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      Poverty dynamics and health in late childhood in the UK: evidence from the Millennium Cohort Study

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          Abstract

          Objective

          To assess the prevalence of different trajectories of exposure to child poverty and their association with three indicators of adolescent physical and mental health in UK children.

          Methods

          We analysed data on 10 652 children from a large, prospective, nationally representative sample in the UK Millennium Cohort Study. The outcomes were mental health, measured by the Strengths and Difficulties Questionnaire (SDQ), physical health, measured by obesity and any longstanding illness, at age 14. The exposure was relative poverty (<60% of median of equivalised household income), measured at 9 months, 3, 5, 7, 11 and 14 years. Poverty trajectories were characterised using latent class analysis. ORs and 95% CIs were estimated using multivariable logistic regression, adjusted for maternal education and ethnicity.

          Results

          Four poverty trajectories were identified: never in poverty (62.4%), poverty in early childhood (13.4%), poverty in late childhood (5.0%) and persistent poverty (19.4%). Compared with children who never experienced poverty, those in persistent poverty were at increased risk of mental health problems (SDQ score≥17 (adjusted OR (aOR): 3.17; 95% CI: 2.40 to 4.19)), obesity (aOR: 1.57; 95% CI: 1.20 to 2.04) and longstanding illness (aOR: 1.98; 95% CI: 1.55 to 2.52). Poverty in early childhood was related to higher risk of obesity than that in late childhood, while the opposite is observed for mental health problems and longstanding illness.

          Conclusions

          Persistent poverty affects one in five children in the UK. Any exposure to poverty was associated with worse physical and mental health outcomes. Policies that reduce child poverty and its consequences are likely to improve health in adolescence.

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          Most cited references27

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          Developmental plasticity and human health.

          Many plants and animals are capable of developing in a variety of ways, forming characteristics that are well adapted to the environments in which they are likely to live. In adverse circumstances, for example, small size and slow metabolism can facilitate survival, whereas larger size and more rapid metabolism have advantages for reproductive success when resources are more abundant. Often these characteristics are induced in early life or are even set by cues to which their parents or grandparents were exposed. Individuals developmentally adapted to one environment may, however, be at risk when exposed to another when they are older. The biological evidence may be relevant to the understanding of human development and susceptibility to disease. As the nutritional state of many human mothers has improved around the world, the characteristics of their offspring--such as body size and metabolism--have also changed. Responsiveness to their mothers' condition before birth may generally prepare individuals so that they are best suited to the environment forecast by cues available in early life. Paradoxically, however, rapid improvements in nutrition and other environmental conditions may have damaging effects on the health of those people whose parents and grandparents lived in impoverished conditions. A fuller understanding of patterns of human plasticity in response to early nutrition and other environmental factors will have implications for the administration of public health.
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            Life course epidemiology.

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              Psychometric Properties of the Parent and Teacher Versions of the Strengths and Difficulties Questionnaire for 4- to 12-Year-Olds: A Review

              Since its development, the Strengths and Difficulties Questionnaire (SDQ) has been widely used in both research and practice. The SDQ screens for positive and negative psychological attributes. This review aims to provide an overview of the psychometric properties of the SDQ for 4- to 12-year-olds. Results from 48 studies (N = 131,223) on reliability and validity of the parent and teacher SDQ are summarized quantitatively and descriptively. Internal consistency, test–retest reliability, and inter-rater agreement are satisfactory for the parent and teacher versions. At subscale level, the reliability of the teacher version seemed stronger compared to that of the parent version. Concerning validity, 15 out of 18 studies confirmed the five-factor structure. Correlations with other measures of psychopathology as well as the screening ability of the SDQ are sufficient. This review shows that the psychometric properties of the SDQ are strong, particularly for the teacher version. For practice, this implies that the use of the SDQ as a screening instrument should be continued. Longitudinal research studies should investigate predictive validity. For both practice and research, we emphasize the use of a multi-informant approach.
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                Author and article information

                Journal
                Arch Dis Child
                Arch. Dis. Child
                archdischild
                adc
                Archives of Disease in Childhood
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                0003-9888
                1468-2044
                November 2019
                11 June 2019
                : 104
                : 11
                : 1049-1055
                Affiliations
                [1 ] departmentDepartment of Public Health and Policy , University of Liverpool , Liverpool, UK
                [2 ] UCL Great Ormond Street Institute of Child Health , London, UK
                Author notes
                [Correspondence to ] Dr Eric T C Lai; etcl@ 123456liverpool.ac.uk
                Article
                archdischild-2018-316702
                10.1136/archdischild-2018-316702
                6837248
                31186294
                3f667c87-03e5-4316-9dca-7f8843fbad00
                © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

                History
                : 13 December 2018
                : 24 April 2019
                : 27 April 2019
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100004440, Wellcome Trust;
                Funded by: MRC Clinician Scientist Fellowship;
                Categories
                Original Article
                1506
                Custom metadata
                unlocked

                Medicine
                child poverty,trajectories,mental health,physical health,longitudinal study
                Medicine
                child poverty, trajectories, mental health, physical health, longitudinal study

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