Child mental health and income gradient from early childhood to adolescence: Evidence from the UK

Murong Yang; Claire Carson; Cathy Creswell; Mara Violato

doi:10.1016/j.ssmph.2023.101534

Child mental health and income gradient from early childhood to adolescence: Evidence from the UK

SSM Popul Health. 2023 Oct 14:24:101534. doi: 10.1016/j.ssmph.2023.101534. eCollection 2023 Dec.

Authors

Murong Yang¹, Claire Carson², Cathy Creswell³, Mara Violato¹

Affiliations

¹ Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, OX3 7LF, UK.
² National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, OX3 7LF, UK.
³ Department of Experimental Psychology, University of Oxford, OX2 6GG, UK.

Abstract

Background: Children from low income families are likely to have poorer mental health than their more affluent peers. However, it is unclear how this association varies at different developmental stages and what the potential underpinning mechanisms are. This study investigates the relationship between family income and mental health problems from early childhood to adolescence in the UK, and examines the potential mediating role of family-related factors over time.

Methods: Data were drawn from the UK Millennium Cohort Study at ages 3, 5, 7, 11, 14 and 17 years. Child mental health was measured by the Strengths and Difficulties Questionnaire Total Difficulties Score, and the Internalising and Externalising subscales. Family income was operationalised as permanent income. Cross-sectional analyses were conducted at each age to examine the association between income and mental health problems, and to examine potential mechanisms based on the Parental Stress and Parental Investment theories.

Results: The samples included 8096 children aged up to 14 years, of which 5667 remained in the study at age 17. Results indicated a statistically significant association between lower family income and poorer mental health in all age groups after adjusting for confounding factors. The strength of the association was reduced after adjustment for Parental Stress and Parental Investment factors, with the larger attenuation driven by Parental Stress factors in most cases. Fully adjusted models suggested an increased independent association between maternal psychological distress and children's mental health as children grew older.

Conclusions: While lower family income is associated with a child's poorer mental health, much of this association is explained by other factors such as maternal psychological distress, and therefore the direct association is relatively small. This suggests that policies targeting income redistribution may reduce child mental health problems, and also benefit the wider family, reducing the prevalence of other associated risk factors.

Keywords: Child mental health; Externalising problems; Health inequalities; Income gradient; Internalising problems.