How does the local area deprivation influence life chances for children in poverty in Wales: A record linkage cohort study

Objectives Children growing up in poverty are less likely to achieve in school and more likely to experience mental health problems. This study examined factors in the local area that can help a child overcome the negative impact of poverty. Design A longitudinal record linkage retrospective cohort study. Participants This study included 159,131 children who lived in Wales and completed their age 16 exams (Key Stage 4 (KS4)) between 2009 and 2016. Free School Meal (FSM) provision was used as an indicator of household-level deprivation. Area-level deprivation was measured using the Welsh Index of Multiple Deprivation (WIMD) 2011. An encrypted unique Anonymous Linking Field was used to link the children with their health- and educational records. Outcome measures The outcome variable ‘Profile to Leave Poverty’ (PLP) was constructed based on successful completion of age 16 exams, no mental health condition, no substance and alcohol misuse records in routine data. Logistic regression with stepwise model selection was used to investigate the association between local area deprivation and the outcome variable. Results 22% of children on FSM achieved PLP compared to 54.9% of non-FSM children. FSM Children from least deprived areas were significantly more likely to achieve PLP (adjusted odds ratio (aOR) - 2.20 (1.93, 2.51)) than FSM children from most deprived areas. FSM children, living in areas with higher community safety, higher relative income, higher access to services, were more likely to achieve PLP than their peers. Conclusion The findings indicate that community-level improvements such as increasing safety, connectivity and employment might help in child's education attainment, mental health and reduce risk taking behaviours.

Mental and behavioural disorders due to use of opioids F110 Mental and behavioural disorders due to use of opioids F111 Mental and behavioural disorders due to use of opioids F112 Mental and behavioural disorders due to use of opioids F113 Mental and behavioural disorders due to use of opioids F114 Mental and behavioural disorders due to use of opioids F115 Mental and behavioural disorders due to use of opioids F116 Mental and behavioural disorders due to use of opioids F117 Mental and behavioural disorders due to use of opioids F118 Mental and behavioural disorders due to use of opioids F119 Mental and behavioural disorders due to use of opioids F12 Mental and behavioural disorders due to use of cannabinoids F120 Mental and behavioural disorders due to use of cannabinoids F121 Mental and behavioural disorders due to use of cannabinoids F122 Mental and behavioural disorders due to use of cannabinoids F123 Mental and behavioural disorders due to use of cannabinoids F124 Mental and behavioural disorders due to use of cannabinoids F125 Mental and behavioural disorders due to use of cannabinoids F126 Mental and behavioural disorders due to use of cannabinoids F127 Mental and behavioural disorders due to use of cannabinoids F128 Mental and behavioural disorders due to use of cannabinoids F129 Mental and behavioural disorders due to use of cannabinoids F13 Mental and behavioural disorders due to use of sedatives or hypnotics F130 Mental and behavioural disorders due to use of sedatives or hypnotics F131 Mental and behavioural disorders due to use of sedatives or hypnotics F132 Mental and behavioural disorders due to use of sedatives or hypnotics F133 Mental and behavioural disorders due to use of sedatives or hypnotics F134 Mental and behavioural disorders due to use of sedatives or hypnotics F135 Mental and behavioural disorders due to use of sedatives or hypnotics F136 Mental and behavioural disorders due to use of sedatives or hypnotics F137 Mental and behavioural disorders due to use of sedatives or hypnotics F138 Mental and behavioural disorders due to use of sedatives or hypnotics F139 Mental and behavioural disorders due to use of sedatives or hypnotics F14 Mental and behavioural disorders due to use of cocaine F140 Mental and behavioural disorders due to use of cocaine F141 Mental and behavioural disorders due to use of cocaine F142 Mental and behavioural disorders due to use of cocaine F143 Mental and behavioural disorders due to use of cocaine F144 Mental and behavioural disorders due to use of cocaine F145 Mental and behavioural disorders due to use of cocaine F146 Mental and behavioural disorders due to use of cocaine

