Children In Household Research Articles

The Effect of Food Deserts on the Body Mass Index of Elementary Schoolchildren

Families in low‐income neighborhoods sometimes lack access to supermarkets that provide a broad range of healthy foods. We investigate whether these so called “food deserts” play a role in childhood obesity using a statewide panel data set of Arkansas elementary schoolchildren. We use fixed‐effects panel data regression models to estimate the average food desert effect. We next compare children who left (entered) food deserts to children who were always (never) in food deserts and homogenize samples for those whose food desert status changed as a result of a change in residence and those whose status changed only as a consequence of the entry or exit of a supermarket. We present evidence that exposure to food deserts is associated with higher z‐scores for body mass index. On average, this is in the neighborhood of 0.04 standard deviations. The strongest evidence and largest association is among urban students and especially those that transition into food deserts from non‐deserts. Our food desert estimates are similar in magnitude to findings reported in earlier work on diet and lifestyle interventions targeting similarly aged schoolchildren. That said, we are unable to conclude that the estimated food desert effect is causal because many of the transitions into or out of food deserts result from a change in residence, an event that is endogenous to the child's household. However, there is evidence that food deserts are a risk indicator and that food desert areas may be obesogenic in ways that other low‐income neighborhoods are not.

Estimating the effect of childhood socioeconomic disadvantage on oral cancer in India using marginal structural models.

Early life socioeconomic disadvantage could affect adult health directly or indirectly. To the best of our knowledge, there are no studies of the direct effect of early life socioeconomic conditions on oral cancer occurrence in adult life. We conducted a multicenter, hospital-based, case-control study in India between 2011 and 2012 on 180 histopathologically confirmed incident oral and/or oropharyngeal cancer cases, aged 18 years or more, and 272 controls that included hospital visitors, who were not diagnosed with any cancer in the same hospitals. Life-course data were collected on socioeconomic conditions, risk factors, and parental behavior through interview employing a life grid. The early life socioeconomic conditions measure was determined by occupation of the head of household in childhood. Adult socioeconomic measures included participant's education and current occupation of the head of household. Marginal structural models with stabilized inverse probability weights were used to estimate the controlled direct effects of early life socioeconomic conditions on oral cancer. The total effect model showed that those in the low socioeconomic conditions in the early years of childhood had 60% (risk ratio [RR] = 1.6 [95% confidence interval {CI} = 1.4, 1.9]) increased risk of oral cancer. From the marginal structural models, the estimated risk for developing oral cancer among those in low early life socioeconomic conditions was 50% (RR = 1.5 [95% CI = 1.4, 1.5]), 20% (RR = 1.2 [95% CI = 0.9, 1.7]), and 90% (RR = 1.9 [95% CI = 1.7, 2.2]) greater than those in the high socioeconomic conditions when controlled for smoking, chewing, and alcohol, respectively. When all the three mediators were controlled in a marginal structural model, the RR was 1.3 (95% CI = 1.0, 1.6). Early life low socioeconomic condition had a controlled direct effect on oral cancer when smoking, chewing tobacco, and alcohol were separately adjusted in marginal structural models.

Prospective Associations Between Early Long-Term Household Tobacco Smoke Exposure and Subsequent Indicators of Metabolic Risk at Age 10.

