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The influence of early childhood education and care on the relation between early-life social adversity and children’s mental health in the environmental influences for Child Health Outcomes Program

Published online by Cambridge University Press:  10 December 2024

Michelle Bosquet Enlow*
Affiliation:
Department of Psychiatry and Behavioral Sciences, Boston Children’s Hospital, Boston, MA, USA Department of Psychiatry, Harvard Medical School, Boston, MA, USA
Courtney K. Blackwell
Affiliation:
Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
Phillip Sherlock
Affiliation:
Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
Maxwell Mansolf
Affiliation:
Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
Traci A. Bekelman
Affiliation:
Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Department of Epidemiology, School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
Clancy Blair
Affiliation:
Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
Nicole R. Bush
Affiliation:
Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California San Francisco, San Francisco, CA, USA Department of Pediatrics, School of Medicine, University of California San Francisco, San Francisco, CA, USA
J. Carolyn Graff
Affiliation:
College of Nursing, University of Tennessee Health Science Center, Memphis, TN, USA
Christine Hockett
Affiliation:
Avera Research Institute, Sioux Falls, SD, USA Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, SD, USA
Leslie D. Leve
Affiliation:
Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, USA
Kaja Z. LeWinn
Affiliation:
Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California San Francisco, San Francisco, CA, USA
Elizabeth B. Miller
Affiliation:
Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
Monica McGrath
Affiliation:
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
Laura E. Murphy
Affiliation:
Department of Psychiatry, University of Tennessee Health Science Center, Memphis, TN, USA
Wei Perng
Affiliation:
Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Department of Epidemiology, School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
*
Corresponding author: Michelle Bosquet Enlow; Email: michelle.bosquet@childrens.harvard.edu

Abstract

Early adversity increases risk for child mental health difficulties. Stressors in the home environment (e.g., parental mental illness, household socioeconomic challenges) may be particularly impactful. Attending out-of-home childcare may buffer or magnify negative effects of such exposures. Using a longitudinal observational design, we leveraged data from the NIH Environmental influences on Child Health Outcomes Program to test whether number of hours in childcare, defined as 1) any type of nonparental care and 2) center-based care specifically, was associated with child mental health, including via buffering or magnifying associations between early exposure to psychosocial and socioeconomic risks (age 0–3 years) and later internalizing and externalizing symptoms (age 3–5.5 years), in a diverse sample of N = 2,024 parent–child dyads. In linear regression models, childcare participation was not associated with mental health outcomes, nor did we observe an impact of childcare attendance on associations between risk exposures and symptoms. Psychosocial and socioeconomic risks had interactive effects on internalizing and externalizing symptoms. Overall, the findings did not indicate that childcare attendance positively or negatively influenced child mental health and suggested that psychosocial and socioeconomic adversity may need to be considered as separate exposures to understand child mental health risk in early life.

Information

Type
Regular Article
Copyright
© The Author(s), 2024. Published by Cambridge University Press

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