Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC, Australia.
Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.
Int J Epidemiol. 2018 Aug 1;47(4):1307-1316. doi: 10.1093/ije/dyy086.
Disadvantage rarely manifests as a single event, but rather is the enduring context in which a child's development unfolds. We aimed to characterize patterns of stability and change in multiple aspects of disadvantage over the childhood period, in order to inform more precise and nuanced policy development.
Participants were from the Longitudinal Study of Australian Children birth cohort (n = 5107). Four lenses of disadvantage (sociodemographic, geographic environment, health conditions and risk factors), and a composite of these representing average exposure across all lenses, were assessed longitudinally from 0 to 9 years of age. Trajectory models identified groups of children with similar patterns of disadvantage over time for each of these lenses and for composite disadvantage. Concurrent validity of these trajectory groups was examined through associations with academic performance at 10-11 years.
We found four distinct trajectories of children's exposure to composite disadvantage, which showed high levels of stability over time. In regard to the individual lenses of disadvantage, three exhibited notable change over time (the sociodemographic lens was the exception). Over a third of children (36.3%) were exposed to the 'most disadvantaged' trajectory in at least one lens. Trajectories of disadvantage were associated with academic performance, providing evidence of concurrent validity.
Children's overall level of composite disadvantage was stable over time, whereas geographic environments, health conditions and risk factors changed over time for some children. Measuring disadvantage as uni-dimensional, at a single time point, is likely to understate the true extent and persistence of disadvantage.
劣势很少表现为单一事件,而是儿童发展展开的持久背景。我们旨在描述儿童期多个劣势方面的稳定性和变化模式,以便为更精确和细致的政策制定提供信息。
参与者来自澳大利亚儿童纵向研究(n=5107)。从 0 到 9 岁,从四个劣势视角(社会人口统计学、地理环境、健康状况和风险因素)以及代表所有视角平均暴露的综合视角,对劣势进行了纵向评估。轨迹模型确定了在每个视角和综合劣势方面具有相似劣势模式的儿童群体。这些轨迹组的同时有效性通过与 10-11 岁的学业成绩的关联来检验。
我们发现了儿童复合劣势暴露的四个不同轨迹,这些轨迹在时间上表现出高度的稳定性。关于劣势的个别视角,有三个在时间上发生了显著变化(社会人口统计学视角除外)。超过三分之一的儿童(36.3%)在至少一个视角中暴露于“最劣势”轨迹。劣势轨迹与学业成绩相关,提供了同时有效性的证据。
儿童的总体复合劣势水平在时间上是稳定的,而地理环境、健康状况和风险因素在某些儿童中随时间发生变化。在单一时间点测量单一维度的劣势可能会低估劣势的真实程度和持续性。