Impact of childhood poverty and poor housing on adolescent health in the UK

Background

Childhood poverty and poor housing frequently co-occur and are linked to adverse health outcomes, but their cumulative and combined impact across childhood remains unclear. We examined joint trajectories of poverty and housing quality from infancy to late childhood and estimated their contribution to adolescent mental and physical health outcomes.

Methods

We analysed longitudinal data from 8,982 children in the UK Millennium Cohort Study. Household poverty, defined as equivalised household income below 60% of the national median, and poor housing, defined as overcrowding or damp, were assessed from age 9 months to 11 years. Joint trajectories were identified using group-based multi-trajectory models. Associations with mental health problems and poor self-reported health at age 17, and asthma at age 14, were estimated using multivariable Poisson regression models. Population attributable fractions estimated the proportion of adverse outcomes attributable to persistent poverty and/or poor housing.

Findings

Four distinct trajectories were identified: Not in poverty or poor housing (54·7%), not in poverty but in poor housing (14·3%), in poverty but not in poor housing (17·9%), and in persistent poverty and poor housing (13·1%). Compared with children not in poverty or poor housing, those exposed to persistent poverty and poor housing had increased risks of mental health problems (adjusted risk ratio [aRR] 2·7, 95% CI 2·0–3·3), poor self-reported health (2·0, 1·4–2·7), and asthma (1·3, 1·1–1·7). Persistent poverty and/or poor housing accounted for 41·6% of mental health problems, 26·4% of poor self-reported health, and 12·9% of asthma.

Conclusions

Nearly half of UK children are exposed to persistent poverty and/or poor housing, with substantial implications for health. Policies that simultaneously address child poverty and housing conditions are essential to reduce health inequalities in the next generation.

Key messages

• Persistent childhood poverty and poor housing have lasting consequences for adolescent mental and physical health and contribute substantially to health inequalities in the UK.

• Policies that address child poverty and poor housing together could reduce a substantial proportion of adverse adolescent health outcomes.