Although there are established risks associated with gestational tobacco smoke exposure, few studies have addressed the metabolic hazards of domestic exposure in early childhood. This study prospectively examines the long-term relationship between early childhood exposure to household smoke and two adiposity-related measures at age 10. Participants from the Quebec Longitudinal Study of Child Development birth cohort were categorized into one of three groups of early childhood household exposure to tobacco smoke over four time points (from ages 1 to 7 years): never-exposed; transient exposure; and continuous exposure. Follow-up measures of body mass index and waist circumference were independently assessed at age 10. Compared to being never exposed, transient and continuous household smoke exposure predicted increases of 0.93 cm (95% confidence interval [CI] between 0.05 and 1.82 cm; P = .03) and 1.56 cm (95% CI between 0.07 and 3.05 cm; P = .04) in children's waist circumference, respectively. Children exposed to transient and continuous household smoke, compared to unexposed children, also showed 0.48 and 0.81 point increases in their body mass index, respectively, both Ps = .005. Once adjusted, for confounding variables, only transient household smoke remained associated with 43% greater odds of belonging to the overweight/obese category (95% CI between 1.12 and 1.81 cm; P < .01). We found significant long-term prospective associations between home-based secondhand smoke exposure and unhealthy body fat distribution. Waist circumference in youth has become an important risk factor for obesity-related diseases in adulthood. Our findings emphasize the importance public health initiatives and parental sensitization aimed at domestic exposure reductions during the critical early childhood years.

Vegetable parenting practices scale. Item response modeling analyses

Objective: To evaluate the psychometric properties of a vegetable parenting practices scale using multidimensional polytomous item response modeling which enables assessing item fit to latent variables and the distributional characteristics of the items in comparison to the respondents. We also tested for differences in the ways item function (called differential item functioning) across child's gender, ethnicity, age, and household income groups. Method: Parents of 3–5 year old children completed a self-reported vegetable parenting practices scale online. Vegetable parenting practices consisted of 14 effective vegetable parenting practices and 12 ineffective vegetable parenting practices items, each with three subscales (responsiveness, structure, and control). Multidimensional polytomous item response modeling was conducted separately on effective vegetable parenting practices and ineffective vegetable parenting practices. Results: One effective vegetable parenting practice item did not fit the model well in the full sample or across demographic groups, and another was a misfit in differential item functioning analyses across child's gender. Significant differential item functioning was detected across children's age and ethnicity groups, and more among effective vegetable parenting practices than ineffective vegetable parenting practices items. Wright maps showed items only covered parts of the latent trait distribution. The harder- and easier-to-respond ends of the construct were not covered by items for effective vegetable parenting practices and ineffective vegetable parenting practices, respectively. Conclusions: Several effective vegetable parenting practices and ineffective vegetable parenting practices scale items functioned differently on the basis of child's demographic characteristics; therefore, researchers should use these vegetable parenting practices scales with caution. Item response modeling should be incorporated in analyses of parenting practice questionnaires to better assess differences across demographic characteristics.

The relationship between childhood adversity and food insecurity: 'It's like a bird nesting in your head'.

Adverse childhood experiences, including abuse, neglect and household instability, affect lifelong health and economic potential. The present study investigates how adverse childhood experiences are associated with food insecurity by exploring caregivers' perceptions of the impact of their childhood adversity on educational attainment, employment and mental health. Semi-structured audio-recorded in-person interviews that included (i) quantitative measures of maternal and child health, adverse childhood experiences (range: 0-10) and food security using the US Household Food Security Survey Module; and (ii) qualitative audio-recorded investigations of experiences with abuse, neglect, violence and hunger over participants' lifetimes. Households in Philadelphia, PA, USA. Thirty-one mothers of children <4 years old who reported low or very low household food security. Twenty-one caregivers (68 %) reported four or more adverse childhood experiences, and this severity was significantly associated with reports of very low food security (Fisher's exact P=0·021). Mothers reporting emotional and physical abuse were more likely to report very low food security (Fisher's exact P=0·032). Qualitatively, participants described the impact of childhood adverse experiences with emotional and physical abuse/neglect, and household substance abuse, on their emotional health, school performance and ability to maintain employment. In turn, these experiences negatively affected their ability to protect their children from food insecurity. The associations between mothers' adverse experiences in childhood and reports of current household food security should inspire researchers, advocates and policy makers to comprehensively address family hardship through greater attention to the emotional health of caregivers. Programmes meant to address nutritional deprivation and financial hardship should include trauma-informed approaches that integrate behavioural interventions.

