Archives: Publications

Purpose
The aim of this study is to examine the association between household energy poverty (EP) and trajectories of emotional and behavioural difficulties during childhood.

Methods
The Growing up in Ireland study is two nationally representative prospective cohorts of children. The Infant Cohort (n = 11,134) were recruited at age 9 months (9 m) and followed up at 3, 5, 7 and 9 years (y). The Child Cohort (n = 8,538) were recruited at age 9 y and followed up at 13 y and 17/18 y. EP was a composite of two relative measures of EP. Emotional and behavioural difficulties were repeatedly measured using the strengths and difficulties questionnaire (SDQ). Linear spline multilevel models were used, adjusted for confounders to examine the association between (1) EP (9 m or 3 y) and trajectories of emotional and behavioural difficulties from 3 to 9 y in the Infant Cohort and (2) EP at 9 y and the same trajectories from 9 to 18 y in the Child Cohort.

Results
In adjusted analyses, EP at 9 m or 3 y of age was associated with higher total difficulties score at 3 y (0.66, 95% CI 0.41, 0.91) and 5 y (0.77, 95% CI 0.48, 1.05) but not at 7 y or 9 y. EP at 9 y was associated with higher total difficulties score at 9 y (1.73, 95% CI 1.28, 2.18), with this difference reducing over time leading to 0.68 (95% CI 0.19, 1.17) at 17/18 y.

Conclusions
Our study demonstrates a potential association between early life EP and emotional and behavioural difficulties that may be transient and attenuate over time during childhood. Further studies are required to replicate these findings and to better understand if these associations are causal.

This study examined the role of neighbourhood characteristics in explaining socioeconomic inequalities in child mental health (the total difficulties score from the Strengths and Difficulties Questionnaire) using data from Cohort ’08 of Growing Up in Ireland Waves 3 (age 5; baseline) and 5 (age 9; follow-up). Twenty neighbourhood items were grouped into neighbourhood safety, built environments, cohesion, interaction, and disorder. Data were analysed using regression, single and multiple mediation, and network psychometric analyses. We found that neighbourhood safety, cohesion, interaction, and disorder were associated with child mental health. These four domains separately (by up to 18 %) or in concert (by up to 23 %) partially explained socioeconomic inequalities in child mental health. Built environments may explain socioeconomic inequalities in mental health in urban children only. Findings from network analysis indicated that specific concerns over “people being drunk or taking drugs in public” and “this is a safe neighbourhood” had the strongest connections with child mental health. Improving neighbourhood characteristics may be important to reduce socioeconomic inequalities in child mental health in Ireland.

Background
Self-harm is a major public health concern in young people and is governed by a complex interaction of different risk factors. While many studies have identified these risk factors, less is known about how they tend to co-occur together.

Methods
A latent class analysis was conducted using risk factors for self-harm from two waves at ages 13 and 17 from the Growing Up in Ireland (GUI) study their associations with self-harm were examined longitudinally at ages 17 and 20, respectively.

Results
At age 13, there was a ‘peer problems’ group with higher probabilities of bullying, being unpopular and internalising problems and a ‘school and substance use problems’ group with higher probabilities of substance use, truancy or excessive absence from school and violence. Both of these two groups had over a two-fold risk of self-harm at age 17 in comparison to the low risk factor group. At age 17, there was a group with depression that was diagnosed by a medical professional with the highest relative risk (RR:13.9 (95 % CI 10.2–19.0)) of self-harm at age 20. Two other groups with undiagnosed depression had high probabilities of being bullied, and either high or low probabilities of substance use that had a 9.4 (95 % CI 6.8–13.1) and 7.4 (95 % CI 5.5–10.0) relative risk of self-harm at age 20, respectively.

Conclusions
Identifying hidden sub-groups using risk factors for self-harm in young people can inform potential public health interventions by clinicians and other professionals who work with young people.

Background
The COVID-19 pandemic has been dubbed the “biggest public health crisis since the Second World War”. In Ireland, schools were closed for 141 days, dramatically altering the day to day lives of children in Ireland. This research aimed to evaluate the overall wellbeing of schoolchildren in Ireland and capture the prevalence and factors contributing to poor mental health.

Methods
A cross-sectional study was performed based on data from the Growing Up in Ireland COVID-19 web survey of the ’08 Infant cohort. Mental Health Inventory-5 scores were used to assess children at risk of mental health disorders. Logistic regression examined associations between various demographic and psychosocial factors and risk of mental health disorders.

