Modelling the joint impact of early-life interventions on adult health: an illustrative example of multiple long-term conditions with role limitations in midlife using the 1970 British Cohort Study (BCS70)

Stannard, Sebastian; Berrington, Ann; Ziauddeen, Nida; S., Simon D.; Paranjothy, Shantini; Owen, Rhiannon; Alwan, Nisreen A.

doi:10.1186/s12916-025-04467-3

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Modelling the joint impact of early-life interventions on adult health: an illustrative example of multiple long-term conditions with role limitations in midlife using the 1970 British Cohort Study (BCS70)

Sebastian Stannard

, Ann Berrington

, Nida Ziauddeen

, Simon D. S. Fraser

, Shantini Paranjothy, Rhiannon Owen

, Nisreen A. Alwan

BMC Medicine, Volume: 23, Issue: 1

Swansea University Author: Rhiannon Owen

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DOI (Published version): 10.1186/s12916-025-04467-3

Abstract

BackgroundEvidence on how policy interventions early in childhood can prevent or delay multiple long-term conditions (MLTCs) is limited. We modelled prevention scenarios using five early-life domains on the outcome of MLTCs with role-limitation using effectiveness data of combined real-life early in...

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Published in:	BMC Medicine
ISSN:	1741-7015
Published:	Springer Science and Business Media LLC 2025
Online Access:	Check full text
URI:	https://cronfa.swan.ac.uk/Record/cronfa71445