Measuring child awareness for adult symptomatic HIV using a verbal assessment tool: concordance between adult–child dyads on adult HIV-associated symptoms and illnesses

ObjectivesThis study assessed children's awareness for adult HIV-associated symptoms and illnesses using a verbal assessment tool by analysing inter-rater reliability between adult–child dyads. This study also evaluated sociodemographic and household...

The Interrelatedness of Adverse Childhood Experiences Among High-Risk Juvenile Offenders

The interrelatedness of adverse childhood experiences (ACEs) in 64,329 juvenile offenders was examined. ACEs include childhood abuse (physical, emotional, and sexual), neglect (physical and emotional), and household dysfunction (family violence, family substance use, family mental illness, separation/divorce, and family incarceration). Prevalence ranged from 12% to 82% for each ACE. Of youth experiencing one ACE 67.5% reported four or more additional exposures and 24.5% exposure to six or more additional ACEs. Females have higher prevalence and multiple exposures. ACEs are interrelated, necessitating assessment of multiple ACEs rather than one or a few. ACE exposure differs by gender and race/ethnicity.

Impact of dental caries on quality of life among preschool children: emphasis on the type of tooth and stages of progression.

The aim of this cross-sectional study was to evaluate the impact of dental caries on the quality of life of preschool children and their parents/caretakers, with an emphasis on the type of tooth and stage of progression. A randomly selected sample of preschool children, 3-5 yrs of age, underwent an oral examination for the assessment of dental caries using the International Caries Detection and Assessment System II (ICDAS II) criteria. Parents/caretakers answered two questionnaires, one on the oral health-related quality of life (OHRQoL) of the child [the Early Childhood Oral Health Impact Scale (ECOHIS)], and the other on the socio-economic characteristics of the family. Statistical analyses were performed using the chi-square test, Kruskal-Wallis test, Mann-Whitney U-test, and Poisson regression. A total of 451 preschool children participated in the study. The majority of carious lesions exhibited severe decay (60.6%) and were found in both anterior (incisors/canines) and posterior (molars) teeth. The final Poisson model revealed negative impacts on quality of life from more advanced stages of dental caries, both in incisors/canines and molars. Child's age and household income were also associated with impact on quality of life. Carious lesions in more advanced stages of progression in anterior and posterior teeth were associated with a negative impact on the quality of life of preschool children.

Adult bone strength of children from single-parent families: the Midlife in the United States Study.

Bone health may be negatively impacted by childhood socio-environmental circumstances. We examined the independent associations of single-parent childhood and parental death or divorce in childhood with adult bone strength indices. Longer exposure to a single-parent household in childhood was associated with lower bone strength in adulthood. Because peak bone mass is acquired during childhood, bone health may be negatively impacted by childhood socio-environmental disadvantage. The goal of this study was to determine whether being raised in a single-parent household is associated with lower bone strength in adulthood. Using dual-energy X-ray absorptiometry data from 708 participants (mean age 57 years) in the Midlife in the United States Biomarker Project, we examined the independent associations of composite indices of femoral neck bone strength relative to load (in three failure modes: compression, bending, and impact) in adulthood with the experience of single-parent childhood and parental death or divorce in childhood. After adjustment for gender, race, menopause transition stage, age, and body mass index, each additional year of single-parent childhood was associated with 0.02 to 0.03 SD lower indices of adult femoral neck strength. In those with 9-16 years of single-parent childhood, the compression strength index was 0.41 SD lower, bending strength index was 0.31 SD lower, and impact strength index was 0.25 SD lower (all p values < 0.05). In contrast, parental death or divorce during childhood was not by itself independently associated with adult bone strength indices. The magnitudes of these associations were unaltered by additional adjustment for lifestyle factors and socioeconomic status in childhood and adulthood. Independent of parental death or divorce, growing up in a single-parent household is associated with lower femoral neck bone strength in adulthood, and this association is not entirely explained by childhood or adult socioeconomic conditions or lifestyle choices.

Childhood acute respiratory infections and household environment in an Eastern Indonesian urban setting.

