Abstract
Background
Mental disorders and alcohol misuse are common in families but their effects on the physical health of children are not known. We investigated the risk of emergency hospital admissions during childhood associated with living with an adult who has a mental health disorder, or who had an alcohol-related hospital admission.
Methods
We did this cohort study in a total population electronic child cohort in Wales, UK, which includes all children who live in Wales or with a mother who is resident in Wales. We used Cox regression to model time to first emergency hospital admission during the first 14 years of life associated with living with an adult who has a mental health disorder, or who had an alcohol-related hospital admission. We adjusted our results for social deprivation and perinatal risk factors.
Findings
We included data for 253 717 children with 1 015 614 child-years of follow-up. Living with an adult with a mental disorder was associated with an increased risk of emergency admission for all causes (adjusted hazard ratio [aHR] 1·17, 95% CI 1·16–1·19), for injuries and external causes (1·14, 1·11–1·18), and childhood victimisation (1·55, 1·44–1·67). Children living with a household member who had an alcohol-related hospital admission had a significantly higher risk of emergency admissions for injuries and external causes (aHR 1·13, 95% CI 1·01–1 ·26) and victimisation (1·39, 1·00–1·94), but not for all-cause emergency admissions (1·01, 0·93–1·09).
Interpretation
The increased risk of emergency admissions in children associated with mental disorders and alcohol misuse in the household supports the need for policy measures to provide support to families that are affected.
Mental disorders and alcohol misuse are common in families but their effects on the physical health of children are not known. We investigated the risk of emergency hospital admissions during childhood associated with living with an adult who has a mental health disorder, or who had an alcohol-related hospital admission.
Methods
We did this cohort study in a total population electronic child cohort in Wales, UK, which includes all children who live in Wales or with a mother who is resident in Wales. We used Cox regression to model time to first emergency hospital admission during the first 14 years of life associated with living with an adult who has a mental health disorder, or who had an alcohol-related hospital admission. We adjusted our results for social deprivation and perinatal risk factors.
Findings
We included data for 253 717 children with 1 015 614 child-years of follow-up. Living with an adult with a mental disorder was associated with an increased risk of emergency admission for all causes (adjusted hazard ratio [aHR] 1·17, 95% CI 1·16–1·19), for injuries and external causes (1·14, 1·11–1·18), and childhood victimisation (1·55, 1·44–1·67). Children living with a household member who had an alcohol-related hospital admission had a significantly higher risk of emergency admissions for injuries and external causes (aHR 1·13, 95% CI 1·01–1 ·26) and victimisation (1·39, 1·00–1·94), but not for all-cause emergency admissions (1·01, 0·93–1·09).
Interpretation
The increased risk of emergency admissions in children associated with mental disorders and alcohol misuse in the household supports the need for policy measures to provide support to families that are affected.
| Original language | English |
|---|---|
| Pages (from-to) | e279-e288 |
| Number of pages | 10 |
| Journal | The Lancet Public Health |
| Volume | 3 |
| Issue number | 6 |
| Early online date | 5 Jun 2018 |
| DOIs | |
| Publication status | Published - 30 Jun 2018 |
Bibliographical note
FundingEconomic and Social Research Council, Medical Research Council, Alcohol Research UK, Public Health Wales.
Acknowledgments
This work was supported by funds from the Economic and Social Research Council, the Medical Research Council, and Alcohol Research UK to the ELAStiC Project (ES/L015471/1) and Public Health Wales. The views expressed are entirely those of the authors and should not be assumed to be the same as those of the funding body. The research was also supported by The Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement, a UK Clinical Research Collaboration Public Health Research Centre of Excellence, and The Centre for the Improvement of Population Health through E-records Research (CIPHER). CIPHER is funded by: Arthritis Research UK, the British Heart Foundation, Cancer Research UK, the Chief Scientist Office (Scottish Government Health Directorates), the Economic and Social Research Council, the Engineering and Physical Sciences Research Council, the Medical Research Council, the National Institute for Health Research, the National Institute for Social Care and Health Research (Welsh Government), and the Wellcome Trust (Grant reference: MR/K006525/1). Funding from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council (grant RES-590-28-0005), Medical Research Council, the Welsh Government, and the Wellcome Trust (grant WT087640MA), under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged.
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