Co-occurring adversities in childhood as predictors of multimorbidity

Background

Parental and family adversities are important determinants of children’s health (1) and may contribute to the early development of multiple long-term conditions (multimorbidity). These adversities rarely occur in isolation: families may simultaneously experience parental mental ill-health, domestic violence and abuse, harmful alcohol or drug use, housing insecurity, and involvement with the criminal justice system.(2) However, little is known about how different combinations and trajectories of family adversity shape the development of physical and mental health conditions from childhood into early adulthood.

This project will use longitudinal cohorts within the UK Longitudinal Linkage Collaboration (UKLLC), linked to electronic health records, to identify patterns of co-occurring family adversity and investigate their relationship with subsequent multimorbidity. A precision prevention approach will identify groups of children with different adversity profiles and determine whether these are associated with distinct trajectories and combinations of later physical and mental health conditions. This will provide new evidence on which children are at greatest risk of developing multimorbidity and when opportunities for prevention may arise.

Aims

• Identify patterns of co-occurring parental and family adversity across childhood.
• Determine whether different patterns of family adversity are associated with subsequent multimorbidity and distinct health trajectories.

Training Outcomes

• Harmonisation and analysis of complex exposures and health outcomes across UKLLC cohorts
• Use of linked electronic health records to characterise multimorbidity and disease trajectories.
• Advanced longitudinal and linked health-data analysis, including latent class, trajectory and multistate modelling.
• Patient and public involvement to inform research questions, interpretation and dissemination.
• Stakeholder engagement with healthcare, policy and third-sector partners to support translation into precision prevention.

References

1. Syed S, Howe LD, Lacey RE, et al. (2025). Adverse childhood experiences in firstborns and mental health risk and health-care use in siblings: a population-based birth cohort study of half a million children in England. The Lancet Public Health; 10:e111–e123.
2. Allen K, Melendez-Torres GJ, Ford T, Bonell C, Berry V, et al. Parental domestic violence and abuse, mental ill-health, and substance misuse and the impact on child mental health: a secondary data analysis using the UK Millennium Cohort Study. BMC Public Health. 2024;24:2310.