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We modelled prevention scenarios using five early-life domains on the outcome of MLTCs with role-limitation using effectiveness data of combined real-life early interventions.MethodsOur study sample was 6201 participants in the 1970 British Cohort Study. The outcome was MLTCs with role-limitation (i.e. impacting everyday life functioning) as reported by participants at age 46. We constructed adversity scores within early-life domains (from prenatal to age 10) including prenatal to birth, developmental attributes, education, socioeconomic factors and family environment and used adjusted multivariable logistic regression to examine their relationship with the outcome. We generated adjusted population attribution fractions to estimate the reduction in outcome risk if cohort members reduced their adversity scores. Using effect estimates on early-life exposures from evaluations of real-life interventions including Family Hubs, the Family Nurse Partnership and the teenage pregnancy prevention framework, we calculated the absolute reduction in the outcome risk had cohort members been exposed to all three interventions.ResultsReducing early life adversity scores from 3 + to 1, from 3 + to 0, from 2 to 0 in the developmental attributes domain and from 3 + to 2, from 3 + to 0, from 1 to 0 in the prenatal to birth domain, lowered the outcome risk. For the developmental attributes domain, the combined effect of the interventions could result in a 0.5% reduction in MLTCs with role limitations for those with a domain adversity score of 3 +. For the prenatal-birth domain, the combined effect of the interventions could result in a 11.5% and 2.5% reduction in MLTCs with role limitations for those with a domain adversity score of 3 + and 1, respectively.ConclusionsInterventions during pregnancy, the postnatal period and childhood may reduce MLTC risk in midlife.</abstract><type>Journal Article</type><journal>BMC Medicine</journal><volume>23</volume><journalNumber>1</journalNumber><paginationStart/><paginationEnd/><publisher>Springer Science and Business Media LLC</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic>1741-7015</issnElectronic><keywords>Multimorbidity; Childhood; Prevention; Intervention; Long-term conditions; Early life</keywords><publishedDay>18</publishedDay><publishedMonth>11</publishedMonth><publishedYear>2025</publishedYear><publishedDate>2025-11-18</publishedDate><doi>10.1186/s12916-025-04467-3</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm>Another institution paid the OA fee</apcterm><funders>This study/project is funded by the National Institute for Health Research (NIHR) under its Programme Artificial Intelligence for Multiple and Long-Term Conditions (NIHR203988).</funders><projectreference/><lastEdited>2026-03-06T12:30:35.7480626</lastEdited><Created>2026-02-17T12:37:58.5370792</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Health Data Science</level></path><authors><author><firstname>Sebastian</firstname><surname>Stannard</surname><orcid>0000-0002-6139-1020</orcid><order>1</order></author><author><firstname>Ann</firstname><surname>Berrington</surname><orcid>0000-0002-1683-6668</orcid><order>2</order></author><author><firstname>Nida</firstname><surname>Ziauddeen</surname><orcid>0000-0002-8964-5029</orcid><order>3</order></author><author><firstname>Simon D. S.</firstname><surname>Fraser</surname><orcid>0000-0002-4172-4406</orcid><order>4</order></author><author><firstname>Shantini</firstname><surname>Paranjothy</surname><order>5</order></author><author><firstname>Rhiannon</firstname><surname>Owen</surname><orcid>0000-0001-5977-376X</orcid><order>6</order></author><author><firstname>Nisreen A.</firstname><surname>Alwan</surname><orcid>0000-0002-4134-8463</orcid><order>7</order></author></authors><documents><document><filename>71445__36365__1c760fc528ba4a84b9d693e0c99a85fa.pdf</filename><originalFilename>71445.VoR.pdf</originalFilename><uploaded>2026-03-06T12:28:48.7223920</uploaded><type>Output</type><contentLength>7422178</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>© The Author(s) 2025. 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spelling	2026-03-06T12:30:35.7480626 v2 71445 2026-02-17 Modelling the joint impact of early-life interventions on adult health: an illustrative example of multiple long-term conditions with role limitations in midlife using the 1970 British Cohort Study (BCS70) 0d30aa00eef6528f763a1e1589f703ec 0000-0001-5977-376X Rhiannon Owen Rhiannon Owen true false 2026-02-17 MEDS BackgroundEvidence on how policy interventions early in childhood can prevent or delay multiple long-term conditions (MLTCs) is limited. We modelled prevention scenarios using five early-life domains on the outcome of MLTCs with role-limitation using effectiveness data of combined real-life early interventions.MethodsOur study sample was 6201 participants in the 1970 British Cohort Study. The outcome was MLTCs with role-limitation (i.e. impacting everyday life functioning) as reported by participants at age 46. We constructed adversity scores within early-life domains (from prenatal to age 10) including prenatal to birth, developmental attributes, education, socioeconomic factors and family environment and used adjusted multivariable logistic regression to examine their relationship with the outcome. We generated adjusted population attribution fractions to estimate the reduction in outcome risk if cohort members reduced their adversity scores. Using effect estimates on early-life exposures from evaluations of real-life interventions including Family Hubs, the Family Nurse Partnership and the teenage pregnancy prevention framework, we calculated the absolute reduction in the outcome risk had cohort members been exposed to all three interventions.ResultsReducing early life adversity scores from 3 + to 1, from 3 + to 0, from 2 to 0 in the developmental attributes domain and from 3 + to 2, from 3 + to 0, from 1 to 0 in the prenatal to birth domain, lowered the outcome risk. For the developmental attributes domain, the combined effect of the interventions could result in a 0.5% reduction in MLTCs with role limitations for those with a domain adversity score of 3 +. For the prenatal-birth domain, the combined effect of the interventions could result in a 11.5% and 2.5% reduction in MLTCs with role limitations for those with a domain adversity score of 3 + and 1, respectively.ConclusionsInterventions during pregnancy, the postnatal period and childhood may reduce MLTC risk in midlife. Journal Article BMC Medicine 23 1 Springer Science and Business Media LLC 1741-7015 Multimorbidity; Childhood; Prevention; Intervention; Long-term conditions; Early life 18 11 2025 2025-11-18 10.1186/s12916-025-04467-3 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Another institution paid the OA fee This study/project is funded by the National Institute for Health Research (NIHR) under its Programme Artificial Intelligence for Multiple and Long-Term Conditions (NIHR203988). 