This pilot study evaluated the potential effect of household environmental factors such as income, maternal characteristics, and indoor air pollution on children’s respiratory status in an Eastern Indonesian community. Household data were collected from cross-sectional (n = 461 participants) and preliminary childhood case-control surveys (pneumonia cases = 31 diagnosed within three months at a local health clinic; controls = 30). Particulate matter (PM2.5 and PM10) was measured in living rooms, kitchens, children’s bedrooms, and outside areas in close proximity once during the case-control household interviews (55 homes) and once per hour from 6 a.m. to midnight in 11 homes. The household survey showed that children were 1.98 times (p = 0.02) more likely to have coughing symptoms indicating respiratory infection, if mothers were not the primary caregivers. More children exhibited coughing if they were not exclusively breastfed (OR = 2.18; p = 0.06) or there was a possibility that their mothers were exposed to environmental tobacco smoke during pregnancy (OR = 2.05; p = 0.08). This study suggests that household incomes and mother’s education have an indirect effect on childhood pneumonia and respiratory illness. The concentrations of PM2.5 and PM10 ranged from 0.5 to 35.7 µg/m3 and 7.7 to 575.7 µg/m3, respectively, based on grab samples. PM was significantly different between the case and control groups (p < 0.01). The study also suggests that ambient air may dilute indoor pollution, but also introduces pollution into the home from the community environment. Effective intervention programs need to be developed that consider multiple direct and indirect risk factors to protect children.

THE SHORT‐ AND LONG‐TERM EFFECTS OF DEVELOPMENT PROJECTS: EVIDENCE FROM ETHIOPIA

AbstractThis paper examines the short‐term and long‐term impact of development projects on recipients' wellbeing in Ethiopia. Specifically, it compares the effects of five types of development projects—unconditional and conditional direct transfers, agricultural and social‐infrastructure knowledge transfers, and credit projects—on children's nutrition and on household consumption and income levels. The main finding is that knowledge transfers have the largest positive impact on children's nutritional status and household consumption, in both the short and the long term. The impact of direct transfers on children's health is also positive but less significant, whereas the effect of credit projects is here undetectable. Copyright © 2014 John Wiley &amp; Sons, Ltd.

Community coverage with insecticide-treated mosquito nets and observed associations with all-cause child mortality and malaria parasite infections.

Randomized trials and mathematical modeling suggest that insecticide-treated mosquito nets (ITNs) provide community-level protection to both those using ITNs and those without individual access. Using nationally representative household survey datasets from 17 African countries, we examined whether community ITN coverage is associated with malaria infections in children < 5 years old and all-cause child mortality (ACCM) among children < 5 years old in households with one or more ITNs versus without any type of mosquito net (treated or untreated). Increasing ITN coverage (> 50%) was protective against malaria infections and ACCM for children in households with an ITN, although this protection was not conferred to children in households without ITNs in these data. Children in households with ITNs were protected against malaria infections and ACCM with ITN coverage > 30%, but this protection was not significant with ITN coverage < 30%. Results suggest that ITNs are more effective with higher ITN coverage.

Childhood Health and Household Income

Childhood Health and Household Income

The impact of grandparental investment on mothers’ fertility intentions in four European countries

