We used longitudinal data on 10,500 children from the nationally representative UK millennium cohort study. Trajectories of poverty, maternal mental health, and secondary caregiver mental health were constructed from child age of 9 months through to 14 years. We assessed the associations of these trajectories with mental health outcomes at the age of 17 years. Population-attributable fractions were calculated to quantify the contribution of caregivers\' mental health problems and poverty to adverse outcomes at the country level.
We identified five distinct trajectories. Compared with children with low poverty and good parental mental health, those who experienced poverty and poor primary or secondary caregiver mental health (53%) had worse outcomes. Children exposed to both persistent poverty and poor caregiver mental health were at markedly increased risk of socioemotional behavioural problems (aOR 4.2; 95% CI 2.7-6.7), mental health problems (aOR 2.5; CI 1.6-3.9), and cognitive disability (aOR 1.7; CI 1.1-2.5). We estimate that 40% of socioemotional behavioural problems at the age of 17 were attributable to persistent parental caregivers\' mental health problems and poverty.
More than half of children growing up in the UK are persistently exposed to either one or both of poor caregiver mental health and family poverty. The combination of these exposures is strongly associated with adverse health outcomes in the next generation.
方法:我们使用了英国具有全国代表性的千禧年队列研究中的10,500名儿童的纵向数据。贫困的轨迹,产妇心理健康,和二级照顾者心理健康从9个月至14岁的儿童构成。我们评估了17岁时这些轨迹与心理健康结果的关联。计算了人口归因分数,以量化护理人员的心理健康问题和贫困对国家一级不良后果的贡献。
结果:我们确定了五个不同的轨迹。与贫困程度低、父母心理健康良好的儿童相比,那些经历过贫困和主要或次要照顾者心理健康状况不佳的人(53%)的结局更差.暴露于持续贫困和贫困照顾者心理健康的儿童社会情绪行为问题的风险显着增加(aOR4.2;95%CI2.7-6.7),心理健康问题(aOR2.5;CI1.6-3.9),和认知障碍(aOR1.7;CI1.1-2.5)。我们估计,17岁时40%的社会情绪行为问题可归因于持续的父母照顾者的心理健康问题和贫困。
结论:在英国长大的儿童中,有一半以上的人持续面临照顾者不良的心理健康和家庭贫困中的一种或两种。这些暴露的组合与下一代的不良健康结果密切相关。