How community resources mitigate the association between household poverty and the incidence of adverse childhood experiences

• Published in: International journal of public health Vol. 64; no. 7; pp. 1059 - 1068
• Main Authors: Blair, Alexandra, Marryat, Louise, Frank, John
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-09-2019; Springer Nature B.V
• Subjects: Adverse childhood experiences; Adverse Childhood Experiences - statistics & numerical data; Breast Feeding - statistics & numerical data; Breastfeeding & lactation; Child; Child Care - standards; Child Health; Child poverty; Child, Preschool; Environmental Health; Female; Households; Housing - standards; Humans; Incidence; Income; Infant; Longitudinal Studies; Male; Medicine; Medicine & Public Health; Occupational Medicine/Industrial Medicine; Original; Original Article; Parks, Recreational - standards; Poverty - statistics & numerical data; Public Health; Scotland - epidemiology; Socioeconomic Factors; Transportation - standards; Scotland; Childhood circumstances; Poverty; Child health; Inequalities; Health equity; Adverse childhood experiences; Social epidemiology
• ISSN: 1661-8556; 1661-8564
• DOI: 10.1007/s00038-019-01258-5

Objectives
To assess what proportion of the association between household low income and incidence of adverse childhood experiences (ACE) would be eliminated if all households had access to housing, transportation and childcare services, breastfeeding counselling, and parks.
Methods
Using Growing Up in Scotland birth cohort data (
N
 = 2816), an inverse probability-weighted regression-based mediation technique was applied to assess associations between low-income status (< £11,000 in 2004/5), resource access, and cumulative 8-year ACE incidence (≥ 1, ≥ 3 ACEs). Resource access was measured based on households’ self-reported difficulties (yes/no) in accessing housing, transportation, childcare, and breastfeeding counselling, and park proximity (within 10 min from the residence).
Results
The protective effects of resources were heterogeneous. Only access to transportation was associated with lower ACE incidence in both low- and higher-income households. If all had access to transportation, 21% (95% CI 3%, 41%) of the income-based inequality in incidence of 3 or more ACEs could be eliminated.
Conclusions
While second best to the elimination of child poverty, measures to improve families’ access to community resources such as transportation may mitigate the effects of poverty on ACE incidence.