Using a large nationally representative cohort, we showed that more than 1 in 10 (13%) of young people in the UK experienced low perceived emotional support at age 14. Several key findings emerged from our analyses. Overall, we found that children of parents with low socioeconomic background were more likely to report low emotional support, consistent with a socio-economic gradient. Low perceived emotional support and poor family relationships in adolescence were more prevalent among socially disadvantaged children and children who experienced high levels of family adversity including parental mental illness, domestic violence and abuse and alcohol use throughout childhood and early adolescence. Over 10% of children experienced persistent poverty and persistent parental mental health in our trajectory analysis [16], and this combination of exposure was associated with more than twofold increased risk of low perceived emotional support and higher odds of low-quality parent–adolescent relationship at age 14 years.

Our estimate of low emotional support impacting 13% of young people in the UK is consistent with other studies [21]. To our knowledge, ours is the first longitudinal study to explore the relationship between early life course family-related risk factors and psychosocial needs in later adolescence. Few cross-sectional studies exist, but have mainly focused on the effects of single parental socioeconomic conditions such as family income and education [14], and surprisingly little is known about their social distribution [22]. In a cross-sectional study, Weyers et al. [14] found low social support to be more frequent among socio-economically disadvantaged people. Nonetheless, there is also some evidence from the recent Children’s Commissioner report suggesting that quality family relationships and strong social and emotional support can address social disadvantage in later life [7].

Previous studies of social and emotional support for young people have not looked at the impact of long-term patterns of multiple adversities on perceived quality of emotional support in adolescence [11]. Indeed, measures of emotional support are often used as mediating or interacting variables to assess protective or buffering effects against adverse health outcomes [23]. The evidence emerging from our longitudinal analysis shows that family emotional support is unevenly distributed across a wider social spectrum [24], which may have important implications for public policies and interventions.

Our analysis suggests that early-life social disadvantage and adversity are associated with lower levels of family support and poor family relationships in young adulthood. We further observed that each adversity (parental mental illness, domestic violence and abuse, alcohol use and poverty) in isolation was independently associated with an increased risk of low family support and a low-quality relationship. Children exposed to the combination of adversities, particularly persistent poverty and poor parental mental health were found to be at highest risk compared to those in the low adversity cluster group. This finding is consistent with the perspective that the availability of psychosocial resources, such as perceived emotional support, emerges from social conditions and other life experiences [25]. If true, then the exposure of children and young people to persistent adversity throughout childhood may be indicative of parents who experience higher levels of stress and are thus less able to provide emotional support to their children.

The potential mechanisms through which family-related stress impacts perceived psychological outcomes are well established [26]. Our longitudinal analyses add strength to the explanation that poverty and material deprivation may be potent causes of family stress [27], which may also erode the conditions under which emotional support can be provided to protect against stress. Numerous studies have demonstrated the connection between stressful life conditions such as income poverty and other family adversities including, family violence and mental health problems, such as depression and anxiety [16, 18, 28]. The co-occurrence of these mental health problems with economic disadvantage can greatly affect parenting behaviours and increase family conflict [26], which can negatively impact family support and the quality of family relationship [13, 26].

Further, the patterning of family support across socio-economic hierarchy can be explained in relation to family structure. Increasing evidence suggests that family structure and the context in which children grow up can play an important role in how social and economic disadvantage impacts young people’s psychosocial conditions [7]. While young people from two-parent households may experience some levels of stress caused by parental conflict and family violence [26, 29], several studies indicate that those from single-parent households are more likely to face psychological distress [7]. One possible reason for this is that single-parent households usually have fewer financial and emotional resources to meet their children’s needs, leading to increased stress and an unsupportive family atmosphere that negatively affects parent–child relationships [7]. Although this study did not directly investigate the various forms of family structure, unpacking and understanding the composition of contemporary families may be useful in developing effective family support programs and policies.

A key strength of the study is the use of a large and contemporary UK birth cohort, making the findings generalisable to the UK population regarding experiences of family adversities, emotional support, and quality of family relationships during adolescence. We also assume that our findings may apply to other high-income countries where poverty and other family adversities, such as parental mental health problems are prevalent. Additionally, a multi trajectory modelling technique was applied to predict multiple adversity exposures across childhood. This approach incorporates information on the timing and accumulation of experienced childhood adversities [16, 30].

However, a few limitations of this study should be noted. First, despite using validated tools and measures to assess our exposure trajectories and outcomes, we relied on self-reported information from cohort members and parents, which may be subject to reporting bias. Nevertheless, previous studies have found high internal consistency and reliability for our interest variables [18, 31], including our main outcome variable (i.e., perceived emotional support) [21]. Second, missing data are ubiquitous problems in longitudinal studies. We, however, repeated our analysis using imputation techniques to account for missing data. The sensitivity analysis comparing the main and imputed analyses showed similar results (see, appendix pp 3). Third, although the SPS-3 has been shown to be a reliable measure of perceived emotional support among adolescents [19], it is not specific to parents in the MCS. Nonetheless, the associations we found remain consistent for other outcomes specific to parents that we used in the study (i.e., closeness and conflict with parents). Lastly, although a wide range of information in our longitudinal data allowed us to adjust for potential confounders, unmeasured confounding factors such as genetics were not analysed due to data constraints.

Despite these limitations, our study makes a significant contribution to the literature on the social distribution and antecedents of emotional support by assessing significant links between social disadvantage during childhood, and levels of family support and quality of family relationships in adolescence. Drawing from a syndemic [32] and a life course perspective, our findings highlighted the importance of childhood and early adolescence and related family experiences for perceptions of emotional support in young adulthood.

From a public health perspective, our results corroborate other studies that advocate for a range of integrated responses to improve children’s life chances and break intergenerational cycles of adversity. This is likely to require a reduction in child poverty, actions to reduce other childhood adversities, and investment in both universal and targeted parenting support for families. Emotional support for young people within families does not spring from the ether. Our analysis suggests that poverty and family adversity are likely to have considerable impacts on parents’ ability to provide the necessary emotional support to children and young people. Child poverty, a major socioeconomic determinant of psychological and mental health [16, 18], is currently on the rise in the UK [16, 28]. Thus, policies aimed at improving family support for adolescents should also address easily modifiable determinants of child health such as child poverty in addition to prioritising more support for family mental health problems.