How does the local area deprivation influence life chances for children in poverty in Wales: A record linkage cohort study

Abstract

Background Children growing up in poverty are less likely to achieve in school and more likely to experience mental health problems. This study examined factors in the local area that can help a child overcome the negative impact of poverty. Method This retrospective cohort study included 159,131 children who lived in Wales and completed their age 16 exams (Key Stage 4 (KS4)) between 2009 and 2016. Free School Meal (FSM) provision was used an indicator of household level deprivation. Area level deprivation was measured by the Welsh Index of Multiple Deprivation 2011. An encrypted unique Anonymous Linking Field was used to link the children with their health and educational records. The outcome variable of 'Overall doing well' was comprised of achieved at KS4, no mental health condition, no substance, and alcohol abuse records. Bidirectional logistic regression models were used to investigate the association between local areas deprivation and child's outcome. Results 22% of children on FSM were 'overall doing well' compared to 54.9% of non-FSM children. FSM Children who lived in the least deprived areas are significantly more likely to do well (adjusted odds ratio (aOR) - 2.20 (1.93-2.51)) than children lived in the most deprived areas. FSM children, living in areas with higher community safety, higher relative income, higher access to services, are more likely to do well than their peers. Conclusion This study highlights that investing in community development (e.g., safety, back to work schemes, connectivity) helps in child's education attainment, mental health and reduce risk-taking behaviours.