More than a snapshot in time: Pathways of disadvantage over childhood

Goldfeld, S, O'Connor, M, O'Connor, E, Chong, S, Badland, H, Woolfenden, S, Redmond, G, Williams, K, Azpitarte, F, Cloney, D and Mensah, F 2018, 'More than a snapshot in time: Pathways of disadvantage over childhood', International Journal of Epidemiology, vol. 47, no. 4, pp. 1307-1316.


Document type: Journal Article
Collection: Journal Articles

Title More than a snapshot in time: Pathways of disadvantage over childhood
Author(s) Goldfeld, S
O'Connor, M
O'Connor, E
Chong, S
Badland, H
Woolfenden, S
Redmond, G
Williams, K
Azpitarte, F
Cloney, D
Mensah, F
Year 2018
Journal name International Journal of Epidemiology
Volume number 47
Issue number 4
Start page 1307
End page 1316
Total pages 10
Publisher Oxford University Press
Abstract Background: Disadvantage rarely manifests as a single event, but rather is the enduring context in which a child's development unfolds. We aimed to characterize patterns of stability and change in multiple aspects of disadvantage over the childhood period, in order to inform more precise and nuanced policy development. Methods: Participants were from the Longitudinal Study of Australian Children birth cohort (n=5107). Four lenses of disadvantage (sociodemographic, geographic environment, health conditions and risk factors), and a composite of these representing average exposure across all lenses, were assessed longitudinally from 0 to 9 years of age. Trajectory models identified groups of children with similar patterns of disadvantage over time for each of these lenses and for composite disadvantage. Concurrent validity of these trajectory groups was examined through associations with academic performance at 10-11 years. Results: We found four distinct trajectories of children's exposure to composite disadvantage, which showed high levels of stability over time. In regard to the individual lenses of disadvantage, three exhibited notable change over time (the sociodemographic lens was the exception). Over a third of children (36.3%) were exposed to the 'most disadvantaged' trajectory in at least one lens. Trajectories of disadvantage were associated with academic performance, providing evidence of concurrent validity. Conclusions: Children's overall level of composite disadvantage was stable over time, whereas geographic environments, health conditions and risk factors changed over time for some children. Measuring disadvantage as uni-dimensional, at a single time point, is likely to understate the true extent and persistence of disadvantage.
Subject Epidemiology
Keyword(s) Adversity
Childhood
Disadvantage
Health inequity
Longitudinal
Measurement
DOI - identifier 10.1093/ije/dyy086
Copyright notice © The Author(s) 2018. All rights reserved.
ISSN 0300-5771
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