Social inequalities in child development: the role of differential exposure and susceptibility to stressful family conditions

Joost Oude Groeniger*, Tanja Aj Houweling, Pauline W Jansen, Nil Horoz, J Marieke Buil, Pol Ac van Lier, Frank J van Lenthe

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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BACKGROUND: Stressful family conditions may contribute to inequalities in child development because they are more common among disadvantaged groups (ie, differential exposure) and/or because their negative effects are stronger among disadvantaged groups (ie, differential impact/susceptibility). We used counterfactual mediation analysis to investigate to what extent stressful family conditions contribute to inequalities in child development via differential exposure and susceptibility.

METHODS: We used data from the Generation R Study, a population-based birth cohort in the Netherlands (n=6842). Mother's education was used as the exposure. Developmental outcomes, measured at age 13 years, were emotional and behavioural problems (Youth Self-Report), cognitive development (Wechsler Intelligence Scale for Children) and secondary education entry level. Financial and social stress at age 9 years were the putative mediators.

RESULTS: Differential exposure to financial stress caused a 0.07 (95% CI -0.12 to -0.01) SD worse emotional and behavioural problem -score, a 0.05 (95% CI -0.08 to -0.02) SD lower intelligence score and a 0.05 (95% CI -0.05 to -0.01) SD lower secondary educational level, respectively, among children of less-educated mothers compared with children of more-educated mothers. This corresponds to a relative contribution of 54%, 9% and 6% of the total effect of mother's education on these outcomes, respectively. Estimates for differential exposure to social stress, and differential susceptibility to financial or social stress, were much less pronounced.

CONCLUSION: Among children of less-educated mothers, higher exposure to financial stress in the family substantially contributes to inequalities in socioemotional development, but less so for cognitive development and educational attainment.

Original languageEnglish
Article number219545
Pages (from-to)74-80
Number of pages7
JournalJournal of Epidemiology and Community Health
Issue number2
Early online date25 Nov 2022
Publication statusPublished - Feb 2023

Bibliographical note

Funding This work was supported by a grant from the Netherlands Organization for Health Research and Development (ZonMw) (project No. 531003013). TH is
financially supported by an NWO grant (grant number NWA.1238.18.001), and though a grant awarded by the Norwegian Research Council (project number
288638) to the Centre for Global Health Inequalities Research (CHAIN) at the Norwegian University for Science and Technology (NTNU). PWJ is member of
the SEED Consortium. SEED stands for Social InEquality and its Effects on child Development: A study of birth cohorts in the UK, Germany and the Netherlands
(Grant # 462-16-030) and is part of the Dynamics of inequality across the Lifecourse (DIAL) Programme of the EU’s New Opportun

© Author(s) (or their employer(s)) 2022.


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