Cumulative family risks across income levels predict deterioration of children’s general health during childhood and adolescence

Abstract

Family is considered an important agent in the health development of children. This process is significant but quite complex because the prevalence of potential risk factors in the family can hinder children’s health. This study examined if multiple family risks might have cumulative effect on children and youth’s health across various levels of household income. The data in this study were drawn from the 2011–2012 U.S. National Survey of Children’s Health (N = 79,601). A cumulative family risk (CFR) index was developed, which included such constructs as single-parenthood, unstable employment, large family, parenting stress, poor maternal education, poor maternal general health and poor maternal mental health. Multiple logistic regression analyses showed that CFR level was significantly related to children and youth’s poor health outcome (p < .001). When poverty levels were considered, however, the impact of CFRs on children and youth’s health was attenuated. The impact of CFRs was higher on children and youth from affluent families than on those from poor families. Overall there was a consistent pattern of trend in the point estimate as well as confidence limits as levels of affluence and numbers of family risk increased although some of the confidence intervals overlapped. Living in disadvantaged families might serve as a protective factor against CFRs possibly through repeated exposure to hardships and subsequent formation of resilience among some of the disadvantaged children.

Intergenerational transmission of family adversity: Examining constellations of risk factors

“…Previous research has recognised the empirical challenges of trying to comprehensively assess the ways in which risk factors co-occur. One approach is the use of cumulative risk indices, which quantifies the number of risks present in a child’s life and establishing associations to a range of outcomes, such as educational attainment, health and wellbeing [3–5]. This approach is based on the assumption that it is the accumulation rather than the content of the risk factor that matters most in shaping children’s development.…”

“…Cumulative risk indices involve identifying a set of risk factors (e.g. low maternal education, parental worklessness, teen parenthood, maternal depression), dichotomizing them (as extant or not) and adding them to derive a risk score for each individual in a given sample, combining multiple risks into a single index [3, 5]. Using a cumulative risk index does however not consider how different risk factors combine in individual lives and how they work together in shaping developmental outcomes.…”

Psychosocial Risk, Symptom Burden, and Concerns in Families Affected by Childhood Cancer

“…Previous research has explored the relationship between family factors (e.g., family cohesion, parent distress) and symptom burden as well as health-related quality of life, and found that family and parent factors are related to health outcomes [39]. The relationship between family risk and child health has been well-established in the general population [40,41]. Results of this work have called for a need to identify interventions focused on family function and parent distress as potential moderators of child health, although interventions focused on parent or family functioning within pediatric oncology are relatively rare [42][43][44].…”

Healthy living practices in families and child health: 5-year follow-up of Taiwan Birth Cohort Study

“…However, most of the existing literature used cross-sectional designs that demonstrated the association of CHLPF with health outcomes at a specific point in time. 16 Thus, a longitudinal follow-up study that would investigate the associations between major variables 6 is warranted to examine the long-term implications of these practices.…”

“…For children, the family is a major socialiser that forms an important proximal environment for developing routines, capacity, knowledge and norms for healthy living. 6–8 If begun in early childhood, these familial factors can, in response to risks and adversities, promote positive health outcomes and reduce negative outcomes for children. 9 Because family is involved in daily health promotion for children, 10 the family context and its embedded routines are essential for shaping children’s health, health behaviour and lifestyles during growth.…”