Author Identifier (ORCID)
Abstract
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.
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.
Keywords
externalising problems, internalising problems, mediation analysis, multi-cohort study, Socioeconomic inequalities
Document Type
Journal Article
Date of Publication
1-1-2026
E-ISSN
14697610
ISSN
00219630
Publication Title
Journal of Child Psychology and Psychiatry
Publisher
Wiley
School
Nutrition and Health Innovation Research Institute
RAS ID
101968
Funding Information
The authors would like to acknowledge the LifeCycle project funded by the European Union's Horizon 2020 Research and Innovation Programme under Grant Agreement No. 733206. Cohort-specific acknowledgments can be found in Table S11 in Appendix S3. DA is funded by the European Union's Horizon Europe Research and Innovation Programme under the Marie Skłodowska-Curie Postdoctoral Fellowship Grant Agreement No. 101106261 (ESICRI). YWC is part-funded by an NIHR Research Professorship (NIHR302438) awarded to DT-R, and by NIHR Oxford Health Biomedical Research Centre – the views expressed are those of the author(s) and not necessarily those of NIHR or the Department of Health and Social Care. The work of VG, KG and BK is co-funded by the German Federal Ministry of Education and Research (Bundesministerium für Bildung und Forschung, BMBF) as part of the German Center for Child and Adolescent Health (DZKJ), 01GL2406A. BK is the Else Kröner Seniorprofessor of Paediatrics at LMU – University of Munich, financially supported by the charitable Else Kröner-Fresenius-Foundation, LMU Medical Faculty and LMU University Hospitals. AL is funded by an NHMRC Investigator Grant (#2010063). SP has been awarded a Margarita Salas postdoctoral contract MGS/2021/19(UP2021-021) financed by the European Union-NextGenerationEU. BS is supported by a grant from the Instituto de Salud Carlos III (CD23/00090 [co-financed by European Union]). DT-R is supported by the NIHR on a Research Professorship (NIHR 302438) and through the NIHR School for Public Health Research (SPHR), Grant Reference Number PD-SPH-2015. BK received support for scientific and educational activities from Budenheim, Danone, DGC, DSM, Nestlé and Reckitt.
Funding received from the National Health and Medical Research Council (NHMRC)
2010063
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Recommended Citation
Avraam, D., Melis, G., Cadman, T., Carson, J., Charles, M. A., Chua, Y. W., Elhakeem, A., Escribano, J., Grote, V., Gruszfeld, D., Guerlich, K., Huang, R., Harris, J. R., Ibarluzea, J., Julvez, J., Koletzko, B., Lin, A., Martin, U., McEachan, R., . . . Taylor‐Robinson, D. (2026). Early‐life pathways to inequalities in child mental health: Evidence from eight birth cohorts. Journal of Child Psychology and Psychiatry. Advance online publication. https://doi.org/10.1111/jcpp.70207