Co-Occurrence of Health Conditions during Childhood: Longitudinal Findings from the UK Millennium Cohort Study (MCS).

Abstract

AIMS:To identify patterns of stability and change in co-occurrence in children between 5-11 years, and to assess if they vary by socio-demographic factors. METHODS:Data from 9548 singleton children from the UK Millennium Cohort Study (MCS) were assessed for co-occurrence of five common adverse conditions: wheeze; longstanding illness; unfavorable weight; injury; and socio-emotional difficulties. We summed adverse conditions (0-5) for each child at ages 5, 7, and 11 and identified co-occurrence (≥2 conditions). Using multinomial regression, we explored associations between co-occurrence trajectories and child's sex and ethnicity, maternal education, and income quintile. RESULTS:45.6% of children experienced co-occurrence between 5-11 years (7% experienced constant co-occurrence). More children moved into co-occurrence than moved out (16.9 vs. 11.9%). Mutually-adjusted relative risk ratios (aRRR) showed a gradient by maternal education: compared to children with no co-occurrence whose mothers had a higher/degree, children whose mothers had no qualifications were more likely to move into (aRRR = 1.32(95%CI:1.02,1.70)), out of (1.74(1.34,2.26)), have fluctuating (1.52(1.09,2.10)) or constant co-occurrence (2.58(1.76,3.80)). The same gradient (high vs. low) was evident for income quintiles. Girls were less likely to experience co-occurrence. CONCLUSIONS:Co-occurrence of adverse conditions is common during childhood, and trajectories are socially patterned. Child-focused care for lower-income children and boys early in life may prevent and reduce co-occurrence in later childhood.