Analysis reveals impact of poverty and family adversity on adolescent health

In the UK today, persistent poverty and/or persistent poor parental mental health affects over four in ten children, University of Liverpool researchers have found.

The combination of both affects one in ten children and is strongly associated with adverse child outcomes, particularly poor child mental health, reveals their study published today in The Lancet Regional Health Europe.

Corresponding author Dr. Nicholas Kofi Adjei said: "This study is the first to assess the clustering of trajectories of child poverty and multiple indicators of family adversities—including parental mental ill health, domestic violence and abuse, alcohol misuse and their impacts on subsequent child behavior and health outcomes in adolescence—in a representative UK sample."

The researchers, from the University of Liverpool, Newcastle University, King's College London and Stockholm University 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. Six trajectories of poverty and family adversity for children were identified: Low poverty and family adversity (43.2% of those included in analysis), persistent parental alcohol use (7.7%), persistent domestic violence and abuse (3.4%), persistent poor parental mental health (11.1%), 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 with those exposed to persistent poor parental mental health and poverty were particularly at increased risk of socioemotional behavioral problems, cognitive disability, drug experimentation and obesity.

Dr. Adjei said: "Our longitudinal analysis provides strong evidence that adverse conditions have important effects on children's lives, but it is even more detrimental when multiple risk factors co-occur. The findings add to the current body of evidence by showing that poor parental mental health and poverty co-occur or cluster and their persistence across the developmental stages is associated with adverse child outcomes, particularly poor child mental health.

"The study demonstrates that interventions to address specific childhood adversities may not be meaningful if childhood socioeconomic conditions are not considered."

The researchers have outlined several recommendations following the analysis, says Professor David Taylor-Robinson, the senior author on the study: "The cluster of poverty and poor parental mental health is common, and particularly harmful to children's health. In the UK, immediate policy considerations include increasing child benefits and the child support element in universal credit uplift reversing changes to the welfare system that have led to rising child poverty, re-investing in support services and children's preventive services such as children's centres, and improving access to mental health services for families."

This study is part of the Overcoming Adverse Childhood Experiences (ORACLE) project funded by the National Institute of Health Research (NIHR). The main aim of the project is to understand the lived experiences of children, young people, and family members, and wider structural determinants, of risks and assets around parental mental health problems, substance misuse and intimate partner abuse. ORACLE is led by Professor Ingrid Wolfe (King's College London), Professor Eileen Kaner (Newcastle University) and Professor David Taylor-Robinson (University of Liverpool).