Social isolation in childhood and adult inflammation: evidence from the National Child Development Study

Background Social isolation is known to be associated with poorer health amongst adults, including coronary heart disease. It is hypothesized that this association may be mediated by inflammation. There has been little prospective research on the long-term impact of social isolation in childhood on adult health or the pathways which might be involved. The aim of this study was to investigate whether social isolation in childhood is associated with increased adult inflammation and the mechanisms involved across the life course. Methods This study used multiply-imputed data on 7,462 participants of the National Child Development Study in Great Britain. The association between child social isolation (7-11 yrs) and levels of C-reactive protein (CRP) in middle age (44 yrs) was examined. We additionally investigated the role of adult social isolation, psychological distress, health behaviors and socioeconomic factors as potential mediators using path analysis and concurrent measurements made across the life course. Results Socially isolated children had higher levels of C-reactive protein in mid-life (standardized coefficient= 0.05, p≤0.001). In addition children who were socially isolated tended to have lower subsequent educational attainment, be in a less advantaged social class in adulthood, were more likely to be psychologically distressed across adulthood and were more likely to be obese and to smoke. All of these factors partially explained the association between childhood social isolation and CRP. However this association remained statistically significant after considering all mediators simultaneously. Conclusions Social isolation in childhood is associated with higher levels of C-reactive protein in mid-life. This is explained in part through complex mechanisms acting across the life course. Identification and interventions targeted towards socially isolated children may help reduce long-term adult health risk

Adverse childhood experiences and multiple mental health outcomes through adulthood: A prospective birth cohort study

Objective: Exposure to adverse childhood experiences (ACEs) is associated with a broad range of mental health-related outcomes. Previous studies tended to use retrospectively reported ACEs, measure mental health outcomes at a one time point in adulthood and focus on individual outcomes. Hence, this study aimed to examine the association between prospectively and retrospectively measured ACEs and a wide range of mental health-related outcomes, spanning ages 16 to55, using a prospective birth cohort, representative of those born around 1958 in Great Britain. Methods: The study used the 1958 National Child Development Study (n ​= ​7980). Adverse childhood experiences were measured both prospectively and retrospectively, and combined into ACE scores. The associations between the ACE scores and mental health were quantified with linear regression for continuous and robust Poisson regression for binary outcomes. Results: We found a dose-response association between prospectively and retrospectively reported ACEs and all studied mental health-related outcomes, after accounting for multiple covariates. Among those with 2+ (vs 0) prospective ACEs, the risk of clinically significant psychological distress was up to 2.14 times higher, and of seeing a mental health specialist up to 2.85 times higher. Conclusions: Our findings reiterate the need for early-life interventions to reduce inequalities in mental health

Area-level and family-level socioeconomic position and body composition trajectories: longitudinal analysis of the UK Millennium Cohort Study

Background: Inequalities in the trajectories of body composition in childhood and adolescence have been infrequently studied. Despite the importance of environmental factors in obesity development, little research has looked at area-level socioeconomic position, independent of family socioeconomic position. We aimed to assess how inequalities in body composition develop with age. Methods: The Millennium Cohort Study is a longitudinal study of 19 243 families who had a child born between 2000 and 2002 in the UK. Multilevel growth curve models were applied to examine change in fat mass index (FMI), fat free mass index (FFMI; using the Benn index), and fat mass to fat free mass ratio (FM:FFM), measured using Bioelectrical Impedance Analysis, from ages 7 years to 17 years by the Index of Multiple Deprivation (IMD) and household income at baseline. Findings: Inequalities in FMI and FM:FFM ratio are evident at age 7 years and widen with age. At age 17 years, adolescents in the most disadvantaged IMD group had FMI 0·57 kg/mB (B=Benn parameter; 95% CI 0·43 to 0·70) higher and FM:FFM ratio 0·037 (95% CI 0·026 to 0·047) higher compared with the most advantaged group. Disadvantaged socioeconomic position is associated with higher FFMI but is reversed in adolescence after adjustment for FMI. Inequalities were greater in girls at age 7 years (mean FMI 0·22 kg/mB; 95% CI 0·13 to 0·32) compared with boys of the same age (0·05 kg/mB; –0·04 to 0·15, p=0·3), but widen fastest in boys, especially for FMI, in which there was over an 11 times increase in the inequality from age 7 years of 0·05kg/mB (95% CI –0·04 to 0·15) to 0·62 kg/mB at 17 years (0·42 to 0·82). Inequalities for the IMD were similar to income, and persisted at age 17 years independent of family socioeconomic position. Interpretation: Childhood and adolescence is an important period to address inequalities in body composition, as they emerge and widen. Policies should consider FFM as well as FM, and inequalities in the environment. Funding: Medical Research Council, Economic and Social Research Council

Adverse childhood experiences and adult inflammation: findings from the 1958 British birth cohort

