Life-course influences of poverty on violence and homicide: 30-year Brazilian birth cohort study.

BACKGROUND: Homicide is the leading cause of death among young people in Latin America, one of the world's most violent regions. Poverty is widely considered a key cause of violence, but theories suggest different effects of poverty, depending on when it is experienced in the life-course. Longitudinal studies of violence are scarce in Latin America, and very few prospective data are available worldwide to test different life-course influences on homicide. METHODS: In a prospective birth cohort study following 5914 children born in southern Brazil, we examined the role of poverty at birth, in early childhood, and in early adulthood on violence and homicide perpetration, in criminal records up to age 30 years. A novel Structured Life Course Modelling Approach was used to test competing life-course hypotheses about 'sensitive periods', 'accumulation of risk', and 'downward mobility' regarding the influence of poverty on violence and homicide. RESULTS: Cumulative poverty and poverty in early adulthood were the most important influences on violence and homicide perpetration. This supports the hypothesis that early adulthood is a sensitive period for the influence of poverty on lethal and non-lethal violence. Results were replicable using different definitions of poverty and an alternative outcome of self-reported fights. CONCLUSION: Cumulative poverty from childhood to adulthood was an important driver of violence and homicide in this population. However, poverty experienced in early adulthood was especially influential, suggesting the importance of proximal mechanisms for violence in this context, such as unemployment, organized crime, drug trafficking, and ineffective policing and justice systems.

Childhood Behavioural Problems and Adverse Outcomes in Early Adulthood: a Comparison of Brazilian and British Birth Cohorts.

PURPOSE: Examine associations between childhood behavioural problems with criminal behaviour, emotional disorders, substance use and unemployment in early adulthood in two birth cohorts from a middle- and high-income country. METHODS: Data were utilised from large, prospective birth cohorts in Brazil (1993 Pelotas Birth Cohort; N = 3939) and the UK (Avon Longitudinal Study of Parents and Children; ALSPAC; N = 5079). Behavioural problems were reported on by parents at age 11 years (including disobeys, temper, lies, fights, steals). Outcomes (assessed with youth between ages 22 and 24 years) included criminal behaviour, emotional disorders, substance use and NEET (not in education, employment or training). RESULTS: In both cohorts, children with 'conduct problems' (those with increased probability of all five behaviours at age 11), were at higher risk of criminal behaviour, emotional disorders and NEET in adulthood compared to those with 'low problems'. Associations for 'conduct problems' were stronger in Pelotas compared to ALSPAC for hazardous alcohol use [Pelotas: risk ratio = 1.39, 95% CI = 1.14-1.70; ALSPAC: risk ratio = 0.76, 95% CI = 0.57-1.02] and illegal drug use [Pelotas: risk ratio = 1.32, 95% CI = 1.16-1.50; ALSPAC: risk ratio = 1.05, 95% CI = 0.91-1.20], whereas associations for criminal behaviour [Pelotas: risk ratio = 1.92, 95% CI = 1.29-2.86; ALSPAC: risk ratio = 2.75, 95% CI = 2.04-3.73] and NEET [Pelotas: risk ratio = 1.38, 95% CI = 1.13-1.70; ALSPAC: risk ratio = 3.04, 95% CI = 1.99-4.65] were stronger in ALSPAC. CONCLUSIONS: Childhood conduct problems were associated with criminal behaviour, emotional disorders and unemployment in adulthood in both Brazil and the UK. Additional associations were found for substance use in Brazil.

Maternal dietary patterns during pregnancy and intelligence quotients in the offspring at 8 years of age: Findings from the ALSPAC cohort.

Dietary intake during pregnancy may influence child neurodevelopment and cognitive function. This study aims to investigate the associations between dietary patterns obtained in pregnancy and intelligence quotients (IQ) among offspring at 8 years of age. Pregnant women enrolled in the Avon Longitudinal Study of Parents and Children completed a food frequency questionnaire at 32 weeks' gestation (n = 12,195). Dietary patterns were obtained by cluster analysis. Three clusters best described women's diets during pregnancy: "fruit and vegetables," "meat and potatoes," and "white bread and coffee." The offspring's IQ at 8 years of age was assessed using the Wechsler Intelligence Scale for Children. Models, using variables correlated to IQ data, were performed to impute missing values. Linear regression models were employed to investigate associations between the maternal clusters and IQ in childhood. Children of women who were classified in the meat and potatoes cluster and white bread and coffee cluster during pregnancy had lower average verbal (ß = -1.74; p < .001 and ß = -3.05; p < .001), performance (ß = -1.26; p = .011 and ß = -1.75; p < .001), and full-scale IQ (ß = -1.74; p < .001 and ß = -2.79; p < .001) at 8 years of age when compared to children of mothers in the fruit and vegetables cluster in imputed models of IQ and all confounders, after adjustment for a wide range of known confounders including maternal education. The pregnant women who were classified in the fruit and vegetables cluster had offspring with higher average IQ compared with offspring of mothers in the meat and potatoes cluster and white bread and coffee cluster.

Dietary patterns by cluster analysis in pregnant women: relationship with nutrient intakes and dietary patterns in 7-year-old offspring.

Little is known about how dietary patterns of mothers and their children track over time. The objectives of this study are to obtain dietary patterns in pregnancy using cluster analysis, to examine women's mean nutrient intakes in each cluster and to compare the dietary patterns of mothers to those of their children. Pregnant women (n = 12 195) from the Avon Longitudinal Study of Parents and Children reported their frequency of consumption of 47 foods and food groups. These data were used to obtain dietary patterns during pregnancy by cluster analysis. The absolute and energy-adjusted nutrient intakes were compared between clusters. Women's dietary patterns were compared with previously derived clusters of their children at 7 years of age. Multinomial logistic regression was performed to evaluate relationships comparing maternal and offspring clusters. Three maternal clusters were identified: 'fruit and vegetables', 'meat and potatoes' and 'white bread and coffee'. After energy adjustment women in the 'fruit and vegetables' cluster had the highest mean nutrient intakes. Mothers in the 'fruit and vegetables' cluster were more likely than mothers in 'meat and potatoes' (adjusted odds ratio [OR]: 2.00; 95% Confidence Interval [CI]: 1.69-2.36) or 'white bread and coffee' (OR: 2.18; 95% CI: 1.87-2.53) clusters to have children in a 'plant-based' cluster. However the majority of children were in clusters unrelated to their mother dietary pattern. Three distinct dietary patterns were obtained in pregnancy; the 'fruit and vegetables' pattern being the most nutrient dense. Mothers' dietary patterns were associated with but did not dominate offspring dietary patterns.

Depression symptom trajectories and associated risk factors among adolescents in Chile.

Adolescence is a key period for studying the development of depression, with studies in Europe and North America showing a pattern of elevated risk that begins in early adolescence and continues to increase as adolescents age. Few studies have examined the course of adolescent depression and associated risk factors in low and middle-income countries. This longitudinal cohort study examined depression symptom trajectories and risk factors in a sample of socio-economically disadvantaged adolescents in Chile (n = 2,508). Data were collected over an 18-month period as part of a clinical trial for secondary students aged 12 to 18 (median age 14). Clinical levels of depression were prevalent in this sample at baseline (35% for girls and 28% for boys); yet latent growth models of symptom trajectories revealed a pattern of decreasing symptoms over time. There was evidence of an anxiety-depression developmental pathway for girls, with elevated anxiety levels initially predicting poorer depression outcomes later on. Poor problem-solving skills were associated with initial depression levels but did not predict the course of depressive symptoms. Critically, the declining symptom trajectories raise important methodological issues regarding the effects of repeated assessment in longitudinal studies.