Childhood poverty, social support, immigration background and adolescent health and life satisfaction: A population-based longitudinal study

Abstract

Objectives: This study examined whether poverty (neighborhood and household) was associated with future health or life satisfaction outcomes and whether the association operated through social support (adult support at home, adult support at school, peer belonging), or differed by the immigration background (nonimmigrant family or immigrant family) of the family.

Methods: This study utilized a retrospective, longitudinal, population-based cohort that included self-reported survey data from the Middle Years Development Instrument (MDI) completed by children at age 9 and age 12, linked to administrative records. Participants included 5906 children in British Columbia, Canada. Neighborhood and household poverty were observed at age 8. Social support from adults and peers was self-reported at age 9. Outcomes (overall health; life satisfaction) were self-reported at age 12. Adjusted multi-level multiple linear regression analyses and parallel mediation analyses were utilized. The interaction between poverty exposure and immigration background was also examined.

Results: Exposure to either poverty type was associated with lower levels of life satisfaction and overall health at age 12, though household poverty appeared to be associated with lower outcomes in comparison to neighborhood poverty. The indirect effects of poverty on outcomes appeared to operate primarily through adult support at home and peer belonging. Children in immigrant families had a larger negative association between neighborhood poverty and life satisfaction.

Conclusions: Household poverty had a larger negative association to outcomes in comparison to neighborhood poverty. The association of poverty to outcomes differed by immigration background and operated partially through adult support at home and peer belonging.

Keywords: ADOLESCENT DEVELOPMENT: Life satisfaction; ADOLESCENT DEVELOPMENT: Physical Health; ADOLESCENT RELATIONSHIPS: Connectedness; ADOLESCENT RELATIONSHIPS: Peer relationships; GROUP OR ENVIRONMENT: Immigrants; GROUP OR ENVIRONMENT: Social class/SES; PREVENTION AND INTERVENTION: Parental support.

Figure 1

Flow diagram of analytic sample inclusion and exclusion. A total of 6543 children completed both the MDI grade 4 (MDI4) and MDI grade 7 (MDI7) surveys and were eligible for inclusion in the study. Of the 5906 participants with successful data linkages that were present in BC at ages 7 to 8, 785 (13.3%) had at least one item of missing data. Missingness in individual MDI7 outcome scales was 2.5% for overall health, and 4.2% for satisfaction with life. Missingness in individual MDI4 social support scales was between 4.7% to 5.8%. Regarding differences between those who completed both the MDI4 and MDI7 surveys compared to those who only completed the MDI7 survey, those with unlinked data were more likely to have lived in poverty and more likely at grade 7 to have less peer belonging and adult support at school. Children lost to follow‐up were more likely to be living in poverty and more likely to be first‐ or second‐generation immigrants. For children who were present in B.C. during the study period with successful data records linkages, the administrative data variables (poverty exposure, sex, immigrant generation status, special educational needs designation) had ≤1% missing data.

Figure 2

Parallel mediation analysis examining the mediating effect of perceived social support sources in the relationship of household poverty at age 8 on a standardized score for satisfaction with life at age 12. a _n is the effect of household poverty at age 8 on perceived social support sources; b _n is the effect of perceived social support on satisfaction with life at age 12. C^' is the direct effect of household poverty on satisfaction with life. C is the total effect of household poverty on satisfaction with life. The parallel mediation analysis also adjusted for the variables of sex, immigrant generation status, special educational needs designation at age 7, parental mental health condition, and age at MDI outcome assessment.