F147
Mental and behavioural disorders due to use of cocaine F148 Mental and behavioural disorders due to use of cocaine F149 Mental and behavioural disorders due to use of cocaine F15 Mental and behavioural disorders due to use of other stimulants, including caffeine F150 Mental and behavioural disorders due to use of other stimulants, including caffeine F151 Mental and behavioural disorders due to use of other stimulants, including caffeine F152 Mental and behavioural disorders due to use of other stimulants, including caffeine F153 Mental and behavioural disorders due to use of other stimulants, including caffeine F154 Mental and behavioural disorders due to use of other stimulants, including caffeine F155 Mental and behavioural disorders due to use of other stimulants, including caffeine F156 Mental and behavioural disorders due to use of other stimulants, including caffeine F157 Mental and behavioural disorders due to use of other stimulants, including caffeine F158 Mental and behavioural disorders due to use of other stimulants, including caffeine F159 Mental and behavioural disorders due to use of other stimulants, including caffeine F16 Mental and behavioural disorders due to use of hallucinogens F160 Mental and behavioural disorders due to use of hallucinogens F161 Mental and behavioural disorders due to use of hallucinogens F162 Mental and behavioural disorders due to use of hallucinogens F163 Mental and behavioural disorders due to use of hallucinogens F164 Mental and behavioural disorders due to use of hallucinogens F165 Mental and behavioural disorders due to use of hallucinogens F166 Mental and behavioural disorders due to use of hallucinogens F167 Mental and behavioural disorders due to use of hallucinogens F168 Mental and behavioural disorders due to use of hallucinogens F169 Mental and behavioural disorders due to use of hallucinogens F18 Mental and behavioural disorders due to use of volatile solvents F180 Mental and behavioural disorders due to use of volatile solvents F181 Mental and behavioural disorders due to use of volatile solvents F182 Mental and behavioural disorders due to use of volatile solvents F183 Mental and behavioural disorders due to use of volatile solvents F184 Mental and behavioural disorders due to use of volatile solvents F185 Mental and behavioural disorders due to use of volatile solvents F186 Mental and behavioural disorders due to use of volatile solvents F187 Mental and behavioural disorders due to use of volatile solvents F188 Mental and behavioural disorders due to use of volatile solvents F189 Mental and behavioural disorders due to use of volatile solvents F19 Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances F190 Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances F191 Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances F192 Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances F193 Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances

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Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances F195 Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances F196 Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances F197 Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances F198 Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances F199 Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances O355 Maternal care for (suspected) damage to fetus by drugs R781 Finding of opiate drug in blood R782 Finding of cocaine in blood R783 Finding of hallucinogen in blood R784 Finding of other drugs of addictive potential in blood R785 Finding of psychotropic drug in blood T40 Poisoning  Injecting drug user 13c1.
Never injecting drug user 13c3.
Current drug user 13c8.
Continuous use of drugs 13cD.
Episodic use of drugs 13cE.
Prolong high dose use cannabis 13cF.
Previously injecting drug user 13cK.
Current non recreat drug user 13cL.
Has never injected drugs 13cM.
Behavioural tolerance to drug 13cR.
Physical tolerance to drug 13cS.
Reverse Occasional drug user 1V01.
Smokes drugs in cigarette form 1V09.
Smokes drugs through a pipe 1V0A.
Chases the dragon 1V0B.
Am spent per day on drug habit 1V0E.
Time spent obtaining drugs 1V11.
Time spent taking drugs 1V12.
Time spent recover from drugs 1V2..
Frequency of drug misuse 1V22.
Age at starting drug misuse 1V23.
Time since stopped drug misuse 1V24.
Total time drugs misused 1V26.
Does not inject drugs 1V35.
Shares drug equipment 1V36.
Sharing drug inject equipment 1V3A.
Not share drug inject equipmen 1V3B.
Cleaning of needles 1V3E.
Does not clean needles 1V3H.
Uses needle exchange scheme 1V3K.
Needle syringe exch scheme use 1V3M.
Needle and syringe exch used 1V4.. Priority of drug activity 1V40.
No priority to drug activities 1V41.
Priority to drug activities 1V42.
Drug priority over family 1V44.
No routine of drug activities 1V51.
Has routine of drug activities 1V52.
Same drug routine every day 1V53.
Drug addiction therapy 8B230 Drug add maint ther naltrexone 8B231 Drug add maint ther lofexidine 8B2M.
Drug add detox ther methadone 8B2P.
Drug add maint ther methadone 8B2Q.
Drug harm reduction programme 8BAx.
Drug detox programme completed 8H7x.
Refer to drug abuse counsellor 8HHL.
Ref to comm drug dependen team 8HHd.
Referral to drug treatment cen 8HHe.
Referral to com drug alco team 8Hh1.
Refer substance misuse service 8Hl5.
Referral to drugs therapist 8Hl6.
Drug depend home detox contra 8IE7.
Subst mis clin man plan agreed 9HC3.
Subst mis clin man plan review 9HC4.
Decl to give subst misuse hist 9HC9.
On substance misuse programme 9N0Z.
Seen in drug rehab centre 9N1yJ Seen in drug misuse clinic 9N6a.
Refer by drug statutor service 9N6b.
Ref by drug non-statutory serv 9N6g.
Under care community drug team 9NX2.
In-house subs misuse treatment 9NdN.
Other drug psychoses E02y0 Drug-induced delirium