Early Poverty, Early Poor Health, and Health Outcomes in Later Childhood: A Birth Cohort Study

2020 ◽  
Author(s):  
Wan-Lin Chiang ◽  
Tung-liang Chiang

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e052237
Author(s):  
Wan-Lin Chiang ◽  
Tung-liang Chiang

ObjectiveThis study analyses the mediating effects of early health prior to age 3 on the association between early poverty and the health outcomes of children at age 12.DesignPopulation-based longitudinal birth cohort study.SettingTaiwan Birth Cohort Study (TBCS), 2005–2017.Participants16 847 TBCS children born in 2005 and followed up at 18 months, 3, 5, 8 and 12 years with available data on poverty and health status.Main outcome measuresChild’s general health, measured by the mothers’ ratings of their child’s health, and hospitalisation experience at 12 years of age.ResultsAmong the TBCS children, the prevalence of fair/poor health and hospitalisation was 20.8% and 2.5% at age 12. The ORs of experiencing fair/poor health and hospitalisation at age 12 were 1.33 (95% CI 1.21 to 1.45) and 1.35 (1.07 to 1.69) for early poverty, respectively. When early poor health was added in the multiple logistic regression models, the effects of early poverty were attenuated on poor general health and no longer significant on hospitalisation for children aged 12 years. Mediation analysis showed that 50%–87% of the total effect of early poverty on health at age 12 was mediated by early health status before age 3.ConclusionsOur findings suggest that poor health in early life plays as a significant mediator in the relationship between early poverty and the long-term health outcomes of children. Universal health coverage thus should be achieved to prevent the adverse health effects of poverty throughout the life course, as one of the most important strategies for children growing up in poverty.



2020 ◽  
pp. jech-2020-214737
Author(s):  
Tiffany Xie ◽  
Carlos de Mestral ◽  
G David Batty

BackgroundChildren who have been exposed to public (out-of-home) care experience a range of negative outcomes by late adolescence and early adulthood. The longer-term impact of childhood care is, however, uncertain.AimTo examine if there is a prospective association between childhood public care and adverse life outcomes in middle-age.MethodsWe used data from the UK 1958 birth cohort study of 18 558 individuals. Parents reported offspring care status at age 7, 11 and 16. An array of social, criminal, cognitive, and health outcomes was self-reported by cohort members at age 42 (71% response proportion in eligible sample) and a cognitive test battery was administered at age 50 (62% response).ResultsA total of 420 (3.8%) of 11 160 people in the analytical sample experienced childhood public care by age 16. Net of confounding factors, experience of public care (vs none) was linked to 11 of the 28 non-mutually exclusive endpoints captured in middle-age, with the most consistent effects apparent for psychosocial characteristics: 4/7 sociodemographic (eg, odds ratio; 95% confidence interval for homelessness: 2.1; 1.4 to 3.1); 2/2 antisocial (eg, use of illicit drug: 2.0; 1.2 to 3.5); 2/3 psychological (eg, mental distress: 1.6; 1.2 to 2.1); 1/3 health behaviours (eg, current cigarette smoker: 1.7; 1.3 to 2.2); 2/8 somatic health (physical disability: 2.7; 1.9 to 3.8); and 0/5 cognitive function (eg, beta coefficient; 95% confidence interval for immediate word recall: −0.1; −0.3 to 0.1) endpoints.ConclusionsThe present study suggests that selected associations apparent between childhood care and outcomes in adolescence and early adulthood are also evident in middle-age.



2013 ◽  
Vol 26 (2) ◽  
pp. 111-116 ◽  
Author(s):  
Mia Eriksson ◽  
Katri Räikkönen ◽  
Johan G. Eriksson






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