title: Increased household financial strain, the Great Recession and child health-findings from the UK Millennium Cohort Study.
abstract: There is a growing body of evidence associating financial strain (FS) with poor health but most of this research has been cross-sectional and adult-focused. During the 'Great Recession' many UK households experienced increased FS. The primary aim of this study was to determine the impact of increased FS on child health.
  
  
  
  We analysed the Millennium Cohort Study, a longitudinal study of children born in the UK between 2000 and 2002. Surveys at 7 years (T1, 2008) and 11 years (T2, 2012) spanned the 'Great Recession'. Three measures of increased FS were defined; 'became income poor' (self-reported household income dropped below the 'poverty line' between T1 and T2); 'developed difficulty managing' (parental report of being 'financially comfortable' at T1 and finding it 'difficult to manage' at T2); 'felt worse off' (parental report of feeling financially 'worse off' at T2 compared with T1). Poisson regression was used to estimate risk ratios (RR), adjusted risk ratios (aRR) and 95% CIs for six child health outcomes: measured overweight/obesity, problematic behaviour as scored by parents and teachers, and parental reports of fair/poor general health, long-standing illness and bedwetting at T2 (N=13 112). In subanalyses we limited our sample to those who were above the poverty line at T2.
  
  
  
  Compared with those who were not financially strained at both time points, children in households which experienced increased FS were at an increased risk of all unhealthy outcomes examined. In most cases, these increased risks persisted after adjustment for confounding and when limiting the sample to those above the poverty line.
  
  
  
  FS is associated with a range of new or continued poor child health outcomes. During times of widespread economic hardship, such as the 'Great Recession', measures should be taken to buffer children and their families from the impact of FS, and these should not be limited to those who are income poor.
authors.affiliation: UCL GOSH Institute of Child Health, London, UK.
authors.forename: Caoimhe
authors.identifier: 0000-0003-1763-4889
authors.initials: C
authors.lastname: McKenna
authors.affiliation: UCL GOSH Institute of Child Health, London, UK.
authors.forename: Catherine
authors.initials: C
authors.lastname: Law
authors.affiliation: UCL GOSH Institute of Child Health, London, UK.
authors.forename: Anna
authors.initials: A
authors.lastname: Pearce
mesh_terms: D002648:Child; D002653:Child Behavior Disorders / Q000453:epidemiology; D000067576:Child Health / Q000191:economics / Q000706:statistics & numerical data*; D002675:Child, Preschool; D015331:Cohort Studies; D057172:Economic Recession / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D053206:Nocturnal Enuresis / Q000453:epidemiology; D050177:Overweight / Q000453:epidemiology; D011203:Poverty / Q000191:economics / Q000706:statistics & numerical data
keywords: EPIDEMIOLOGY; SOCIAL MEDICINE