Early‐life pathways to inequalities in child mental health: evidence from eight birth cohorts

@article{avraam2026earlylife,
  title = {{Early‐life pathways to inequalities in child mental health: evidence from eight birth cohorts}},
  author = {Demetris Avraam and Gabriella Melis and Tim Cadman and Jennie Carson and Marie Aline Charles and Yu Wei Chua and Ahmed Elhakeem and Joaquín Escribano and Veit Grote and Dariusz Gruszfeld and Kathrin Guerlich and Rae‐Chi Huang and Jennifer R. Harris and Jesus Ibarluzea and Jordi Julvez and Berthold Koletzko and Ashleigh Lin and Unai Martin and Rosemary McEachan and Maria Melchior and Phillip Melton and Johanna Thorbjornsrud Nader and Angela Pinot de Moira and Maja Popovic and Simona Porru and Lorenzo Richiardi and Blanca Sarzo and Daniela Schlüter and Jordi Sunyer and Morris Swertz and Elvira Verduci and John Wright and Annick Xhonneux and Tiffany Yang and Daniela Zugna and Anne‐Marie Nybo Andersen and Katrine Strandberg‐Larsen and David Taylor‐Robinson},
  journal = {Journal of Child Psychology and Psychiatry, and Allied Disciplines},
  year = {2026},
  month = jul,
  doi = {10.1111/jcpp.70207},
  url = {https://doi.org/10.1111/jcpp.70207},
  note = {CC BY 4.0},
}

TY  - JOUR
TI  - Early‐life pathways to inequalities in child mental health: evidence from eight birth cohorts
AU  - Demetris Avraam
AU  - Gabriella Melis
AU  - Tim Cadman
AU  - Jennie Carson
AU  - Marie Aline Charles
AU  - Yu Wei Chua
AU  - Ahmed Elhakeem
AU  - Joaquín Escribano
AU  - Veit Grote
AU  - Dariusz Gruszfeld
AU  - Kathrin Guerlich
AU  - Rae‐Chi Huang
AU  - Jennifer R. Harris
AU  - Jesus Ibarluzea
AU  - Jordi Julvez
AU  - Berthold Koletzko
AU  - Ashleigh Lin
AU  - Unai Martin
AU  - Rosemary McEachan
AU  - Maria Melchior
AU  - Phillip Melton
AU  - Johanna Thorbjornsrud Nader
AU  - Angela Pinot de Moira
AU  - Maja Popovic
AU  - Simona Porru
AU  - Lorenzo Richiardi
AU  - Blanca Sarzo
AU  - Daniela Schlüter
AU  - Jordi Sunyer
AU  - Morris Swertz
AU  - Elvira Verduci
AU  - John Wright
AU  - Annick Xhonneux
AU  - Tiffany Yang
AU  - Daniela Zugna
AU  - Anne‐Marie Nybo Andersen
AU  - Katrine Strandberg‐Larsen
AU  - David Taylor‐Robinson
PY  - 2026
DA  - 2026/07/28
JO  - Journal of Child Psychology and Psychiatry, and Allied Disciplines
DO  - 10.1111/jcpp.70207
UR  - https://doi.org/10.1111/jcpp.70207
AB  - Background: Socioeconomic inequalities in children's emotional and behavioural problems are already present at school entry. We examined associations between early‐life socioeconomic conditions and children's externalising and internalising problems and assessed whether early‐life risk factors mediated these associations.  Methods: We analysed harmonised individual participant data from eight birth cohorts within the EU Child Cohort Network. Maternal educational level during pregnancy was used as an indicator of early‐life socioeconomic conditions (SECs). Scores of children's externalising and internalising problems around school entry age were used as the outcome variables. Inequalities were quantified using the Slope Index of Inequality which captures the difference in prevalence of problems between children from highest and lowest SECs. Mediation analysis was used to assess the mediating role of five early‐life risk factors: maternal smoking during pregnancy, gestational age, small for gestational age, postpartum depression and breastfeeding.  Results: Inequalities in externalising and internalising problems by SECs were consistent across cohorts: Children of mothers with low educational level had on average a 12 and 11 percentage point increased prevalence of externalising and internalising problems respectively. Early‐life factors explained around 8% (DNBC, Denmark) to 54% (INMA, Spain) of the inequality in externalising problems and 7% (ELFE, France) to 25% (ALSPAC, UK) in internalising problems.  Conclusions: Children from lower SECs consistently had a higher prevalence of both externalising and internalising problems around school entry age. These inequalities were partly mediated by early‐life factors. Public health interventions in pregnancy and the preschool period are critical to address the early emergence of inequalities in children's mental health.
SN  - 0021-9630
SN  - 1469-7610
ER  -