Is adolescent multiple risk behaviour associated with reduced socioeconomic status in young adulthood and do those with low socioeconomic backgrounds experience greater negative impact? Findings from two UK birth cohorts

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Abstract

Background Multiple risk behaviour (MRB) refers to the occurrence of two or more risk behaviours. Adolescent MRB is associated with multiple negative health outcomes including premature mortality and morbidity. It is also associated with deleterious social and educational outcomes such as reduced GCSE score, unemployment and police arrests. To date no studies have determined the relationship between adolescent MRB and young adult socioeconomic status (SES). The aim of the study was to examine the nature of the association between adolescent MRB and young adult SES including whether those with low early life SES experience greater negative impact.

Methods Two birth cohort studies; The British Cohort Study 1970 (BCS70) and The Avon Longitudinal Study of Parents and Children (ALSPAC), born in 1991–1992, were used and two comparable MRB score variables were derived. Logistic regression was used to explore the association between MRB and young adult SES. The moderating effect of three early life SES variables was assessed using logistic regression models with and without interaction parameters. Evidence to support the presence of moderation was determined by likelihood ratio tests p≤0.05. Missing data were addressed using multiple imputation methods.

Results Adolescents had a median of two risk behaviours in BCS70 and three in ALSPAC. Adolescent MRB was negatively associated with young adult SES (university degree attainment) in BCS70 (OR 0.81, 95% CI: 0.76, 0.86) and ALSPAC (OR 0.85, 95% CI: 0.82, 0.88). There was a dose response: each incremental risk behaviour resulted in reduced odds of university degree attainment. There was a negative association between MRB and occupational status at age 34 in BCS70 (adjusted OR 0.86 95% CI: 0.82, 0.90). In BCS70, there was evidence that parental occupational status (p=0.009), maternal education (p=0.03) and household income (p=0.03) moderated the effect of adolescent MRB on young adult SES with the negative effect of MRB on degree attainment being stronger for those from low socioeconomic backgrounds. There was no evidence in ALSPAC that early life SES moderated this relationship.

Conclusion Adolescence appears to be a critical time in the life course to address risk behaviours, due to the likelihood that behaviours established here may have effects in later in life. Intervening on adolescent MRB could improve adult SES outcomes and thus indirectly affect longer term health. Evidence for a moderation effect in the BCS70 but not ALSPAC highlights that alternative measures should be explored to capture the nuance of contemporary young adult SES.
Original languageEnglish
DOIs
Publication statusPublished - Sep 2020

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