AbstractBACKGROUNDEvolutionary theory predicts that grandparental investment should support the childbearing of adult children, but evidence from contemporary developed countries is mixed or relatively weak. One possible reason for this lack of clarity is that grandparental support for fertility may vary by country, the economic situation of the adult child's household, and the lineage and the sex of the grandparent.OBJECTIVEWe investigate the associations between grandparental investments and the intentions of mothers to have a second or third child in four European countries - Bulgaria, France, Lithuania, and Norway - while paying special attention to effect of the country, the financial security of the household, and the different grandparent types.METHODSUsing the first wave data (2004-08) of the Generations and Gender Surveys, we measured grandparental investment by the amount of child care help and emotional support mothers reported receiving from their parents. We studied these factors with binary logistic regression analysis.RESULTSBoth emotional support and child care help from grandparents were associated with increased fertility intentions in France and Norway. Emotional support was also associated with increased fertility intentions in Bulgaria, while grandparental child care help was associated with decreased intentions in Lithuania. Emotional support was more strongly associated with fertility intentions in financially secure households. Emotional support received from a maternal grandmother, a maternal grandfather, and a paternal grandmother; and child care help received from a maternal grandfather; were associated with an increased probability that a mother would report the intention to have another child.CONCLUSIONSGrandparental investment, especially emotional support, appears to be most influential in wealthier European countries and among more financially secure families. When a family's socioeconomic situation and the broader environment are generally favourable for having several children, grandparents may provide the extra push that supports the intention to have another child.1. IntroductionResearch has shown that, due to demographic changes, especially increased life expectancy and the challenges of combining wage work and parenting, grandparental investment in children and grandchildren has become increasingly important in modern, western societies (Coall and Hertwig 2010; 2011). However, the question of whether grandparents also contribute to higher fertility has been harder to answer, as the existing empirical evidence has been mixed. Grandparental child care help has been found to be correlated with an increased probability that parents will have another child in the Netherlands (Kaptijn et al. 2010; Thomese and Liefbroer 2013), and one study has detected a positive association between grandparental child care help and childbearing in several European countries if the grandchildren were not very young (Aassve, Meroni, and Pronzato 2012). By contrast, Waynforth (2011) found no association between grandparental child care and parents' fertility in the UK, although the closeness of the parents to their own parents was shown to be associated with an increased likelihood of having another child.The possible positive effect of grandparental help is thus relatively weak, and can be expected to vary by country and parity, as well as by the type and the availability of grandparental investment. In addition, grandparental effect may vary by grandparental lineage. In a recent study, Tanskanen, Jokela, Danielsbacka, and Rotkirch (2014) found that parents who had contact with the paternal grandparents of their first child were more likely to have a second child, while parents who had contact with the maternal grandmother of their first two children were less likely to have a third or subsequent child.The present study uses the first wave of the Generations and Gender Surveys (GGS) to investigate the association between grandparental investment and the fertility intentions of mothers in four European countries: France, Norway, Bulgaria, and Lithuania. …

Correlates of stunting among children in Ghana.

BackgroundStunting, is a linear growth retardation, which results from inadequate intake of food over a long period of time that may be worsened by chronic illness. Over a long period of time, inadequate nutrition or its effects could result in stunting. This paper examines the correlates of stunting among children in Ghana using data from the 2008 Ghana Demographic and Health Survey (GDHS).MethodsThe paper uses data from the children recode file of the 2008 Demographic and Health Survey (DHS), a nationally representative cross sectional survey conducted in Ghana. A total of 2379 children under five years who had valid anthropometric data were used for the study. Data on the stunting of children were collected by measuring the height of all children under six years of age. A measuring board produced by Shorr Productions was used to obtain the height of the children. Children under 2 years of age were measured lying down on the board while those above 2 years were measured standing. In the DHS data, a z-score is given for the child’s height relative to the age. Both bi-variate and multi-variate statistics are used to examine the correlates of stunting.ResultsStunting was common among males than females. Age of child was a significant determinant of stunting with the highest odd of stunting been among children aged 36–47 months. Region was significantly related to stunting. Children from the Eastern Region were more likely to be stunted than children from the Western Region which is the reference group (OR = 1.7 at p < 0.05). Number of children in household was significantly related to stunting. Children in households with 5–8 children were 1.3 times more likely to be stunted compared to those with 1–4 children (p < .05). Mother’s age was a significant predictor of stunting with children whose mothers were aged 35–44 years being more likely to be stunted.ConclusionCulturally appropriate interventions and policies should be put in place to minimise the effects of the distal, proximal and intermediate factors on stunting among under 5 children in Ghana.

