External Publications Using GUI Data

Large-scale international migration continues apace. From a health-care services perspective, it is important to understand the influence of migrant heritage on utilization, to allocate resources appropriately and facilitate equity. However, the differences in utilization across different migrant groups remain poorly understood, particularly so for paediatric populations. This paper contributes to filling this gap in knowledge, examining the health-care contact of children for whom their primary caregiver is foreign-born, using longitudinal data from two nationally representative surveys. The study setting is Ireland, which provides an interesting case as a small, open European country, which for the first-time experienced net inward migration in the past two decades. For both cohorts, panel regression models, adjusting for socioeconomic and health indicators, demonstrated lower utilization of general practitioner (GP) services for children of caregivers from ‘less-advanced, non-Anglosphere, non-European Union (EU)’ nations, relative to native-born counterparts. Relatively lower attendances at Emergency Departments and hospital nights were also observed for this group, as well as for children born to EU (non-UK) caregivers. The insights provided are instructive for policymakers for which immigration is a substantial phenomenon in current and future population demographics.

Background
Historically, breastfeeding rates in Ireland have been low compared with international averages. It has been suggested that maternal ethnicity and citizenship may influence breastfeeding rates, with ethnic minorities thought more likely to breast feed.

Aim
The aim of this study is to investigate the association among maternal citizenship, ethnicity, birthplace and breast feeding. It is hypothesised that Irish mothers (identified through Irish citizenship, self-identified Irish ethnicity or Irish birthplace) are less likely to breast feed than non-Irish mothers.

Methods
The study population of Growing Up in Ireland: the National Longitudinal Study of Children was used for this study. Analysis was restricted to 11 092 biological mother and infant pairs with a complete breastfeeding history. Logistic regression analysis was used to estimate ORs and 95% CIs for breast feeding relative to maternal citizenship and ethnicity, controlling for the confounding effects of other maternal variables.

Results
Results indicated that 55.9% (6202 of 11 092) of mothers had initiated breast feeding, with only 7.9% (874 of 11 092) of mothers currently breast feeding their infant (at 9 months of age). Irish citizens (4693 of 9368, 50.0%) were significantly less likely to have initiated breast feeding compared with non-Irish citizens (1503 of 1695, 88.7%). Irish born mothers (4179 of 8627, 48.8%) were also significantly less likely to have initiated breast feeding than mothers born elsewhere (2023 of 2462, 82.2%).

Conclusions
Maternal citizenship and ethnicity appear to be the strongest influencing factors on breastfeeding initiation and duration. However, this raises a possibility that the increase in breastfeeding rates seen recently may be the result of increased immigration into Ireland, rather than the success of policy and research efforts.

A large body of international literature has documented a correlation between nontraditional family structure and poorer child outcomes, yet researchers continue to disagree as to whether the association represents a true causal effect. This article extends this literature by employing propensity score matching using the first wave of data from the Growing up in Ireland child cohort study. We argue that the Irish case is of particular interest given the highly selective nature of non-marriage. We find that, on average, non-marriage has negative effects on a child educational development at age 9 but the effects are smaller in relation to health outcomes and the child’s self-concept. However, selection effects account for a non-trivial proportion of the differences in child outcomes across lone-mother and cohabiting families although hidden bias remains an important issue. This has important implications for policies which promote marriage as the key to child development as it appears that much of the benefits of marriage are not related to marriage per se but to the socio-economic background of mothers.

Objectives
Maternal health behaviours (MHBs) can influence pregnancy outcomes. Despite efforts internationally to encourage positive MHBs, women often fail to comply with pregnancy guidelines. International studies show differences in MHBs between nationalities and an effect of time spent in the host country. There is limited Irish data in this area, with no previous research relating to the effect of time in Ireland.

Study design
This study is a cross-sectional analysis of the Growing Up in Ireland infant cohort, a nationally representative longitudinal study.

Methods
Examination of the MHBs of non-Irish nationals during pregnancy and the effect of time in Ireland on the said behaviours.

Results
An association was found between time spent in Ireland and increased alcohol consumption prevalence. Those living in Ireland for ≤5 years were 60.8% less likely to consume alcohol during pregnancy (0.000) and 29.3% less likely to take folic acid before conception (0.021). Those who smoked during pregnancy were 98.6% more likely to consume alcohol (0.000) and those who consumed alcohol were 95.2% more likely to smoke during pregnancy (0.000).

Conclusions
The results demonstrate differences in MHBs and the influence of time living in Ireland. These findings are of relevance for policy and intervention planning to optimise pregnancy outcomes among non-nationals.

There is now fairly substantial evidence of a socioeconomic gradient in low birth weight for developed countries. The standard summary statistic for this gradient is the concentration index. Using data from the recently published Growing Up in Ireland survey, this paper calculates this index for low birth weight arising from preterm and intrauterine growth retardation. It also carries out a decomposition of this index for the different sources of low birth weight and finds that income inequality appears to be less important for the case of preterm births, while father’s education and local environmental conditions appear to be more relevant for intrauterine growth retardation. The application of the standard Blinder–Oaxaca decomposition also indicates that the socioeconomic gradient for low birth weight appears to arise owing to different characteristics between rich and poor, and not because the impact of any given characteristic on low birth weight differs between rich and poor.

