Informal child care and adolescent psychological well-being: Hong Kong's "Children of 1997" birth cohort.

Cherry Y Leung,C Mary Schooling,Gabriel M Leung,Jan L Wallander

doi:10.1371/journal.pone.0120116

Abstract

BackgroundInformal child care (child care by untrained family members, relatives or employees in the home) in Western populations is often associated with poorer psychological well-being, which may be confounded by socioeconomic position. We examined the association of informal child care, common in non-Western settings, with adolescent psychological well-being, using Hong Kong’s Chinese “Children of 1997” birth cohort.MethodsMultivariable linear regression was used to examine the adjusted associations of informal child care (at 0.5, 3, 5 and 11 years) with parent-reported Rutter score for child behavior at 11 years, self-reported Culture-Free Self-Esteem Inventories score at 11 years and self-reported Patient Health Questionnaire-9 depressive symptom score at 13 years. Model comparisons were used to identify the best representation of child care, in terms of a critical period of exposure to informal child care (independent variable) at a specific age, combination of exposures to informal child care at several ages or an accumulation of exposures to informal child care.ResultsChild care was not associated with behavioral problems. A model considering child care at 3 years best represented the association of child care with self-esteem while a model considering child care at 5 years best represented the association of child care with depressive symptoms. Informal child care at 3 years was associated with lower self-esteem (-0.70, 95% confidence interval (CI) -1.26 to -0.14). Informal child care at 5 years was associated with more depressive symptoms (0.45, 95% CI 0.17 to 0.73).ConclusionIn a developed non-Western setting, informal child care was associated with lower self-esteem and more depressive symptoms.

Highlights

The use of child care is increasing, especially with the surge of employment among women since the 1970s
We examined the association of informal child care, common in non-Western settings, with adolescent psychological wellbeing, using Hong Kong’s Chinese “Children of 1997” birth cohort
Informal child care at 5 years was associated with more depressive symptoms (0.45, 95% CI 0.17 to 0.73)

Summary

Introduction

The use of child care is increasing, especially with the surge of employment among women since the 1970s. In Western countries, such as the United States (U.S.), the likelihood of women working during their child’s infancy is the same as when they have an older preschooler [1]. Experiences in infancy and early childhood may have long-term impacts on cognition and psychological well-being [4,5]. Poor adolescent psychological well-being, including low self-esteem and depressive symptoms, may presage depression in adulthood [9,10]. 20% of adolescents are diagnosed with mental illnesses [11], 10–15% with behavioral problems [12], 15–25% with low self-esteem [13,14] and 3–5% with depression [15]. We examined the association of informal child care, common in non-Western settings, with adolescent psychological wellbeing, using Hong Kong’s Chinese “Children of 1997” birth cohort

Methods

Results

Conclusion