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The role of poverty in explaining health variations in 7-year-old children from different family structures: findings from the UK Millennium Cohort Study
  1. Anna Pearce1,2,
  2. Hannah Lewis1,2,
  3. Catherine Law1,2
  1. 1Department of Health Policy Research Unit in the Health of Children, Young People and Families, UCL Institute of Child Health, London, UK
  2. 2The MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, London, UK
  1. Correspondence to Dr Anna Pearce, UCL Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK; anna.pearce{at}


Background Despite rises in reconstituted and lone-parent families, relatively little is known about how the health of children in different family types varies, and the extent to which any differences might be explained by poverty. The authors examined this using cross-sectional data on 13 681 seven-year-olds from the Millennium Cohort Study.

Methods The authors estimated RRs and 95% CIs for having poor physical (general health, long-standing illness, injury, overweight, asthma, fits) and mental health (using strengths and difficulties scores) according to family structure using Poisson regression. The authors adjusted for confounders (aRR) and then investigated the role of poverty as a mediator by entering a poverty score (based on income, receipt of benefits, subjective poverty and material deprivation) into the main model.

Results Children living in reconstituted and lone-parent families were at a slight increased risk of poor health compared with those living with two natural parents. Adjusting for poverty tended to remove the elevated risk of poor physical health in children living in lone-parent and reconstituted families. However, for the mental health outcomes, poverty tended to remove the elevated risk for lone parents but not for reconstituted families. For example, the aRR for borderline–abnormal total difficulties fell from 1.45 (1.22 to 1.72) to 1.34 (1.13 to 1.59) in children living in reconstituted families and from 1.29 (1.14 to 1.45) to 1.05 (0.92 to 1.19) in those living with lone parents.

Conclusions Poor physical and mental health was slightly more prevalent in children living in lone-parent or reconstituted families. Poverty reduction may help to reduce these differences, especially for children living with lone parents; however, alternative mechanisms should be also explored, particularly for children living in reconstituted families.

  • Child health
  • inequalities
  • poverty
  • policy

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  • Funding This work was supported by the Policy Research Unit in the Health of Children, Young People and Families (funding reference 10090001), which is funded by the Department of Health Policy Research Programme. This is an independent report commissioned and funded by the Department of Health. The views expressed are not necessarily those of the Department. The Centre for Paediatric Epidemiology and Biostatistics was supported in part by the Medical Research Council in its capacity as the MRC Centre of Epidemiology for Child Health. Research at the UCL Institute of Child Health and Great Ormond Street Hospital for Children receives a proportion of the funding from the Department of Health's National Institute for Health Research Biomedical Research Centres funding scheme. The Millennium Cohort Study is funded by grants to former and current directors of the study from the Economic and Social Research Council (Professor Health Joshi and Professor Lucinda Platt) and a consortium of government funders. The study sponsors played no part in the design, data analysis and interpretation of this study; the writing of the manuscript or the decision to submit the paper for publication, and the authors' work was independent of their funders.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.