Background Lower maternal education is associated with higher body mass index (BMI) and higher chronic inflammation in offspring. Childhood adversity potentially mediates these associations. We examined the extent to which addressing childhood adversity could reduce socioeconomic inequities in these outcomes.
Methods We analysed data from two early-life longitudinal cohorts: the Longitudinal Study of Australian Children (LSAC; n=1873) and the UK Avon Longitudinal Study of Parents and Children (ALSPAC; n=7085). Exposure: low/medium (below university degree) versus high maternal education, as a key indicator of family socioeconomic position (0–1 year). Outcomes: BMI and log-transformed glycoprotein acetyls (GlycA) (LSAC: 11–12 years; ALSPAC: 15.5 years). Mediator: multiple adversities (≥2/<2) indicated by family violence, mental illness, substance abuse and harsh parenting (LSAC: 2–11 years; ALSPAC: 1–12 years). A causal mediation analysis was conducted.
Results Low/medium maternal education was associated with up to 1.03 kg/m2 higher BMI (95% CI: 0.95 to 1.10) and up to 1.69% higher GlycA (95% CI: 1.68 to 1.71) compared with high maternal education, adjusting for confounders. Causal mediation analysis estimated that decreasing the levels of multiple adversities in children with low/medium maternal education to be like their high maternal education peers could reduce BMI inequalities by up to 1.8% and up to 3.3% in GlycA.
Conclusions Our findings in both cohorts suggest that slight reductions in socioeconomic inequities in children’s BMI and inflammation could be achieved by addressing childhood adversities. Public health and social policy efforts should help those affected by childhood adversity, but also consider underlying socioeconomic conditions that drive health inequities.
- CHILD HEALTH
- Health inequalities
- LONGITUDINAL STUDIES
- PUBLIC HEALTH
- CARDIOVASCULAR DISEASES
Data availability statement
Data are available upon reasonable request.
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Contributors NP conceptualised and designed the study, drafted the initial manuscript, critically reviewed the manuscript for important intellectual content and obtained funding. MOC, SGr, MMB, DPB and RL conceptualised the study, drafted the initial manuscript and critically reviewed the manuscript for important intellectual content. SGu and DG conceptualised the study, conducted analysis, drafted the initial manuscript and critically reviewed the manuscript for important intellectual content. SGo obtained funding, conceptualised and designed the study, and critically reviewed the manuscript for important intellectual content. SW, HB, GR, MJ and KL conceptualised the study and critically reviewed the manuscript for important intellectual content. NP is responsible for the overall content as the guarantor. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
Funding The UK Medical Research Council (MRC) and Wellcome (Grant ref: 217065/Z/19/Z) and the University of Bristol provide core support for ALSPAC. This publication is the work of the authors and NP and RL will serve as guarantors for the contents of this paper. A comprehensive list of grants funding is available on the ALSPAC website (http://www.bristol.ac.uk/Alspac/external/documents/grant-acknowledgements.pdf). This research was specifically funded by the National Institute of Health (NIH) (Grant ref: DK077659), Wellcome Trust and MRC (Grant ref: 07467/Z/05/Z). Access to ALSPAC data was supported by a University College London Global Engagement Award. This work was also supported by Australian Research Council Discovery Grant (grant number DP160101735) and was supported by the Victorian Government’s Operational Infrastructure Support Program. MOC is supported by the Melbourne Children’s LifeCourse initiative, funded by a Royal Children’s Hospital Foundation Grant (2018-984). MMB is supported by Australian Research Council Discovery Early Career Award (DE190101326) and Australian National Health and Medical Research Council (NHMRC) Investigator Grant Emerging Leadership Level 2 (ID 2009572). SGo is supported by an NHMRC Practitioner Fellowship (APP1155290). HB is supported by an RMIT University VC Senior Research Fellowship. NP was supported by a NHMRC Career Development Fellowship (APP1123677). DB is supported by an NHMRC Investigator Grant (APP1175744). RL and DG’s time on this study was supported by a UK Economic and Social Research Council grant (Grant ref: ES/P010229/1).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Author note The funding sources had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.
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