title: Longitudinal patterns of poverty and health in early childhood: exploring the influence of concurrent, previous, and cumulative poverty on child health outcomes.
abstract: BACKGROUND
  Although the links between poverty and health have often been studied , the dynamics of poverty and physical health in early childhood remain under-investigated. In particular, it is not known whether the health of young children is affected differently from that of adults by patterns of poverty unique to them.
  
  
  METHODS
  We examined patterns of health from 5 to 41 months of age as a function of concurrent, lagged, and chronic exposure to insufficient income. Using data from the first four rounds of the Quebec Longitudinal Study of Child Development, we performed multilevel logistic and multilevel Poisson regressions and latent growth curve analyses to explore associations between exposure to poverty and mother-reported asthma-like attacks, and maternal perception of health status controlling for neonatal, maternal, and environmental characteristics.
  
  
  RESULTS
  The mean number of mother-reported asthma-like attacks significantly decreased as children aged. The likelihood of being perceived in a poorer health status also decreased across time. Concurrent poverty was associated with more mother-reported asthma-like attacks and with a higher risk of being perceived in poorer health status. One-period-lagged poverty was associated with more mother-reported asthma-like attacks and this remained significant after controlling for concurrent poverty. The number of mother-reported asthma-like attacks was significantly higher among children in the chronic poverty class compared to those in the never-poor class, particularly at 17 and 29 months. Perceived health status at 5-months was significantly poorer among chronically poor children compared to never-poor children.
  
  
  CONCLUSIONS
  Exposure to poverty negatively affects two major health indicators in early childhood - maternal perception of child health and mother-reported asthma-like attacks. Patterns of the effects vary according to timing and duration of poverty exposure. Further longitudinal research is warranted to disentangle time-specific from cumulative effects of poverty on child health.
authors.affiliation: Department of Social and Preventive Medicine, Université de Montreal, Montreal, Quebec, Canada. b.nikiema@umontreal.ca
authors.forename: Nikiéma
authors.initials: N
authors.lastname: Béatrice
authors.forename: Gauvin
authors.initials: G
authors.lastname: Lise
authors.forename: Zunzunegui Maria
authors.initials: ZM
authors.lastname: Victoria
authors.forename: Séguin
authors.initials: S
authors.lastname: Louise
mesh_terms: D000328:Adult; D000367:Age Factors; D001249:Asthma / Q000209:etiology*; D002675:Child, Preschool; D005260:Female; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D009035:Mothers; D010465:Perception; D016012:Poisson Distribution; D011203:Poverty; D011792:Quebec; D057566:Self Report; D013997:Time Factors