Investigators from the University of Bristol used data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a large prospective birth cohort study, to determine how early social adversity might influence a child’s body mass index (BMI) over time. ALSPAC enrolled pregnant women in southwest England who were due to deliver in 1991 and 1992 and followed their offspring to study the environmental and genetic factors that affect health and development over time. For this analysis, investigators used 4 social adversity variables collected as part of ALSPAC: (1) residential mobility, defined as the mother’s self-reported number of household moves occurring in the first 4 years of the study child’s life; (2) financial difficulty, defined as the mother’s self-reported difficulty in affording food, clothing, heating, rent/mortgage, and other essentials for their child at 4 different time points (32 weeks’ gestation and when their child was 8, 21, and 33 months old); (3) separation from or death of parent by the child’s fourth birthday; and (4) loss of job by the child’s fourth birthday.
The primary outcome was the study child’s BMI through age 17 years. Investigators used BMI information from a variety of ALSPAC sources, including health visitor records, parental reports, and measurements taken at clinic visits. Investigators used a mixed-effects model to determine the independent association of social adversity variables with child BMI over time after adjusting for confounding variables such as maternal education, family income, maternal smoking habits, home ownership status, maternal parity, maternal pre-pregnancy BMI, and ethnicity.
There were 7,021 parent/child dyads included in analysis, of which 41% experienced at least 1 household move; 62% reported some, moderate, or great financial difficulty; 15% of parents lost their jobs; 13% of parents separated; and <1% of parents died. After adjustment for confounding variables, only parent separation and residential mobility were associated with child BMI. Compared to children whose parents did not separate, children whose parents had separated had a BMI of 1.1% (95% CI, 0.2–2.0) higher at age 4 years than those whose parents remained together, but this difference became insignificant by age 9 years. Compared to children who had no household moves, children who moved 2 times had a significantly higher BMI at ages 16 and 17 years. Children who moved 3+ times had a significantly higher BMI at ages 15, 16, and 17 years compared to children with no household moves.
The authors conclude that policies to curtail high residential mobility and to boost housing security could have a favorable impact on child health.
Dr. Stevenson has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.
Social disruptions in the living environment and adverse childhood experiences,...