Babies, soft drinks and snacks: a concern in low- and middle-income countries?

Undernutrition in infants and young children is a global health priority while overweight is an emerging issue. Small‐scale studies in low‐ and middle‐income countries have demonstrated consumption of sugary and savoury snack foods and soft drinks by young children. We assessed the proportion of children 6–23 months of age consuming sugary snack foods in 18 countries in Asia and Africa using data from selected Demographic and Health Surveys and household expenditures on soft drinks and biscuits using data from four Living Standards Measurement Studies (LSMS). Consumption of sugary snack foods increased with the child's age and household wealth, and was generally higher in urban vs. rural areas. In one‐third of countries, >20% of infants 6–8 months consumed sugary snacks. Up to 75% of Asian children and 46% of African children consumed these foods in the second year of life. The proportion of children consuming sugary snack foods was generally higher than the proportion consuming fortified infant cereals, eggs or fruit. Household per capita daily expenditures on soft drinks ranged from $0.03 to $0.11 in three countries for which LSMS data were available, and from $0.01 to $0.04 on biscuits in two LSMS. Future surveys should include quantitative data on the purchase and consumption of snack foods by infants and young children, using consistent definitions and methods for identifying and categorising snack foods across surveys. Researchers should assess associations between snack food consumption and stunting and overweight, and characterise household, maternal and child characteristics associated with snack food consumption.

The Role of Poverty Status and Obesity on School Attendance in the United States

PurposeSeveral studies have shown that obesity influences school performance. Little is known about the joint effect of poverty and obesity associated with school attendance. MethodsData are from the National Survey of Children's Health (N = 93,151), a nationally representative sample of U.S. youth aged 10–17 years. Our dependent variable was ≥11 days of school days missed per year. Body mass index was classified as normal, overweight, and obese using age- and sex-specific criteria. Federal poverty level (FPL) was classified as <200%, 200%–399%, and ≥400% (high income). Covariates included gender, age, child's race or ethnicity, maternal physical and mental health, child's health, family composition, and household tobacco use. Logistic regression models and prevalence ratios were estimated, accounting for the complex survey design. ResultsThe odds of missing ≥11 days of school among overweight youth was 1.5 times that of normal-weight youth (95% confidence interval (CI) = 1.22–1.85) and 1.7 (95% CI = 1.35–2.13) times among obese youth in fully adjusted models. In joint effects models, the probability of missing school was significantly greater for obese youth in both the <200% FPL group (prevalence ratio = 1.78, CI = 1.36–2.34) and the ≥400% FPL group (prevalence ratio = 2.88, CI = 1.91–4.35), when compared with their normal-weight, higher income peers. Predicted probabilities revealed sharper gradients for higher income youth. ConclusionsObesity influences school absenteeism across all income categories. Nonetheless, there may be distinct reasons for missing school for lower and higher income youth, and the long-term consequences of school absences may also differ for these populations.

Setting the stage for chronic health problems: cumulative childhood adversity among homeless adults with mental illness in Vancouver, British Columbia.

BackgroundIt is well documented that childhood abuse, neglect and household dysfunction are disproportionately present in the backgrounds of homeless adults, and that these experiences adversely impact child development and a wide range of adult outcomes. However, few studies have examined the cumulative impact of adverse childhood experiences on homeless adults with mental illness. This study examines adverse events in childhood as predictors of duration of homelessness, psychiatric and substance use disorders, and physical health in a sample of homeless adults with mental illness.MethodsThis study was conducted using baseline data from a randomized controlled trial in Vancouver, British Columbia for participants who completed the Adverse Childhood Experiences (ACE) scale at 18 months follow-up (n = 364). Primary outcomes included current mental disorders; substance use including type, frequency and severity; physical health; duration of homelessness; and vocational functioning.ResultsIn multivariable regression models, ACE total score independently predicted a range of mental health, physical health, and substance use problems, and marginally predicted duration of homelessness.ConclusionsAdverse childhood experiences are overrepresented among homeless adults with complex comorbidities and chronic homelessness. Our findings are consistent with a growing body of literature indicating that childhood traumas are potent risk factors for a number of adult health and psychiatric problems, particularly substance use problems. Results are discussed in the context of cumulative adversity and self-trauma theory.Trials registrationThis trial has been registered with the International Standard Randomized Control Trial Number Register and assigned ISRCTN42520374.

