Yang Murong, Carson Claire, Creswell Cathy, Violato Mara
Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, OX3 7LF, UK.
National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, OX3 7LF, UK.
SSM Popul Health. 2023 Oct 14;24:101534. doi: 10.1016/j.ssmph.2023.101534. eCollection 2023 Dec.
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.
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.
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.
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.
低收入家庭的儿童心理健康状况可能比家境更为富裕的同龄人更差。然而，目前尚不清楚这种关联在不同发育阶段如何变化，以及潜在的支撑机制是什么。本研究调查了英国从幼儿期到青春期家庭收入与心理健康问题之间的关系，并探讨了家庭相关因素随时间推移可能起到的中介作用。
数据取自英国千禧世代研究中3岁、5岁、7岁、11岁、14岁和17岁儿童的信息。儿童心理健康状况通过长处与困难问卷总困难得分以及内化和外化分量表进行衡量。家庭收入采用永久收入来衡量。在每个年龄段进行横断面分析，以检验收入与心理健康问题之间的关联，并依据父母压力理论和父母投资理论探讨潜在机制。
样本包括8096名14岁及以下儿童，其中5667名儿童在17岁时仍参与研究。结果表明，在调整混杂因素后，所有年龄组中较低的家庭收入与较差的心理健康之间存在统计学上的显著关联。在调整父母压力和父母投资因素后，这种关联的强度有所降低，在大多数情况下，父母压力因素导致的减弱幅度更大。完全调整后的模型显示，随着儿童年龄增长，母亲心理困扰与儿童心理健康之间的独立关联有所增加。
虽然较低的家庭收入与儿童较差的心理健康有关，但这种关联很大程度上可由母亲心理困扰等其他因素来解释，因此直接关联相对较小。这表明，旨在进行收入再分配的政策可能会减少儿童心理健康问题，同时也会使整个家庭受益，降低其他相关风险因素的患病率。
