Understanding inequalities in child development and the impact on adolescent health

Introduction:

Optimal development in childhood is important for future health. Evidence on the relationship between components of child development and adolescent health, and the influence of socioeconomic conditions, is poorly understood. This research aimed to identify aspects of development most associated with adolescent health and understand trajectories of development, in mid-childhood, in terms of socioeconomic and adolescent health impacts.

Methods:

A participatory systematic review was undertaken to synthesise evidence on the relationship between child development (3-7 years) and health in adolescence (8 -15 years); and to identify factors which shape the relationship. Then, longitudinal analysis progressed in three steps. First, group-based trajectory models (GBTM) to identify trajectories of; socioemotional, cognitive and concurrent socioemotional and cognitive problems, from age 3 to 14 years. Second, multinomial regression to assess associations between socioeconomic, parental and school level predictors and the derived trajectories. Finally logistic regression to assess associations between trajectory groups and adolescent health at age 14 and 17.

Results:

Poor socioemotional development at school starting age was the aspect of child development most strongly associated with overweight and mental ill health in adolescence, followed by cognitive development. In each model four mid-childhood development trajectories were found. These were trajectories of early, late, and persistent and no problems. In each analysis, those in the problem trajectories were more socioeconomically disadvantaged. Trajectories of persistent cognitive and socioemotional problems and all adverse trajectories of socioemotional problems were strongly associated with overweight and mental ill health in adolescence.

Conclusion:

There are socioeconomic inequalities in children’s socioemotional and cognitive development. This inequality will have a negative impact on weight and mental health in adolescence, driven mainly by adverse socioemotional development. Child and adolescent health policy with a central focus on social and emotional wellbeing using prevention and mitigation approaches is needed to improve health and reduce health inequalities in adolescents.