Socioeconomic inequalities in mental health difficulties over childhood: a longitudinal sex-stratified analysis using the UK Millennium Cohort Study

Chua, Yu Wei ORCID: 0000-0002-2174-6149, Schlüter, Daniela, Pearce, Anna, Sharp, Helen and Taylor-Robinson, David ORCID: 0000-0002-5828-7724 (2025) Socioeconomic inequalities in mental health difficulties over childhood: a longitudinal sex-stratified analysis using the UK Millennium Cohort Study Social Science & Medicine, 378. p. 118159. ISSN 0277-9536, 1873-5347

Access the full-text of this item by clicking on the Open Access link.

Text Manuscript-cmh-trajectories-SSM.pdf - Author Accepted Manuscript Available under License Creative Commons Attribution. Download (1MB) | Preview

Abstract

Stark socioeconomic inequalities in childhood mental health have been widely reported. Understanding whether they vary with age, by type of difficulty or sex can inform public health policies to tackle socioeconomic inequalities. We investigated the effects of early life childhood socioeconomic circumstances (SECs) (maternal education and household income) on developmental trajectories of externalising and internalising difficulties in childhood and adolescence, in males and females from the UK-representative Millennium Cohort Study (N = 15383). We estimated the Slope Index of Inequality (SII) (absolute difference between the most versus least advantaged) using linear mixed-effects regression models, on parent-reported Strengths and Difficulties Questionnaire externalising and internalising difficulties score, at 5, 7, 11, 14, and 17 years(y). The mean externalising score was high at 5y (4.8 [95 %CI: 4.7, 4.9]) and decreased slightly, while mean internalising score increased over childhood, reaching 3.9 [3.8, 4.1] by 17y, with a steeper trend for females in adolescence. Lower maternal education was associated with greater externalising scores at 5y (SII, Male: 3.0 [2.7 to 3.3]; Female: 2.7 [2.4, 3.0]) with inequalities decreasing slightly up to 17y (SII Male: 2.4 [2.0 to 2.7], Female: 2.5 [2.1, 2.8]). Inequalities in internalising scores increased slightly over childhood (SII Female 5y: 1.3 [1.1, 1.6]; 17y: 1.9 [1.5, 2.3]; SII Male 5y = 1.6 [1.3, 1.8], 17y = 1.8 [1.5, 2.2]). Patterns were similar using household income. Disadvantaged SECs are associated with persistently higher levels of parent-reported mental health difficulties up to 17y, with larger effects on externalising than internalising difficulties, but little differences by sex or socioeconomic measure.

Item Type:	Article
Uncontrolled Keywords:	Socioeconomic inequalities, Mental health, Externalising difficulties, Internalising difficulties
Divisions:	Faculty of Health & Life Sciences Faculty of Health & Life Sciences > Inst. Population Health
Depositing User:	Symplectic Admin
Date Deposited:	14 May 2025 10:43
Last Modified:	28 Feb 2026 15:13
DOI:	10.1016/j.socscimed.2025.118159
Open Access URL:	https://doi.org/10.1016/j.socscimed.2025.118159
Related Websites:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3192726
Disclaimer:	The University of Liverpool is not responsible for content contained on other websites from links within repository metadata. Please contact us if you notice anything that appears incorrect or inappropriate.