Parenting style has been highlighted as an important factor in child and adolescent outcomes for a range of indicators including health and educational achievement. The fostering of a positive self-concept and closer parental monitoring of school involvement are two of the suggested mechanisms by which parenting style may affect educational achievement. In recent years, much research has tended to focus on adolescents and there is considerably less information for middle childhood. This paper looks at the role of maternal parenting style (based on child-reports) on academic achievement for a large sample of 9-year-old children who took part in the Growing Up in Ireland study. It shows that an authoritative parenting style was associated with higher scores on measures of reading and maths relative to neglectful or uninvolved styles, however the expected advantage over an authoritarian parenting style did not emerge (and tended to reverse post-adjustment for mediators), and other socio-demographic characteristics such as maternal education were stronger predictors. Adjustments for possible mediating variables had a complex effect on the earlier models and suggest that authoritative parenting may have an indirect effect through both parental monitoring and the promotion of positive self-concept, especially the latter.

Keywords
parenting style, academic achievement, middle childhood, self-concept

This study identified ways to improve the social and educational outcomes of children with disabilities, including informing parents about the school and post-school options available.

Differentials in physical activity (PA) between social and economic groups has been shown to contribute significantly to social gradients in health and life expectancy, yet relatively little is known about why differentials in PA emerge. This paper uses longitudinal data on a nationally representative sample of 6,216 young people aged between 9 and 18, from Ireland, to measure the role of family, school and neighbourhood level factors in accounting for differentials in PA trajectories between groups of young people, defined by level of maternal education, whilst adjusting for the individual characteristics of the young person (sex, age, personality, body mass index and health-status). Levels of PA fall significantly across the sample between 9 and 18, and the decline in PA is larger for the children of lower educated mothers. We find a clear gradient in PA at each age by maternal education for both males and females. Descriptive analyses found social gradients in the majority of our risk factors. Using multi-level, linear spline regression models to decompose differentials between groups, we find that family-level mechanisms account for the biggest proportion of the differential in PA for both males (50.8%) and females (35.1%). Differences in income across maternal education categories accounted for 24.1% of the differential for males and 14.7% among females, making it the second most effective mechanism in explaining the social patterning of PA. Neighbourhood-level processes resulted in a modest reduction in the same differential, while school level processes had the effect of equalising differences in PA across maternal education groups.

This paper discusses the role of grandparents in informal childcare in Ireland. It considers how recent demographic change and government policy on childcare have the potential to place greater pressures on the provision of grandparent childcare. It illustrates research literature that has examined the prevalence and intensity of grandparent care, factors influencing such care, and the role and needs of grandparents in childcare. We argue that there are significant gaps in Irish research evidence about the extent of, role and needs of grandparents as childcarers and outline a data and research agenda that builds on previous research in this area.

Keywords
Childcare, Policy, Grandparents, Intergenerational

This paper draws on longitudinal data to examine the extent to which parents’ educational expectations shape academic development and changes in self-concept among young people with different types of disability. The analysis is based on the Growing Up in Ireland longitudinal study, which tracked 7423 children between the primary to secondary school years, 21% of whom were identified with one of four main disability types. Our conceptual framework assumes that parental expectations at age 9 will be influenced by both the child’s disability and child’s academic achievement at that stage, as well as being influenced by other factors such as parent’s own education, family economic vulnerability, family relationships and family structure. Therefore, we take these factors into account in tracing the consequences of parental expectations at age 9, on academic and social outcomes at age 13 after the transition to secondary education. Among young people with a disability, poorer self-concept at age 13 is partly explained by lower parental expectations, particularly for those with general learning and emotional/behavioural disabilities. Similarly, parental expectations are a significant influence on children’s academic outcomes and partly explain the effects of disability status on academic development. Parents’ beliefs about their children’s abilities have a strong influence on achievement and self-concept, raising important issues around the need to promote equality of opportunity, raising awareness of the educational opportunities available, promoting positive expectations and engagement with school and the importance of promoting a range of opportunities for achievement.

Keywords
Parental expectations, socio-economic background, disability type, examination performance, self-concept

Introduction
The aim of this paper was to examine the role of perinatal, obstetric and post partum factors on maternal and paternal stress. It will present the first examination of the role of prenatal, obstetric, post-partum, and demographic variables in parenting stress for mothers and fathers at 9 months.

Methods
Data from 6821 parental dyads of 9-month-old infants were extracted from the Growing Up in Ireland National Longitudinal Study of Children. Participants completed the Parental Stress Scale, the Dyadic Adjustment Scale, the Quality of Attachment Sub-scale from the Maternal and Paternal Postnatal Attachment Scales, and a single item health status question from the Short Form 12 Health Survey. Information on prenatal care, pregnancy complications, obstetric outcomes, infant health, and participant demographics were also collected. Separate hierarchical linear regressions were conducted for mothers and fathers

Results
Mothers reported higher levels of parenting stress than fathers (p < 0.001). Maternal parenting stress was predicted by attachment, own health status, average sleep, occupation, household income, and having a very rapid labor. Paternal parenting stress was predicted by attachment and own health status.