Background: The relationship between adverse childhood experiences (ACE) and poorer health across the life course is well established. Increased chronic inflammation might be one mechanism through which these associations operate. The aim of this study was to explore the relationship between ACE and adult inflammation using a prospective longitudinal study. We also investigated whether associations were explained by life course socioeconomic, psychological and health behavioural factors, and whether associations differed by gender. // Methods: Multiply imputed data on 7464 participants of the National Child Development Study (1958 British birth cohort) were used. Prospectively collected data on ACE included care placement, physical neglect, parental separation, family history of offences, mental illness, domestic conflict and alcohol misuse across childhood (0–16 years). Adult inflammation was indicated by C-reactive protein (CRP), fibrinogen and Von Willebrand factor (vWF) at age 44/45. Multivariable linear regression models were used to estimate associations between ACE and adult inflammation. // Results: Graded associations for ACE with CRP and fibrinogen were observed (e.g. CRP: 1 ACE: 4.61% higher, 95% CI: −3.13, 12.97; 2+ ACE: 16.35% higher, 95% CI: 6.87, 26.66). Socioeconomic and health behavioral factors were found to particularly explain these associations. After inclusion of all covariates associations between ACE and mid-life inflammation were no longer significant. Associations did not differ for men and women. // Conclusions: ACE were associated in a graded manner with adult inflammation in a British birth cohort. The association was explained by life course socioeconomic and health behavioral factors, in particular. This study highlights the importance of protecting children from ACE and its negative health effects, and in supporting children through education and into skilled, secure work

Parental absence in early childhood and onset of smoking and alcohol consumption before adolescence

Background: Parental absence, due to death or separation from a parent, has been associated with smoking and alcohol consumption in adolescence and adulthood. The aim of this study was to investigate whether parental absence in early childhood was associated with smoking and alcohol uptake before adolescence. / Methods: Data on 10,940 children from the UK’s Millennium Cohort Study were used. Logistic regression was used to test associations between parental absence (0-7 years) and reports of smoking and alcohol consumption at age 11. / Results: Children who experienced parental absence were more likely to have smoked (OR=2.58, 95% CI: 1.88, 3.56) and consumed alcohol (OR=1.46, 95% CI: 1.25, 1.72). No differences were found by child sex or age, or parent absent. Children who experienced parental death were less likely to have drunk alcohol but those who had were more likely to have consumed enough to feel drunk. / Conclusions: Parental absence was associated with early uptake of risky health behaviours in a large, nationally representative UK cohort. Children who experience parental absence should be supported in early life in order to prevent smoking and alcohol initiation

Parental separation in childhood and adult smoking in the 1958 British birth cohort

BACKGROUND: Parental separation or divorce is a known risk factor for poorer adult health. One mechanism may operate through the uptake of risky health behaviours, such as smoking. This study investigated the association between parental separation and adult smoking in a large British birth cohort and also examined potential socioeconomic, relational and psychosocial mediators. Differences by gender and timing of parental separation were also assessed. METHODS: Multiply imputed data on 11 375 participants of the National Child Development Study (the 1958 British birth cohort) were used. A series of multinomial logistic regression models were estimated to investigate the association between parental separation (0–16 years) and adult smoking status (age 42), and the role of potential socioeconomic, relational and psychosocial mediators. RESULTS: Parental separation in childhood was associated with an increased risk of being a current (RRR = 2.14, 95% CI: 1.77, 2.60) or ex-smoker (RRR = 1.50, 95% CI: 1.22, 1.85) at age 42. This association remained after consideration of potential socioeconomic, psychosocial and relational mediators. Relational (parent–child relationship quality, parental involvement and adult partnership status) and socioeconomic factors (overcrowding, financial hardship, housing tenure, household amenities, free school meal receipt and educational attainment) appeared to be the most important of the groups of mediators investigated. No differences by gender or the timing of parental separation were observed. CONCLUSION: Parental separation experienced in childhood was associated with increased risk of smoking. Families undergoing separation should be further supported in order to prevent the uptake of smoking and to prevent later health problems

Parental separation in childhood and adult inflammation: the importance of material and psychosocial pathways

Background: Childhood adversities are known to be associated with poorer health outcomes. A potential mechanism may be through changes in inflammatory processes. One such childhood adversity is separation of parents, however relatively little is known about the association between parental separation and inflammation in adulthood. The aims of this study were to (1) investigate whether parental separation is associated with inflammation in mid-life, (2) focus upon the mechanisms that may be involved in translating childhood adversities, such as parental separation, into poorer health outcomes in adulthood. Methods: We examine the association of parental separation in childhood, defined as the breakdown of the parent’s partnership, and levels of C-reactive protein (CRP) in middle age. The role played by material (through material disadvantage and educational attainment), psychosocial (through parent-child relationship quality and psychological distress) and adiposity (through BMI) mechanisms is investigated using path analysis in a multiply-imputed dataset from a British birth cohort with concurrent measurements made throughout the life course (n=7,462). Results: Participants that report parental separation have higher CRP levels at age 44 than those who grew up with both parents (β=0.16, 95% CI: 0.06, 0.27). This association is largely explained by BMI, material and psychosocial factors. Material disadvantage after separation and educational attainment seem to be particularly important in this association. Conclusions: Parental separation increases CRP in adulthood via chains of disadvantage across the life course. This study points towards potential points for intervention and highlights a need to support separating families in order to minimise the long-term impact on adult health