Poverty and family adversity trajectories and not in education, employment or training (NEET) status in late adolescence: evidence from the UK Millennium Cohort Study.

Background: Young people who are not in education, employment or training (NEET) are at an increased risk of long-term social and economic disadvantage. While previous research has linked various risk factors and individual characteristics to NEET status, evidence on the cumulative impact of early-life exposure to childhood adversity in the UK remains limited. We therefore aimed to investigate the association between trajectories of poverty and family adversity and NEET status in late adolescence, and to characterise socioeconomic differences, including household income and maternal education by NEET status. Methods: We analysed longitudinal data on 8368 participants from the UK Millennium Cohort Study. Using a group-based multi-trajectory modelling approach, we identified six distinct exposure trajectories of poverty and family adversity (ie, low poverty and adversity, persistent poverty, persistent poor parental mental health, persistent parental alcohol use, persistent domestic violence and abuse, and persistent poverty and poor parental mental health) from aged 9 months to 14 years. NEET status was assessed at age 17. Adjusted ORs (aORs) and 95% CIs were estimated using logistic regression models. Population attributable fractions were calculated to estimate the proportion of NEET cases attributable to childhood poverty and family adversity. Results: Overall, 3.5% of participants were NEET at age 17 years. NEET status was more prevalent among young people from socially disadvantaged backgrounds than their peers. Exposure to persistent family childhood adversities was associated with greater likelihood of being NEET. Young people exposed to both persistent poverty and poor parental mental health throughout childhood (9 months to 14 years) had five times greater odds of being NEET (aOR 5.0; 95% CI 3.4 to 7.5) compared with those in low poverty and adversity. An estimated 52.9% (95% CI 41.1% to 61.7%) of NEET cases were attributable to persistent exposure to poverty and family adversity. Conclusion: Family childhood adversities, particularly household poverty and poor parental mental health, are strongly associated with an increased risk of being NEET on transition to adulthood. Interventions that address early-life socioeconomic disadvantage and family functioning may be critical for preventing NEET and mitigating its long-term social and economic consequences.