Socioeconomic Risk Factors for Mental Health Problems in 4–5-Year-Old Children: Australian Population Study

doi:10.1016/j.acap.2009.08.007

Academic Pediatrics

Volume 10, Issue 1, January–February 2010, Pages 41-47

https://doi.org/10.1016/j.acap.2009.08.007 Get rights and content

Objective

To describe the extent to which parent- and teacher-reported child mental health problems vary by different indicators of socioeconomic status.

Methods

Participants were 4–5-year-old children in the Longitudinal Study of Australian Children (LSAC). Parents (N = 4968) and teacher (N = 3245) completed the 3–4-year-old version of Strengths and Difficulties Questionnaire (SDQ). Parents also reported the socioeconomic indicators of income, education, employment, and family composition (1- vs 2-parent families). Logistic regression models were used to predict SDQ total difficulties and each of the 4 SDQ subscales problems, as reported by parents and by teacher, and considered all putative socioeconomic status (SES) predictor variables simultaneously.

Results

The proportions of children scoring in the abnormal range varied according to SES indicator and mental health subscale. All of the SES indicators independently predicted parent-reported child mental health problems, although odds ratios were generally small to moderate (1.2 to 2.4), and not all reached statistical significance. Low income and parent education showed larger associations than sole parenthood or unemployment. The pattern for teachers was similar, though less consistent. Behavioral problems showed stronger associations with social disadvantage than emotional problems.

Conclusions

Research examining pathways to young children's mental health should include diverse measures of SES, particularly of family income and education. The fact that mental health problems were most strongly associated with parent education and income should be of interest to policy makers because education and income reflect investments in the lives of our participants' parents during their own childhood and adolescence.

Section snippets

Study Design and Sampling

This study draws on data from the 4 to 5-year-old cohort of the first wave of the Longitudinal Study of Australian Children (LSAC). LSAC collects information on children's physical and mental health, education, and social, cognitive, and emotional development from parents, child caregivers, preschool teacher, and schoolteacher.²¹ The sampling design and field methods for the first wave (2004) of the nationally representative LSAC have been described elsewhere.²² Briefly, LSAC used a 2-stage

Descriptive Data

Parent SDQ data were available for 4968 children (99.7% of the total LSAC preschool cohort) and teacher SDQ data for 3245 (65.1%). Compared with the 65% with data from both sources, the 35% with parent-reported data only were significantly (all P < .001) more likely to come from disadvantaged families—ie, to be in families where the primary caregiver did not complete Year 12 (39% vs 34%), was not in paid employment (53% vs 47%), or was single (16% vs 12%), or where the household income was <$41

Discussion

In this large population-based cohort, relationships between preschoolers' mental health problems and indicators of low SES were pervasive. Every indicator of disadvantage we examined (low income, sole parenthood, low education, and unemployment) predicted more mental health problems, even though not all associations reached statistical significance. Although these associations were generally small to moderate in size (ORs 1.2 to 2.4), they would undoubtedly have important population

Acknowledgments

We used a confidentialized unit record file from LSAC. The LSAC project was initiated and is funded by the Commonwealth Department of Families, Community Services and Indigenous Affairs, and is managed by the Australian Institute of Family Studies. Dr Davis is supported by a Victorian Health Promotion Foundation Public Health Research Fellowship. Prof Wake has been partly supported by 2 Australian National Health and Medical Research Council (NHMRC) Population Health Career Development Awards

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Children's Mental HealthSocioeconomic Risk Factors for Mental Health Problems in 4–5-Year-Old Children: Australian Population Study

Objective

Methods

Results

Conclusions

Section snippets

Study Design and Sampling

Descriptive Data

Discussion

Acknowledgments

Social Sci Med

J Am Acad Child Adolesc Psychiatry

Social Sci Med

J Am Acad Child Adolesc Psychiatry

Prevalence of psychopathology in preschool-age children

J Child Adolesc Psychiatr Nurs

Parents and teacher reports of DSM-IV psychopathological symptoms in preschool children

Soc Psychiatry Psychiatr Epidemiol

Parental reports of emotional or behavioral difficulties and mental health service use among US school-age children

The mental health of young people in Australia: key findings from the child and adolescent component of the national survey of mental health and well-being

Aust N Z J Psychiatry

Mental health of children and adolescents in Great Britain

Int Rev Psychiatry

Income-related inequality in mental health in Britain: the concentration index approach

Psychol Med