Effects of HIV prevention messages on treatment-seeking and adherence for HIV-infected children in Maputo, Mozambique: A qualitative study

As antiretroviral treatment (ART) becomes more readily available to children in sub-Saharan Africa (SSA), it is important that the experiences of children and their caretakers be carefully examined from more than just a logistical perspective. This paper is based upon an original exploratory and qualitative study that focused on ART in Mozambique. Through in-depth semi-structured interviews, the study examined the experiences of 26 caretakers—primarily mothers—of pediatric patients aged 3–12 receiving ART through the Pediatric Day Hospital of the Maputo Central Hospital (Mozambique) as well as those of their clinicians (7 physicians and 2 dedicated nurses).The interviews focused on the effect of standard HIV prevention communications on pediatric treatment-seeking and ART adherence via several mediating factors such as: 1) Caretakers' sources of HIV information and their perceived reliability; 2) Levels of trust and communication between providers and patients/caretakers related to the completeness of discussions dealing with HIV risk factors and modes of transmission (particularly for the 19% of mothers interviewed who were uninfected themselves) and; 3) The potential propagation of shame and fear through HIV prevention messages which may contribute to sub-optimal adherence (marked, for example, by fear of involuntary disclosure to others in the child's household).The results indicate that all three of these mediating factors deserve further attention as caretakers did, indeed, report adverse effects on initial treatment-seeking and adherence for the children in their care broadly linked with these factors. As patients and their caretakers often must progress through several counseling sessions before or during commencement of ART, there is ample opportunity for these interpersonal and psychosocial factors to be addressed without the need for further financial or human resource allocations.

Child maltreatment and household dysfunction: associations with pubertal development in a British birth cohort

We aimed to establish the association between adverse childhood experiences (maltreatment and household dysfunction) and pubertal maturation, which is associated with later health outcome(s). The 1958 British birth cohort (n = 17 638) includes all born in one week, March 1958, followed up to mid adulthood. Pubertal stage was rated by medical personnel at 11 and 16 years of age (y). Childhood maltreatment (neglect or abuse) and household dysfunction scores were constructed from information ascertained in childhood and at 45 y. Childhood neglect, assessed at 7 y, was associated with late pubertal development on several markers after adjusting for early life circumstances: relative risk ratio (RRRadjusted) was 1.13 (95% CI: 1.06,1.21) and 1.06 (1.00,1.12) for late menarche and breast development (females) per unit increase in neglect score ranging 0-7, respectively; 1.14 (1.08,1.20) for late voice change and 1.07 (1.02,1.13) for pubic hair growth (males). The RRRadjusted for late pubic hair (females) and genitalia and facial hair (males) development was 1.04 (P = 0.052 to 0.085). Abuse score (0-3, for physical, sexual or psychological abuse) was associated in females with late menarche [RRRadjusted = 1.17 (1.01,1.36)] and in males with late pubic hair growth [RRRadjusted = 1.16 (1.01,1.34)] per unit increase, but not with other pubertal markers. Neither score (neglect or abuse) was associated with early puberty, but sexual abuse was associated with early [RRRadjusted = 1.86 (1.06,3.29)] as well as late menarche [RRRadjusted = 1.66 (1.02,2.71)] and witnessing abuse with early genitalia development [RRRadjusted = 1.57 (1.02,2.41)]. Household dysfunction score was not associated consistently with pubertal markers. Cumulative neglect by 7 y was associated with delayed development of several pubertal markers. The underlying role of pubertal development in linking childhood neglect with future adult health warrants further consideration.