Results
This study included 2,867 primary caregiver- child dyads. Almost 25% of 12/13-year-olds were at risk of mental health disorders (MHDs). An adjusted logistic regression model found associations between being at higher risk of MHDs and factors such as reduced physical activity levels (OR 1.35, 95% CI 1.10-1.66), spending less time outdoors (OR 1.48, 95% CI 1.18-1.85), increased screen-time (OR 1.35, 95% CI 1.09-1.67) and increased arguments with PCGs (OR 3.44, 95% CI 2.78-4.27). Having a trusted adult confidante reduced the risk of MHD (OR 0.25, 95% CI 0.14-0.45).

Conclusions
The prevalence of 12/13-year olds at elevated risk of MHD was high, indicating an urgent need for enhancement of child and adolescent mental health services in Ireland. Physical activity, time outdoors and supportive relationships with primary caregivers were positively associated with reduced MHD risk.

Key messages

• Children were impacted by the COVID-19 restriction measures in a way that was disproportionate to their risk.
• To reduce the risk of poor mental health outcomes for a generation of “quarantweens” we need to place children front-andcentre of our response as we recover from COVID-19.

Background
Poverty is associated with poor outcomes, yet exposure to distinct poverty trajectories in early childhood is not well understood.

Objective
To understand the prevalence of different trajectories of household poverty and their association with mid-childhood and primary-parent(mother) indicators of physical health and psychopathology in Ireland.

Methods
We used a nationally representative, prospective cohort (Growing-up-in-Ireland– Infant-Cohort). Household poverty included lowest third income decile, subjective poverty and material deprivation when children were aged 9-months(m),3,5,9-years(y). We used group based multi-trajectory-cluster-modelling to classify trajectories of poverty. Using multivariate logistic regression, adjusted with separate child and mother confounders, we assessed the association of poverty trajectories from 9m to 9y with child outcomes (overweight, any longstanding illness and psychopathology) at age 9y and the same poverty trajectories over the same 9y period with mother outcomes (overweight, any longstanding illness and depression).

Results
Of 11,134 participants, four trajectories were identified: never-in-poverty (43.1%), material/subjective>monetary-poverty (16.1%), monetary>material-poverty (25.6%), and persistent-poverty (15.2%). Children in persistent-poverty compared with never in poverty experienced higher odds of being overweight at 9y (adjusted odds ratio aOR 1.70,95% CI 1.34, 2.16), having a longstanding illness (aOR 1.51,95% CI 1.20, 1.91) and psychopathology (aOR 2.06,95% CI 1.42, 2.99). The outcomes for primary parent (99.7% were mothers) had higher odds of being overweight (aOR 1.49,95% CI 1.16, 1.92), having a longstanding illness (aOR 2.13,95% CI 1.63, 2.79), and depression (aOR 3.54,95% CI 2.54, 4.94).

Conclusions
Any poverty trajectory was associated with poorer psychopathology and physical wellbeing in late childhood for children and their mothers in Ireland.

What is already known on this subject?
Poverty is understood as having both objective (e.g. low household income) and subjective dimensions (e.g., perception of being poor relative to others, poverty related anxiety). Evidence highlights the association between child poverty exposure and child and mother wellbeing outcomes.

What this study adds?
Our study examined predicted trajectories of multi-dimensional poverty and child and mother outcomes using a large national cohort. We identified that any poverty trajectory in childhood had a higher odds of being associated with poor well-being outcomes.

How this study might affect research, practice or policy?
This study highlights the need for strategies to ameliorate any poverty exposure as all poverty trajectories resulted in poorer wellbeing outcomes. Strategies should be considered to ameliorate any poverty exposure in early childhood (e.g., school based resourcing).

What does young adulthood look like for individuals who had mental health problems across childhood? Using the Growing Up in Ireland cohort (born in 1998 and studied from ages 9 to 20) we explored the association between mental health problems between ages 9 and 13, and subsequent poor outcomes in the same individuals at ages 17-20. We consider educational/economic outcomes, health service use, poor mental and physical health, social isolation, substance abuse, and subjective wellbeing in young adults. In a previous study that used latent class modelling, we identified four groups which captured mental health in a general population sample of children. Between ages 9 and 13, children could be grouped into: a low symptoms group (∼65%), an ‘externalising’ group with ADHD or conduct symptoms (∼20%), an ‘internalising’ group with depressive, anxiety or peer issues (∼10%), or a group showing many combined mental health symptoms (∼2%). All mental health problem groups had elevated odds across all 7 adverse outcomes in young adulthood. The 5 areas of young adult functioning most related to childhood mental health were: education/economics, subjective wellbeing, mental health, social isolation and substance abuse. Poor educational/economic outcomes were as likely as poor mental health (OR ∼ 2) in individuals with childhood psychopathology. The 3 childhood problem groups showed different risk profiles in young adulthood. For instance, the childhood internalising group had lower odds of substance abuse than all other groups, but had the highest odds of poor physical health by adulthood. Findings point to the need for a wider range of preventative supports for children and adolescents with a history of mental health problems, beyond just mental health support. These include interventions to improve physical health, treat substance abuse, reduce social isolation, and improve adverse educational and economic outcomes.

