with log-Poisson link were used to estimate the association between previously derived disadvantage trajectories (in each of four lenses of sociodemographic, geographic environments, health conditions and risk factors, and a composite of these) and risk of poor child developmental outcomes. Population-attributable fractions were calculated to quantify the potential benefit of providing all children with optimal conditions for each developmental outcome.Results: Trajectories of disadvantage were associated with developmental outcomes: children in the most disadvantaged composite trajectory had seven times higher risk of poor outcomes on two or more developmental domains, compared with those most advantaged. Trajectories of disadvantage in different lenses were varyingly associated with the child development domains of socio-emotional adjustment, physical functioning and learning competencies. Exposure to the most advantaged trajectory across all lenses could reduce poor developmental outcomes by as much as 70%.Conclusions: Exposure to disadvantage over time is associated with adverse child development outcomes. Developmental outcomes varied with the aspects of disadvantage experienced, highlighting potential targets for more precise policy responses. The findings provide evidence to stimulate advocacy and action to reduce child inequities.