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Out-of-home care in childhood and biomedical risk factors in middle-age: National birth cohort study
Carlos de Mestral1,2, Steven Bell3, Mark Hamer4
1Department of Epidemiology & Public Health, University College London, London, UK.
Insights
Childhood out-of-home care does not appear to impact adult biomarkers. This study found no evidence that adversity experienced in public care biologically mediates later chronic disease risk.
Area of Science:
- Social Epidemiology
- Developmental Psychology
- Biomedical Science
Background:
- Childhood adversity, particularly out-of-home care, is linked to increased chronic disease and mortality.
- The biological mechanisms mediating this relationship remain unclear.
- This study investigates whether biological markers mediate the impact of childhood public care on later health outcomes.
Purpose of the Study:
- To examine if childhood experience of out-of-home care is associated with measurable biological changes.
- To determine if these biological changes mediate the relationship between childhood care and later chronic disease or mortality.
- To explore potential alternative pathways linking childhood care to long-term health.
Main Methods:
- Utilized data from the UK National Child Development Study.
- Prospectively collected data on public care exposure up to age 16.
- Assessed biomarkers (cardiovascular, inflammatory, neuroendocrine, respiratory) at ages 44/45 in 8012 participants.
Main Results:
- 4% of participants (n=322) had experienced public care.
- Children in care showed early life differences in poverty, health, and disability.
- After controlling for confounders, childhood care was unrelated to middle-age biomarkers; no links found with care duration, timing, or type.
Conclusions:
- Biomarkers assessed in this study do not appear to mediate the link between childhood public care and later chronic disease or mortality.
- Alternative pathways, such as mental health, socioeconomic position, and health behaviors, warrant further investigation.
- The biological embodiment of childhood adversity's impact on long-term health requires further research.
Objective:
With there being an apparent impact of experience of out-of-home care in childhood on chronic disease and mortality, we examined how such adversity might be embodied such that it has a measurable impact on human biology, so mediating this relationship.
Methods:
We used data from the UK National Child Development Study in which exposure to public care was prospectively gathered on three occasions up to age 16. Study members also participated in a social survey at age 42 and a clinical examination at age 44/45 when cardiovascular, inflammatory, neuroendocrine, and respiratory risk markers for mortality were collected, 19 of which were included as endpoints in the present analyses.
Results:
Of the 8012 participants in the biomedical survey, 4% (n = 322) had been in care at some point in childhood and/or adolescence. We found the expected marked differences in the early life characteristics of poverty, health, and disability in children with experience of public care relative to their unexposed counterparts. After controlling for these confounding factors, however, care in childhood was essentially unrelated to biomarkers in middle-age. We also found no consistent links between these biomarkers and the duration, timing, or type of care.
Conclusions:
Our results suggest that the biomarkers captured in the present study are unlikely to mediate the link between public care in childhood and later chronic disease or mortality. Processes involving mental health, socioeconomic position, and health behaviors would seem to be a potential alternative pathway warranting investigation.
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