2026-03-06T12:30:35.7480626 2026-02-17T12:37:58.5370792 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Sebastian Stannard 0000-0002-6139-1020 1 Ann Berrington 0000-0002-1683-6668 2 Nida Ziauddeen 0000-0002-8964-5029 3 Simon D. S. Fraser 0000-0002-4172-4406 4 Shantini Paranjothy 5 Rhiannon Owen 0000-0001-5977-376X 6 Nisreen A. Alwan 0000-0002-4134-8463 7 71445__36365__1c760fc528ba4a84b9d693e0c99a85fa.pdf 71445.VoR.pdf 2026-03-06T12:28:48.7223920 Output 7422178 application/pdf Version of Record true © The Author(s) 2025. This article is licensed under a Creative Commons Attribution 4.0 International License. true eng http://creativecommons.org/licenses/by/4.0/
title	Modelling the joint impact of early-life interventions on adult health: an illustrative example of multiple long-term conditions with role limitations in midlife using the 1970 British Cohort Study (BCS70)
spellingShingle	Modelling the joint impact of early-life interventions on adult health: an illustrative example of multiple long-term conditions with role limitations in midlife using the 1970 British Cohort Study (BCS70) Rhiannon Owen
title_short	Modelling the joint impact of early-life interventions on adult health: an illustrative example of multiple long-term conditions with role limitations in midlife using the 1970 British Cohort Study (BCS70)
title_full	Modelling the joint impact of early-life interventions on adult health: an illustrative example of multiple long-term conditions with role limitations in midlife using the 1970 British Cohort Study (BCS70)
title_fullStr	Modelling the joint impact of early-life interventions on adult health: an illustrative example of multiple long-term conditions with role limitations in midlife using the 1970 British Cohort Study (BCS70)
title_full_unstemmed	Modelling the joint impact of early-life interventions on adult health: an illustrative example of multiple long-term conditions with role limitations in midlife using the 1970 British Cohort Study (BCS70)
title_sort	Modelling the joint impact of early-life interventions on adult health: an illustrative example of multiple long-term conditions with role limitations in midlife using the 1970 British Cohort Study (BCS70)
author_id_str_mv	0d30aa00eef6528f763a1e1589f703ec
author_id_fullname_str_mv	0d30aa00eef6528f763a1e1589f703ec_***_Rhiannon Owen
author	Rhiannon Owen
author2	Sebastian Stannard Ann Berrington Nida Ziauddeen Simon D. S. Fraser Shantini Paranjothy Rhiannon Owen Nisreen A. Alwan
format	Journal article
container_title	BMC Medicine
container_volume	23
container_issue	1
publishDate	2025
institution	Swansea University
issn	1741-7015
doi_str_mv	10.1186/s12916-025-04467-3
publisher	Springer Science and Business Media LLC
college_str	Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id	facultyofmedicinehealthandlifesciences
hierarchy_top_title	Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id	facultyofmedicinehealthandlifesciences
hierarchy_parent_title	Faculty of Medicine, Health and Life Sciences
department_str	Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
document_store_str	1
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description	BackgroundEvidence on how policy interventions early in childhood can prevent or delay multiple long-term conditions (MLTCs) is limited. We modelled prevention scenarios using five early-life domains on the outcome of MLTCs with role-limitation using effectiveness data of combined real-life early interventions.MethodsOur study sample was 6201 participants in the 1970 British Cohort Study. The outcome was MLTCs with role-limitation (i.e. impacting everyday life functioning) as reported by participants at age 46. We constructed adversity scores within early-life domains (from prenatal to age 10) including prenatal to birth, developmental attributes, education, socioeconomic factors and family environment and used adjusted multivariable logistic regression to examine their relationship with the outcome. We generated adjusted population attribution fractions to estimate the reduction in outcome risk if cohort members reduced their adversity scores. Using effect estimates on early-life exposures from evaluations of real-life interventions including Family Hubs, the Family Nurse Partnership and the teenage pregnancy prevention framework, we calculated the absolute reduction in the outcome risk had cohort members been exposed to all three interventions.ResultsReducing early life adversity scores from 3 + to 1, from 3 + to 0, from 2 to 0 in the developmental attributes domain and from 3 + to 2, from 3 + to 0, from 1 to 0 in the prenatal to birth domain, lowered the outcome risk. For the developmental attributes domain, the combined effect of the interventions could result in a 0.5% reduction in MLTCs with role limitations for those with a domain adversity score of 3 +. For the prenatal-birth domain, the combined effect of the interventions could result in a 11.5% and 2.5% reduction in MLTCs with role limitations for those with a domain adversity score of 3 + and 1, respectively.ConclusionsInterventions during pregnancy, the postnatal period and childhood may reduce MLTC risk in midlife.
published_date	2025-11-18T05:33:04Z
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Modelling the joint impact of early-life interventions on adult health: an illustrative example of multiple long-term conditions with role limitations in midlife using the 1970 British Cohort Study (BCS70)

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