MOESM2 of Intersection of neighborhood dynamics and socioeconomic status in small-area walkability: the Heart Healthy Hoods project

Additional file 2. Table S2: Census section sociodemographic and walkability indicators according to socioeconomic status (SES) tertiles (N = 2415)

MOESM1 of Intersection of neighborhood dynamics and socioeconomic status in small-area walkability: the Heart Healthy Hoods project

Additional file 1: Additional information on the operationalization of the variables

Reducing child mental health inequities through parental mental health and preschool attendance

Background Prevention is key to reducing socioeconomic inequities in children’s mental health problems, especially given limited availability and accessibility of services supporting treatment. We investigated the potential to reduce these inequities for disadvantaged children by improving parental mental health and preschool attendance in early childhood. Methods Data from the nationally representative birth cohort of the Longitudinal Study of Australian Children (N=5107, commencing in 2004) were used to examine the impact of socioeconomic disadvantage (0-1 year) on children’s mental health problems (10-11 years). Using an interventional effects approach, we estimated the extent to which inequities in children’s mental health problems could be reduced by improving disadvantaged children’s parental mental health (4-5 years) and their preschool attendance (4-5 years). Results Disadvantaged children had a higher prevalence of elevated mental health symptoms (32.8%) compared with their non-disadvantaged peers (18.7%): confounder-adjusted difference in prevalence=11.6% (95% CI: 7.7%-15.4%). Improving disadvantaged children’s parental mental health and their preschool attendance to the level of their non-disadvantaged peers could reduce 6.5% and 0.3% of socioeconomic differences in child mental health problems, respectively (equivalent to 0.8% and 0.04% absolute reductions). If these interventions were delivered in combination, a 10.8% (95% CI: 6.9% to 14.7%) higher prevalence of elevated symptoms would remain for disadvantaged children. Conclusions Targeted policy interventions that improve parent mental health and preschool attendance for disadvantaged children are potential opportunities to reduce socioeconomic inequities in children’s mental health problems. Such interventions should be considered within a broader, sustained, and multipronged approach that includes addressing socioeconomic disadvantage itself.</p

Reducing child mental health inequities through parental mental health and preschool attendance

Background Prevention is key to reducing socioeconomic inequities in children’s mental health problems, especially given limited availability and accessibility of services supporting treatment. We investigated the potential to reduce these inequities for disadvantaged children by improving parental mental health and preschool attendance in early childhood. Methods Data from the nationally representative birth cohort of the Longitudinal Study of Australian Children (N=5107, commencing in 2004) were used to examine the impact of socioeconomic disadvantage (0-1 year) on children’s mental health problems (10-11 years). Using an interventional effects approach, we estimated the extent to which inequities in children’s mental health problems could be reduced by improving disadvantaged children’s parental mental health (4-5 years) and their preschool attendance (4-5 years). Results Disadvantaged children had a higher prevalence of elevated mental health symptoms (32.8%) compared with their non-disadvantaged peers (18.7%): confounder-adjusted difference in prevalence=11.6% (95% CI: 7.7%-15.4%). Improving disadvantaged children’s parental mental health and their preschool attendance to the level of their non-disadvantaged peers could reduce 6.5% and 0.3% of socioeconomic differences in child mental health problems, respectively (equivalent to 0.8% and 0.04% absolute reductions). If these interventions were delivered in combination, a 10.8% (95% CI: 6.9% to 14.7%) higher prevalence of elevated symptoms would remain for disadvantaged children. Conclusions Targeted policy interventions that improve parent mental health and preschool attendance for disadvantaged children are potential opportunities to reduce socioeconomic inequities in children’s mental health problems. Such interventions should be considered within a broader, sustained, and multipronged approach that includes addressing socioeconomic disadvantage itself.</p

Supplementary information files for article Addressing child mental health inequities through parental mental health and preschool attendance

