Impact of Poverty and Family Adversity on Adolescent Health: A Multi-Trajectory Analysis Using the UK Millennium Cohort Study

Adjei, Nicholas Kofi; Schlüter, Daniela K; Straatmann, Viviane S.; Melis, Gabriella; Fleming, Kate; McGovern, Ruth; Howard, Louise; Kaner, Eileen; Wolfe, Ingrid; Taylor‐Robinson, David

doi:10.2139/ssrn.3844825

Cited by 6 publications

(8 citation statements)

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“…Previous existing longitudinal studies have consistently shown that a range of adverse child and adolescent outcomes are patterned according to early childhood household income, with those growing up in the poorest families being much more likely to experience negative outcomes such as poor mental health, poor physical health, smoking, obesity, and poor academic achievement. 11-22 The examination of each of our five single adverse outcomes confirm these previous findings.…”

Section: Discussionsupporting

confidence: 87%

“…Existing literature on the effects of early childhood poverty examines single adverse outcomes in adolescence separately. 11-22 Further, studies of inequality in the cohort born after the Millennium (Generation Z) are sparse. In the present economic and welfare policy context, it is important to understand in detail the experience of those coming of age at present and to consider the implications for population health and policy in coming decades.…”

Section: Introductionmentioning

confidence: 99%

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Clustering of adverse health and educational outcomes in adolescence following early childhood poverty: implications for UK’s ‘levelling up’ agenda

Villadsen

Asaria

Skarda

et al. 2022

Preprint

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Background Early childhood poverty is associated with poorer health and educational outcomes in adolescence. However, there is limited evidence about the clustering of these adverse outcomes by income group. Methods We analysed five outcomes at age 17 known to limit life chances – psychological distress, self–assessed ill health, smoking, obesity, and poor educational achievement – using data from the longitudinal UK Millennium Cohort Study (N=15,245). We compared how single and multiple outcomes were distributed across quintiles of household income in early childhood (0-5 years) and modelled the maximum potential benefit of tackling the income gradient in these outcomes. Findings Children from the poorest households were 12.7(95% CI 6.4-25.1) times more likely than those from the richest to experience four or five adverse adolescent outcomes, with poor educational achievement and smoking showing the largest single risk ratios – 4.6(95% CI: 4.2-5.0) and 3.6(95% CI 3.0-4.2), respectively. We modelled hypothetical absolute and relative poverty elimination scenarios, as well as an income inequality elimination scenario, and found these would yield maximum reductions in multiple adolescent adversity of 5%, 30%, and 80% respectively. Interpretation Early childhood poverty is more strongly correlated with multiple adolescent adversity than any single adverse outcome. Reducing absolute poverty alone is not sufficient to eliminate the life-long burden of multiple adversity, which disproportionately impacts children across the bottom three-fifths of the income distribution. An ambitious levelling up agenda needs co-ordinated multi-agency action to tackle the complex interacting factors generating the steep social gradient in multiple adolescent adversity.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Clustering of adverse health and educational outcomes in adolescence following early childhood poverty: implications for UK’s ‘levelling up’ agenda

Villadsen

Asaria

Skarda

et al. 2022

Preprint

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“…Unfortunately, the evidence-base for the intergenerational health impact of welfare policies is scarce. Predominately, evidence is restricted to (i) investigating the individual income (or poverty) and health impact of welfare reform ( 8 , 14 ) and (ii) investigating the impact of health and income (or poverty) of adults on their children ( 15 ). Figure 1 demonstrates these potential pathways identifying known and lesser known pathways, for example, the secondary damage experienced by welfare changes that occurred prior to the pandemic that were targeted at adults have been exposed with stark consequences for child poverty rates.…”

Section: Introductionmentioning

confidence: 99%

“…However, after the introduction of austerity driven policies child poverty started to rise, leading many to conclude a causal relationship [see ( 16 )] between policy changes and rising child poverty levels. The evidence base for the negative health and well-being outcomes for children and young people because of rising poverty is irrefutable ( Figure 1 ) ( 15 , 17 – 20 ).…”

Section: Introductionmentioning

confidence: 99%

Perspective Commentary: The Implementation of Welfare Policies Are Not Held to the Same Ethical Standards as Research: Raising Intergenerational Health Inequality Concerns

Wickham

2021

Front. Public Health

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Over the last 12 years the United Kingdom (UK) has seen the introduction of an austerity programme—a fiscal policy—with the primary goal to reduce the government's budget deficit and the role of the welfare system. Between 2010 and 2015 there was an estimated reduction of £14.5 billion in spending, attributable to decreasing the value of benefits and restricting entitlement to benefit claimants. By 2020, there had been an estimated unprecedented £27 billion less spent on welfare compared with spending in 2010. Whilst fiscally-successful at reducing spending, some implemented welfare policies have had direct consequences for people's health, increasing inequalities which have been heavily criticized. Moreover, there is growing concern that this has an intergenerational effect. In this paper, we describe the ethical principles in human research, how these have been considered in public health policy, and the existing evidence of the direct and intergenerational health and welfare consequences of some recent, nationally-implemented welfare policies. We argue that ethical principles, specifically the ethical principle of safety that is applied in all research, should be applied to all public welfare policies to stop the rising inequalities in health we are seeing across generations. We highlight that initial changes implemented to welfare policies as a response to COVID-19 demonstrate that there can be a political and societal perceived value in going further to support individuals and their families during times of adversity, and consider the ethical implications of this.

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“…Prioritising child wellbeing, by tackling poverty and family adversity [ 12 ], in tandem with a large scale system wide ‘levelling up’ plan could see the transformation that's needed delivered. To be effective a child wellbeing plan would need the necessary legislative powers to enable delivery, adequate funds as well as devolution of those funds, and a workforce working across the system.…”

mentioning

confidence: 99%

‘Levelling up’ in the UK must involve a reduction in inequalities in children's life chances

Black

Taylor‐Robinson

Lee

et al. 2022

Public Health in Practice

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Impact of Poverty and Family Adversity on Adolescent Health: A Multi-Trajectory Analysis Using the UK Millennium Cohort Study

Cited by 6 publications

References 0 publications

Clustering of adverse health and educational outcomes in adolescence following early childhood poverty: implications for UK’s ‘levelling up’ agenda

Clustering of adverse health and educational outcomes in adolescence following early childhood poverty: implications for UK’s ‘levelling up’ agenda

Perspective Commentary: The Implementation of Welfare Policies Are Not Held to the Same Ethical Standards as Research: Raising Intergenerational Health Inequality Concerns

‘Levelling up’ in the UK must involve a reduction in inequalities in children's life chances

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