Pathway of the Association Between Child Poverty and Low Self-Esteem: Results From a Population-Based Study of Adolescents in Japan.

Child poverty leads to various negative consequences, including low self-esteem, which is a risk factor for mental illness, suicide, or poor academic achievement. However, little is known about why child poverty leads to low self-esteem. We aimed to elucidate the association of child poverty and low self-esteem based on the ecological model, which includes family-level, school-level, and community-level factors. Data were obtained from the Adachi Child Health Impact of Living Difficulty (A-CHILD) study in 2016, and participants included 1,652 children in fourth grade (534 pairs), sixth grade (530 pairs), and eighth grade (588 pairs) living in Adachi City, Tokyo, Japan. A questionnaire survey was implemented to assess child poverty, parental mental health, parental involvement with children, parental social capital by caregivers, and self-esteem and school social capital by children. The structural equation model was applied to elucidate the association between child poverty and low self-esteem, using family-level (parental mental health and parental involvement with children), school-level (school social capital), and community-level (parental social capital) factors. Child poverty was associated with low self-esteem. Child poverty leads to poor parental involvement, which can be indirectly associated with poor parental mental health and poor parental social capital, and poor parental involvement was directly or indirectly associated with low self-esteem through poor school social capital. To mitigate the impact of child poverty on low self-esteem, comprehensive health policies targeting family-level (parental mental health and parental involvement with children), school-level (school social capital), and community-level (parental social capital) factors may be effective.