Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
Adam Smith Business School, University of Glasgow, Glasgow, UK.
J Epidemiol Community Health. 2024 Nov 11;78(12):764-771. doi: 10.1136/jech-2024-222293.
Child mental health has become an increasingly important issue in the UK, especially in the context of significant welfare reforms. Universal Credit (UC) has introduced substantial changes to the UK's social security system, significantly impacting low-income families. Our aim was to assess the effects of UC's introduction on children's mental health for families eligible for UC versus a comparable non-eligible sample.
Using Understanding Society data from 5806 observations of 4582 children (aged 5 or 8 years) in Great Britain between 2012 and 2018, we created two groups: children whose parents were eligible for UC (intervention group) and children whose parents were ineligible for UC (comparison group). Child mental health was assessed using a parent-reported Strengths and Difficulties Questionnaire. The OR and percentage point change in the prevalence of children experiencing mental health difficulties between the intervention group and the comparison group following the introduction of UC were analysed. We also investigated whether the utilisation of childcare services and changes in household income were mechanisms by which UC impacted children's mental health.
Logistic regression results demonstrated that the prevalence of mental health problems among eligible children whose parents were unemployed increased by an OR of 2.18 (95% CI 1.14 to 4.18), equivalent to an 8-percentage point increase (95% CI 1 to 14 percentage points) following the introduction of UC, relative to the comparison group. Exploring potential mechanisms, we found neither reduced household income nor increased use of childcare services, which served as a proxy for reduced time spent with parents, significantly influenced children's mental health.
UC has led to an increase in mental health problems among recipient children, particularly for children in larger families and those aged 8. Policymakers should carefully evaluate the potential health consequences for specific demographics when introducing new welfare policies.
儿童心理健康在英国已成为一个日益重要的问题，尤其是在福利改革的背景下。“通用信贷”（UC）对英国的社会保障制度进行了重大改革，对低收入家庭产生了重大影响。我们的目的是评估“通用信贷”的实施对符合条件的家庭和不具备资格的家庭的儿童心理健康的影响。
利用英国“社会认知”调查 2012 年至 2018 年间收集的 4582 名儿童（5 岁或 8 岁）5806 次观测数据，创建了两组：父母符合“通用信贷”条件的儿童（干预组）和父母不符合“通用信贷”条件的儿童（对照组）。使用父母报告的长处与困难问卷评估儿童心理健康。分析了“通用信贷”实施后，干预组与对照组相比，儿童心理健康问题的发生率（OR）和变化幅度（百分点）。我们还研究了儿童保育服务的利用情况和家庭收入的变化是否是“通用信贷”影响儿童心理健康的机制。
Logistic 回归结果表明，父母失业的符合条件的儿童的心理健康问题发生率增加了 2.18 倍（95%CI 1.14 至 4.18），与对照组相比，这相当于增加了 8 个百分点（95%CI 1 至 14 个百分点）。在探索潜在机制时，我们发现家庭收入减少和儿童保育服务利用增加（作为与父母相处时间减少的代理指标）都没有显著影响儿童的心理健康。
“通用信贷”的实施导致了受助儿童心理健康问题的增加，尤其是对大家庭和 8 岁以上儿童的影响更为明显。政策制定者在引入新的福利政策时，应仔细评估对特定人群的潜在健康影响。