We analyse parental smoking and cessation (quitting) associations with teenager e-cigarette, alcohol, tobacco smoking and other drug use, and explore parental smoking as a mechanism for social reproduction. We use data from Waves 1–3 of Growing Up in Ireland (Cohort ’98). Our analytic sample consisted of n = 6,039 participants reporting in all 3 Waves. Data were collected in Waves 1 and 2 when the children were 9 and 13 years old and in Wave 3 at age 17/18 years. Generalized Estimating Equations (GEE) models were used to analyse teenage substance use at Wave 3. Parental smoking was associated with significantly increased risk of all teenage substance use, adjusted odds ratios were aOR2.13 (ever e-cigarette use); aOR1.92 (ever alcohol use); aOR1.88 (current alcohol use); aOR1.90 (ever use of other drugs); aOR2.10 (ever-smoking); and aOR1.91 (current smoking). Primary caregiver smoking cessation (quitting) was associated with a lower risk for teenager current smoking aOR0.62, ever e-cigarette use aOR 0.65 and other drug use aOR 0.57. Primary caregiver smoking behaviour had greater associations than secondary, and age13 exposure more than age 9. Habitus seems to play a role and wealth was protective for teenage smoking. The findings suggest that prevention interventions should target both caregivers and their children.

Children’s parent and teacher relationships contribute to school adjustment and achievement, yet few studies have examined interactions between these relationships, particularly for father-child relationships. Using the Growing Up in Ireland birth cohort (N = 7,507 children, 50.3% male), we examined child-adult relationship quality – rated by mothers and fathers at age 3 and teachers at age 5 – as predictors of behavioural adjustment (rated by teachers) and academic achievement (formal reading assessments and self-reported academic self-concepts) at age 9. Controlling for prior levels of problem behaviours, verbal ability, and family SES, results indicated small and comparable independent effects of children’s parent and teacher relationships on school adjustment and achievement. For mothers and teachers, moderation analyses showed a cumulative risk pattern for conflictual relationships and a compensatory pattern for close relationships. Children are likely to benefit from improving closeness and reducing conflict in adult-child relationships and interventions that involve mothers, fathers, and teachers.

Little is known about the link between childhood and adolescent mental health (MH) difficulties and political outcomes in adulthood. This represents an important knowledge gap in understanding early individual-level factors for future political outcomes. Using the Growing up in Ireland cohort, following 8,568 children from nine to 20 years, we examine how different MH difficulties, and co-occurrence, are associated with various political outcomes. The results show childhood/adolescent MH difficulties are important predictors of political outcomes at age 20. Adolescents with chronic co-occurring MH difficulties starting in childhood report a lower interest in politics, lower trust in politicians, are less likely to register to vote, and if voting, are more likely to vote for an anti-establishment party. Adolescents with chronic emotional MH difficulties starting in childhood report a higher likelihood of voting for an anti-establishment party, but also show a higher probability of political activism and low external political efficacy.

This article draws on the Growing Up in Ireland study and the Scottish sample of the Millennium Cohort Study to explore the factors influencing inequalities in children’s cognitive skills on entry to primary education. It adopts a multidimensional comparative approach, which directly compares the effects of parental education and household income on several cognitive outcomes (vocabulary, language, reading and numbers) among five-year-old children and examines the extent to which inequalities in these outcomes are mediated by the home learning environment (HLE) and early childhood education (ECE). Home learning environment plays a stronger role in explaining actual vocabulary differences in Ireland while it plays a stronger role in school readiness (teacher-assessed skills) in Scotland. In both countries, use of centre-based care at 9 months and 3 years was markedly higher among the top income quintile. Centre-based care is found to play a mediating role in school readiness in Scotland. Nonetheless, the findings point to important direct effects of family background even when HLE and childcare are taken into account. The analyses point to differences in the trajectory of early skill development in the two countries, with the impact of early skill development being more marked in Scotland than Ireland. Comparative analyses of this kind thus yield important insights for policy development by highlighting potential domains (such as childcare) or timing (preschool or within-school) for intervention.