Trajectories of Poverty since Birth, Cumulative Adversities, and Chronic Health Conditons at 10 years old: Differentiating between Physical and Psychosocial Chronic Health Conditions

Background: Few studies examined the dynamics underlying the association between childhood poverty with psychosocial and physical chronic health conditions (CHC) separately. Our objectives were to examine if both components are similarly affected by child poverty and to disentangle the health effects between early and chronic poverty. Method: We examined data from 1334 children from the Quebec Longitudinal Study of Child Development. Household income and children CHCs during the previous year were reported annually by mothers. Low income was defined according to Statistics Canada thresholds. A cumulative adversity score was determined. Trajectories of household income from birth up to 10 years old were defined with latent class analyses. We adjusted for child sex and parents asthma. Results: Four poverty trajectories were identified: Stable non-poor (76%), decreasing (8%) and increasing poverty (9%), and chronically poor (7%). Chronic poverty was no longer associated with total CHCs after adjusting for the adversity score. Children in a chronically poor trajectory had a higher likelihood of psychosocial CHCs (AOR= 2.1; 95% CI= 1.1-4.1) whereas children in a decreasing trajectory of poverty have a higher likelihood of physical CHCs (AOR=1.6; 95%CI: 1.0, 2.5). The presence of child asthma explained a substantial portion of this latter association. Conclusions: Children psychosocial and physical CHCs are associated with different timing/durations of exposure to poverty. Adversities associated with poverty conditions may mediate the link between poverty and CHCs. These findings have implications for public health interventions and reaffirm the need for public policies aimed at reducing poverty in early childhood.