Supplementary information files for article Addressing child mental health inequities through parental mental health and preschool attendance   Background Prevention is key to reducing socioeconomic inequities in children’s mental health problems, especially given limited availability and accessibility of services supporting treatment. We investigated the potential to reduce these inequities for disadvantaged children by improving parental mental health and preschool attendance in early childhood. Methods Data from the nationally representative birth cohort of the Longitudinal Study of Australian Children (N=5107, commencing in 2004) were used to examine the impact of socioeconomic disadvantage (0-1 year) on children’s mental health problems (10-11 years). Using an interventional effects approach, we estimated the extent to which inequities in children’s mental health problems could be reduced by improving disadvantaged children’s parental mental health (4-5 years) and their preschool attendance (4-5 years). Results Disadvantaged children had a higher prevalence of elevated mental health symptoms (32.8%) compared with their non-disadvantaged peers (18.7%): confounder-adjusted difference in prevalence=11.6% (95% CI: 7.7%-15.4%). Improving disadvantaged children’s parental mental health and their preschool attendance to the level of their non-disadvantaged peers could reduce 6.5% and 0.3% of socioeconomic differences in child mental health problems, respectively (equivalent to 0.8% and 0.04% absolute reductions). If these interventions were delivered in combination, a 10.8% (95% CI: 6.9% to 14.7%) higher prevalence of elevated symptoms would remain for disadvantaged children. Conclusions Targeted policy interventions that improve parent mental health and preschool attendance for disadvantaged children are potential opportunities to reduce socioeconomic inequities in children’s mental health problems. Such interventions should be considered within a broader, sustained, and multipronged approach that includes addressing socioeconomic disadvantage itself.</p

Inequities in children's reading skills: the role of home reading and preschool attendance

ObjectiveChildren from socioeconomically disadvantaged backgrounds have poorer learning outcomes. These inequities are a significant public health issue, tracking forward to adverse health outcomes in adulthood. We examined the potential to reduce socioeconomic gaps in children's reading skills through increasing home reading and preschool attendance among disadvantaged children.MethodsWe drew on data from the nationally representative birth cohort of the Longitudinal Study of Australian Children (N = 5107) to examine the impact of socioeconomic disadvantage (0–1 year) on children's reading skills (8–9 years). An interventional effects approach was applied to estimate the extent to which improving the levels of home reading (2–5 years) and preschool attendance (4–5 years) of socioeconomically disadvantaged children to be commensurate with their advantaged peers, could potentially reduce socioeconomic gaps in children's reading skills.ResultsSocioeconomically disadvantaged children had a higher risk of poor reading outcomes compared to more advantaged peers: absolute risk difference = 20.1% (95% confidence interval [CI]: 16.0%–24.2%). Results suggest that improving disadvantaged children's home reading and preschool attendance to the level of their advantaged peers could eliminate 6.5% and 2.1% of socioeconomic gaps in reading skills, respectively. However, large socioeconomic gaps would remain, with disadvantaged children maintaining an 18.3% (95% CI: 14.0%–22.7%) higher risk of poor reading outcomes in absolute terms.ConclusionThere are clear socioeconomic disparities in children's reading skills by late childhood. Findings suggest that interventions that improve home reading and preschool attendance may contribute to reducing these inequities, but alone are unlikely to be sufficient to close the equity gap.</div

Household income supplements in early childhood to reduce inequities in children's development

Background: Early childhood interventions have the potential to reduce children's developmental inequities. We aimed to estimate the extent to which household income supplements for lower-income families in early childhood could close the gap in children's developmental outcomes and parental mental health. Methods: Data were drawn from a nationally representative birth cohort, the Longitudinal Study of Australian Children (N = 5107), which commenced in 2004 and conducted follow-ups every two years. Exposure was annual household income (0–1 year). Outcomes were children's developmental outcomes, specifically social-emotional, physical functioning, and learning (bottom 15% versus top 85%) at 4–5 years, and an intermediate outcome, parental mental health (poor versus good) at 2–3 years. We modelled hypothetical interventions that provided a fixed-income supplement to lower-income families with a child aged 0–1 year. Considering varying eligibility scenarios and amounts motivated by actual policies in the Australian context, we estimated the risk of poor outcomes for eligible families under no intervention and the hypothetical intervention using marginal structural models. The reduction in risk under intervention relative to no intervention was estimated. Results: A single hypothetical supplement of AU$26,000 (equivalent to ∼USD$17,350) provided to lower-income families (below AU$56,137 (∼USD$37,915) per annum) in a child's first year of life demonstrated an absolute reduction of 2.7%, 1.9% and 2.6% in the risk of poor social-emotional, physical functioning and learning outcomes in children, respectively (equivalent to relative reductions of 12%, 10% and 11%, respectively). The absolute reduction in risk of poor mental health in eligible parents was 1.0%, equivalent to a relative reduction of 7%. Benefits were similar across other income thresholds used to assess eligibility (range, AU$73,329-$99,864). Conclusions: Household income supplements provided to lower-income families may benefit children's development and parental mental health. This intervention should be considered within a social-ecological approach by stacking complementary interventions to eliminate developmental inequities.</p