Sharon Goldfeld1,2, Meredith O'Connor1,2, Elodie O'Connor1, Shiau Chong1, Hannah Badland3, Sue Woolfenden4,5, Gerry Redmond6, Katrina Williams2,7,8, Francisco Azpitarte9,10, Dan Cloney1,11, Fiona Mensah2,12. 1. Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC, Australia. 2. Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia. 3. Centre for Urban Research, RMIT University, Melbourne, VIC, Australia. 4. Department of Community Child Health, Sydney Children's Hospital Network, Sydney, NSW, Australia. 5. School of Women and Children's Health, University of New South Wales, Sydney, NSW, Australia. 6. School of Social and Policy Studies, Flinders University, Adelaide, SA, Australia. 7. Department of Neurodevelopment and Disability, Royal Children's Hospital, Melbourne, VIC, Australia. 8. Clinical Sciences, Murdoch Children's Research Institute, Melbourne, VIC, Australia. 9. Melbourne Institute of Applied Economic and Social Research, University of Melbourne, Melbourne, VIC, Australia. 10. Brotherhood of St Laurence, Melbourne, VIC, Australia. 11. Australian Council for Educational Research, Melbourne, VIC, Australia. 12. Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC, Australia.
Abstract
Background: Disadvantage rarely manifests as a single event, but rather is the enduring context in which a child's development unfolds. We aimed to characterize patterns of stability and change in multiple aspects of disadvantage over the childhood period, in order to inform more precise and nuanced policy development. Methods: Participants were from the Longitudinal Study of Australian Children birth cohort (n = 5107). Four lenses of disadvantage (sociodemographic, geographic environment, health conditions and risk factors), and a composite of these representing average exposure across all lenses, were assessed longitudinally from 0 to 9 years of age. Trajectory models identified groups of children with similar patterns of disadvantage over time for each of these lenses and for composite disadvantage. Concurrent validity of these trajectory groups was examined through associations with academic performance at 10-11 years. Results: We found four distinct trajectories of children's exposure to composite disadvantage, which showed high levels of stability over time. In regard to the individual lenses of disadvantage, three exhibited notable change over time (the sociodemographic lens was the exception). Over a third of children (36.3%) were exposed to the 'most disadvantaged' trajectory in at least one lens. Trajectories of disadvantage were associated with academic performance, providing evidence of concurrent validity. Conclusions: Children's overall level of composite disadvantage was stable over time, whereas geographic environments, health conditions and risk factors changed over time for some children. Measuring disadvantage as uni-dimensional, at a single time point, is likely to understate the true extent and persistence of disadvantage.
Background: Disadvantage rarely manifests as a single event, but rather is the enduring context in which a child's development unfolds. We aimed to characterize patterns of stability and change in multiple aspects of disadvantage over the childhood period, in order to inform more precise and nuanced policy development. Methods:Participants were from the Longitudinal Study of Australian Children birth cohort (n = 5107). Four lenses of disadvantage (sociodemographic, geographic environment, health conditions and risk factors), and a composite of these representing average exposure across all lenses, were assessed longitudinally from 0 to 9 years of age. Trajectory models identified groups of children with similar patterns of disadvantage over time for each of these lenses and for composite disadvantage. Concurrent validity of these trajectory groups was examined through associations with academic performance at 10-11 years. Results: We found four distinct trajectories of children's exposure to composite disadvantage, which showed high levels of stability over time. In regard to the individual lenses of disadvantage, three exhibited notable change over time (the sociodemographic lens was the exception). Over a third of children (36.3%) were exposed to the 'most disadvantaged' trajectory in at least one lens. Trajectories of disadvantage were associated with academic performance, providing evidence of concurrent validity. Conclusions: Children's overall level of composite disadvantage was stable over time, whereas geographic environments, health conditions and risk factors changed over time for some children. Measuring disadvantage as uni-dimensional, at a single time point, is likely to understate the true extent and persistence of disadvantage.
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