Childhood social adversity and clustering of health risk behaviours during early adolescence in a population-based birth cohort

Abstract

Objectives: This study aimed to prospectively explore the association between early lifetime exposure to psychosocial adversity and engagement in health risk behaviours (HRBs) during early adolescence.

Study design: This was a prospective study.

Methods: This study used data from the baseline (2005-2006), third (2016-2017) and fourth waves (2018-2020) of the Generation XXI birth cohort. Socio-economic circumstances (SECs) at baseline, adverse childhood experiences (ACEs; e.g. abuse, neglect, household dysfunction) at age 10 years and HRBs (i.e. alcohol consumption, smoking, physical exercise level, sedentary behaviours, sleep duration and eating behaviours) at age 13 years were measured. Patterns of HRBs were obtained using latent class analysis. Latent class regression analysis was used to estimate the likelihood of being engaged in HRBs according to the extent of exposure to ACEs (i.e. 0 ACEs, 1-3 ACEs, 4-5 ACEs and ≥6 ACEs) and negative family SECs.

Results: Adolescents whose mothers had a low level of education (adjusted odds ratio [aOR] = 2.72 [95% confidence interval {CI}, 2.33-3.18]), low occupational status (aOR = 3.21 [95% CI, 2.68-3.85]) and low income (aOR = 2.70 [95% CI, 2.23-3.28]) were more likely to be engaged in HRBs than their peers with higher SECs. Adolescents who experienced more ACEs were at a significantly increased risk of involvement in HRBs (aOR = 1.86 [95% CI, 1.33-2.63] for 4-5 ACEs vs aOR 2.41 [95% CI, 1.72-3.43] for ≥6 ACEs). No significant gender differences were observed.

Conclusions: Adolescents from families with low SECs were more likely than their more affluent counterparts to be engaged in HRBs. Furthermore, more ACEs contributed to widening health inequalities.

Keywords: Adverse childhood experiences; Latent class analysis; Prospective study; Socio-economic circumstances.