TY - JOUR
T1 - Social inequalities in child mental health trajectories
T2 - a longitudinal study using birth cohort data 12 countries
AU - Cadman, Tim
AU - Avraam, Demetris
AU - Carson, Jennie
AU - Elhakeem, Ahmed
AU - Grote, Veit
AU - Guerlich, Kathrin
AU - Guxens, Mònica
AU - Howe, Laura D.
AU - Huang, Rae Chi
AU - Harris, Jennifer R.
AU - Houweling, Tanja A.J.
AU - Hyde, Eleanor
AU - Jaddoe, Vincent
AU - Jansen, Pauline W.
AU - Julvez, Jordi
AU - Koletzko, Berthold
AU - Lin, Ashleigh
AU - Margetaki, Katerina
AU - Melchior, Maria
AU - Nader, Johanna Thorbjornsrud
AU - Pedersen, Marie
AU - Pizzi, Costanza
AU - Roumeliotaki, Theano
AU - Swertz, Morris
AU - Tafflet, Muriel
AU - Taylor-Robinson, David
AU - Wootton, Robyn E.
AU - Strandberg-Larsen, Katrine
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/10/22
Y1 - 2024/10/22
N2 - Background: Social inequalities in child mental health are an important public health concern. Whilst previous studies have examined inequalities at a single time point, very few have used repeated measures outcome data to describe how these inequalities emerge. Our aims were to describe social inequalities in child internalising and externalising problems across multiple countries and to explore how these inequalities change as children age. Methods: We used longitudinal data from eight birth cohorts containing participants from twelve countries (Australia, Belgium, Denmark, France, Germany, Greece, Italy, Netherlands, Poland, Norway, Spain and the United Kingdom). The number of included children in each cohort ranged from N = 584 (Greece) to N = 73,042 (Norway), with a total sample of N = 149,604. Child socio‐economic circumstances (SEC) were measured using self‐reported maternal education at birth. Child mental health outcomes were internalising and externalising problems measured using either the Strengths and Difficulties Questionnaire or the Child Behavior Checklist. The number of data collection waves in each cohort ranged from two to seven, with the mean child age ranging from two to eighteen years old. We modelled the slope index of inequality (SII) using sex‐stratified multi‐level models. Results: For almost all cohorts, at the earliest age of measurement children born into more deprived SECs had higher internalising and externalising scores than children born to less deprived SECs. For example, in Norway at age 2 years, boys born to mothers of lower education had an estimated 0.3 (95% CI 0.3, 0.4) standard deviation higher levels of internalising problems (SII) compared to children born to mothers with high education. The exceptions were for boys in Australia (age 2) and both sexes in Greece (age 6), where we observed minimal social inequalities. In UK, Denmark and Netherlands inequalities decreased as children aged, however for other countries (France, Norway, Australia and Crete) inequalities were heterogeneous depending on child sex and outcome. For all countries except France inequalities remained at the oldest point of measurement. Conclusions: Social inequalities in internalising and externalising problems were evident across a range of EU countries, with inequalities emerging early and generally persisting throughout childhood.
AB - Background: Social inequalities in child mental health are an important public health concern. Whilst previous studies have examined inequalities at a single time point, very few have used repeated measures outcome data to describe how these inequalities emerge. Our aims were to describe social inequalities in child internalising and externalising problems across multiple countries and to explore how these inequalities change as children age. Methods: We used longitudinal data from eight birth cohorts containing participants from twelve countries (Australia, Belgium, Denmark, France, Germany, Greece, Italy, Netherlands, Poland, Norway, Spain and the United Kingdom). The number of included children in each cohort ranged from N = 584 (Greece) to N = 73,042 (Norway), with a total sample of N = 149,604. Child socio‐economic circumstances (SEC) were measured using self‐reported maternal education at birth. Child mental health outcomes were internalising and externalising problems measured using either the Strengths and Difficulties Questionnaire or the Child Behavior Checklist. The number of data collection waves in each cohort ranged from two to seven, with the mean child age ranging from two to eighteen years old. We modelled the slope index of inequality (SII) using sex‐stratified multi‐level models. Results: For almost all cohorts, at the earliest age of measurement children born into more deprived SECs had higher internalising and externalising scores than children born to less deprived SECs. For example, in Norway at age 2 years, boys born to mothers of lower education had an estimated 0.3 (95% CI 0.3, 0.4) standard deviation higher levels of internalising problems (SII) compared to children born to mothers with high education. The exceptions were for boys in Australia (age 2) and both sexes in Greece (age 6), where we observed minimal social inequalities. In UK, Denmark and Netherlands inequalities decreased as children aged, however for other countries (France, Norway, Australia and Crete) inequalities were heterogeneous depending on child sex and outcome. For all countries except France inequalities remained at the oldest point of measurement. Conclusions: Social inequalities in internalising and externalising problems were evident across a range of EU countries, with inequalities emerging early and generally persisting throughout childhood.
UR - http://www.scopus.com/inward/record.url?scp=85207236073&partnerID=8YFLogxK
U2 - 10.1186/s12889-024-20291-5
DO - 10.1186/s12889-024-20291-5
M3 - Article
C2 - 39438908
AN - SCOPUS:85207236073
SN - 1471-2458
VL - 24
JO - BMC Public Health
JF - BMC Public Health
IS - 1
M1 - 2930
ER -
