Citation

Blair A, Marryat L, Frank J. Int. J. Public Health 2019; 64(7): 1059-1068.

Affiliation

Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.

Copyright

(Copyright © 2019, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s00038-019-01258-5

PMID

31139849

Abstract

OBJECTIVES: To assess what proportion of the association between household low income and incidence of adverse childhood experiences (ACE) would be eliminated if all households had access to housing, transportation and childcare services, breastfeeding counselling, and parks.

METHODS: Using Growing Up in Scotland birth cohort data (N = 2816), an inverse probability-weighted regression-based mediation technique was applied to assess associations between low-income status (< £11,000 in 2004/5), resource access, and cumulative 8-year ACE incidence (≥ 1, ≥ 3 ACEs). Resource access was measured based on households' self-reported difficulties (yes/no) in accessing housing, transportation, childcare, and breastfeeding counselling, and park proximity (within 10 min from the residence).

RESULTS: The protective effects of resources were heterogeneous. Only access to transportation was associated with lower ACE incidence in both low- and higher-income households. If all had access to transportation, 21% (95% CI 3%, 41%) of the income-based inequality in incidence of 3 or more ACEs could be eliminated.

CONCLUSIONS: While second best to the elimination of child poverty, measures to improve families' access to community resources such as transportation may mitigate the effects of poverty on ACE incidence.

Language: en

Keywords

Adverse childhood experiences; Child health; Childhood circumstances; Health equity; Inequalities; Poverty; Social epidemiology