Children from families receiving social welfare and cardiometabolic risk at 10 years old. A longitudinal analysis from a Quebec birth cohort

Background: Childhood poverty is associated with cardiovascular disease (CVD) risk in adults. It is unclear if CVD risk factors are already present among poor children. We assessed the association between receiving social welfare during childhood and CVD risk factors at 10 years old. Methods: Data were from the 1998-2010 Quebec Longitudinal Study of Child Development birth cohort (n=2,120) and restricted to the 10-year olds with fasting cardiometabolic data (n=595). Source of income was measured annually. Receiving social welfare provides income approximately 60% below the low-income cutoffs as established by Statistics Canada. We tested for differences in cardiometabolic levels based on each additional year of receiving social welfare, as well as defined into three levels of exposure since birth (no exposure, 1-4 years, 5-9 years) based on an accumulation lifecourse model of risk. Multivariable linear regression adjusted for sex, pubertal status, weight (overweight including obese, age- and sex- standardized as defined by the CDC), and parental history of hypercholesterolemia or diabetes. Results: Eleven percent had ever received social welfare. For each additional year of receiving social welfare, HDL decreased (-0.03 mmol/L, p<0.01), and triglycerides, insulin and BMI Z-scores increased (0.03 mmol/L, p<0.01; 1.45 pmol/L, p<0.10; and 0.07, p<0.05, respectively). Children from households receiving social welfare for ≥5 years had lower HDL (-0.19 mmol/L, p=0.01), elevated triglycerides (0.28 mmol/L, p=0.001), insulin (12.21 mmol/L, p=0.04) and BMI Z-scores (0.63, p<0.01) compared to children with no exposure. Conclusions: Extreme poverty has important detrimental effects in youth that may precipitate a lifelong risk of CVD.