Impact of Parental Mental Health and Poverty on the Health of the Next Generation: A Multi-Trajectory Analysis Using the UK Millennium Cohort Study

Background: Exposure to parental mental ill-health and poverty in childhood impact health across the life course. Both maternal and paternal mental health may be important influences, but few studies have unpicked the complex interrelationships between these exposures and family poverty for later health.

Methods: We used longitudinal data on 10500 children from the nationally representative UK Millennium Cohort study. Trajectories of poverty, maternal mental health and secondary caregiver mental health were constructed from child age 9 months through to 14 years. We assessed associations of these trajectories with mental health outcomes at age 17 years. Population attributable fractions were calculated to quantify the contribution of caregivers’ mental health problems and poverty to adverse outcomes at the country level.

Findings: We identified five distinct trajectories. Compared with children with low poverty and good parental mental health, those who experienced poverty, poor primary or secondary caregiver mental health (53%) had worse outcomes. Children exposed to both persistent poverty and poor caregiver mental health were at markedly increased risk of socioemotional behavioural problems (aOR 4·2; 95% CI 2·7 – 6·7), mental health problems (aOR 2·5; CI 1·6 – 3·9) and cognitive disability (aOR 1·7; CI 1·1 – 2·5). We estimate that 40% of socioemotional behavioural problems at age 17 were attributable to persistent parental caregivers’ mental health problems and poverty.

Conclusions: More than half of children growing up in the UK are persistently exposed to either one or both of poor caregiver mental health and family poverty. The combination of these exposures is strongly associated with adverse health outcomes in the next generation.