Discussion
A range of perinatal factors was associated with an increased risk of higher parenting stress at 9 months post-partum and the roles of these factors differ between mothers and fathers. These findings are important for predicting and reducing risk of parenting stress in both genders.

Keywords
Attachment, obstetric outcomes, parenting stress, prenatal, well-being

Family and home environment factors have been outlined in previous literature as important variables that affect early reasoning development. However, little research has focused on the association between screen use in the home environment and nonverbal reasoning ability. The aim of this cross-sectional study is to examine the role of both screen time and various screen activities (e.g., television, video, or educational games) in nonverbal reasoning ability in 9,001 5-year-old children using a large birth cohort study (Growing Up in Ireland). Interviews conducted with parents related to the children’s screen use and various family factors, while reasoning ability was measured using a standardized task (Picture Similarities Task, British Ability Scales II). A hierarchical multiple regression examined the role of screen use in nonverbal reasoning, while also statistically controlling for family factors such as parental education and employment status. Screen use variables made a significant contribution to the regression model, even after family factors were accounted for, although the effect sizes were very small. Playing educational games, video games, or engaging in over three hours screen use per day were all significant predictors of nonverbal reasoning scores in the final adjusted model. The results of this study suggest that screen use may play a small role in the development of nonverbal reasoning in young children. The findings highlight the need for further studies in this area and may have implications for current debates in screen time research.

This study uses Growing Up in Ireland data to examine how 9,000 children adjusted to primary school. It finds that the vast majority of five year olds are positive about school, look forward to going to school and say good things about school. The study showed that children start school with different skills and capacities and some children face greater challenges. The study suggests a number of ways to help all children experience a positive transition to primary school.

Background
The use of dietary quality scores/indices to describe diet quality in children has increased in the past decade. However, to date, few studies have focused on the use of these scores on disease outcomes such as childhood obesity and most are developed from detailed dietary assessments. Therefore, the aims of this study were: firstly to construct a diet quality score (DQS) from a brief dietary assessment tool; secondly to examine the association between diet quality and childhood overweight or obesity; thirdly we also aim to examine the associations between individual DQS components and childhood overweight or obesity.

Methods
A secondary analysis of cross sectional data of a sample of 8,568 9-year-old children and their families as part of the Growing Up in Ireland (GUI) study. Subjects were drawn from a probability proportionate to size sampling of primary schools throughout Ireland over the school year 2007–2008. Height and weight were measured by trained researchers using standardised methods and BMI was classified using the International Obesity Taskforce cut-points. The DQS (un-weighted) was developed using a 20-item, parent reported, food frequency questionnaire of foods consumed over the past 24 h. Adjusted odds ratios for overweight and obesity were examined by DQS quintile, using the first quintile (highest diet quality) as the reference category.

Results
The prevalence of normal weight, overweight and obese was 75, 19 and 6 % respectively. DQS ranged from -5 to 25, higher scores indicated higher diet quality in the continuous score. In analyses adjusted for gender, parent’s education, physical activity and T.V. viewing, child obesity but not overweight was significantly associated with poor diet quality: OR of 1.56 (95 % CI 1.02 2.38) in the 5th compared to the 1st DQS quintile. Findings from individual food items were inconsistent.

Conclusions
The findings suggest that diet quality may be an important factor in childhood obesity. A simple DQS developed from a short dietary assessment tool is significantly associated with childhood obesity.

It is well established that cultural and economic resources imparted to children vary significantly by social class. Literature on concerted cultivation has highlighted the way out-of-school activities can reproduce social inequalities in the classroom. Within this literature however, little attention has been given to the role of gender in concerted cultivation. In this paper, we use data from the first wave of the Growing Up in Ireland longitudinal study to consider how both social class and gender influence the out-of-school activities of children. Moreover, we examine how out-of-school activities, class and gender impact on children’s school engagement and academic achievement. We find that while childrearing logics tend to operate within social class categories, there is an additional cultural aspect of gender in the uptake of different types of out-of-school activities. Our findings suggest the need to move beyond explanations of concerted cultivation to explain gender differences in mathematics and reading attainment.

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.

Given growing concerns about disadvantaged boys’ achievement and disengagement from learning, this paper investigates differences in reading ability by gender and social origin. It uses data from the Growing Up in Ireland study to investigate how parents’ approach to learning at home and children’s exposure to early care and education contribute to these differences. We find that both children’s gender and their family’s social class influence their cognitive development between age 3 and age 9, though the effects are additive, with little variation in the gender gap across social class groups. Parents from more advantaged social classes read more to their 3-year-old children than other parents, yet by age 5, when most children have started primary school, these class differences in parental reading are much lower. Parental reading, ECCE participation and length of primary school exposure were found to facilitate language development and partly explain differences in reading scores at age 9, although strong direct effects of social class remained, even accounting for vocabulary score at age 3. The benefits from parental reading, ECCE and exposure to school are broadly similar for boys and girls, though there is some evidence that boys benefit more than girls from longer exposure to school.