External Publications Using GUI Data

Economic recessions have been linked to adult health, but few studies have examined how recessions influence the health of young children. This study examined the impact of life transitions linked to the recent financial crisis on the health of young children in Ireland. Data came from the Growing Up in Ireland Infant Cohort Study (n = 11,134), which assessed children before (2008), during (2011), and after (2013) the Great Recession that followed the financial crisis of 2008 and incorporated questions on the impacts of the financial crisis on families. Using fixed-effects models to control for confounding, we found that a reduction in welfare benefits during the recession was associated with a significant increase in the risks of asthma (β = 0.014, 95% confidence interval (95% CI): 0.004, 0.023) and atopy (β = 0.014, 95% CI: 0.001, 0.027). While parental job loss was not associated with child health, a reduction in working hours was associated with increased reports of child health problems (β = 0.024, 95% CI: 0.004, 0.043), as were difficulties affording basic necessities (β = 0.019, 95% CI: 0.001, 0.038). Results suggest that failing to protect vulnerable families and children during economic recessions may have long-lasting implications for child health.

The notion that digital-screen engagement decreases adolescent well-being has become a recurring feature in public, political, and scientific conversation. The current level of psychological evidence, however, is far removed from the certainty voiced by many commentators. There is little clear-cut evidence that screen time decreases adolescent well-being, and most psychological results are based on single-country, exploratory studies that rely on inaccurate but popular self-report measures of digital-screen engagement. In this study, which encompassed three nationally representative large-scale data sets from Ireland, the United States, and the United Kingdom (N = 17,247 after data exclusions) and included time-use-diary measures of digital-screen engagement, we used both exploratory and confirmatory study designs to introduce methodological and analytical improvements to a growing psychological research area. We found little evidence for substantial negative associations between digital-screen engagement—measured throughout the day or particularly before bedtime—and adolescent well-being.

Identifying the clustering and correlates of physical activity (PA) and sedentary behavior (SB) is very important for developing appropriate lifestyle interventions for children and adolescents. This systematic review (Prospero CRD42018094826) aimed to identify PA and SB cluster patterns and their correlates among boys and girls (0-19 years). The search was carried out in five electronic databases. Cluster characteristics were extracted in accordance with authors’ descriptions by two independent reviewers and a third resolved any disagreements. Seventeen studies met the inclusion criteria and the population age ranged from six to 18 years old. Nine, twelve, and ten cluster types were identified for mixed-sex samples, boys, and girls, respectively. While girls were in clusters characterized by “Low PA Low SB” and “Low PA High SB”, the majority of boys were in clusters defined by “High PA High SB” and “High PA Low SB”. Few associations were found between sociodemographic variables and all cluster types. Boys and girls in “High PA High SB” clusters had higher BMI and obesity in most of the tested associations. In contrast, those in the “High PA Low SB” clusters presented lower BMI, waist circumference, and overweight and obesity. Different cluster patterns of PA and SB were observed in boys and girls. However, in both sexes, a better adiposity profile was found among children and adolescents in “High PA Low SB” clusters. Our results suggest that it is not enough to increase PA to manage the adiposity correlates, it is also necessary to reduce SB in this population.

Background
Childhood adversity is a well-established risk factor for psychopathology; however, many who experience adversity do not go on to develop psychopathology. Poor self-concept and poor parental support are known risk factors for adolescent psychopathology, which may account for some of this mechanism.

Aims
To investigate candidate mediators in the relationship between childhood adversity and psychopathology.

Method
We used data from the age 9 and 13 waves of the child-cohort of the Growing Up in Ireland study. We undertook mediation analysis by path decomposition of the relationship between childhood adversity and psychopathology (internalising and externalising problems) at age 13 and persistent psychopathology. Candidate mediators were self-concept, parent–child relationship and hobby participation at age 9.

Results
Childhood adversity was reported by 28.2% of participants, and was significantly associated with internalising and externalising problems. Parent–child conflict mediated the relationship between childhood adversity and both age 13 and persistent psychopathology, accounting for 52.4% of the relationship between childhood adversity and persistent externalising problems (indirect odds ratio, 1.30; 95% CI 1.19–1.43) and 19.2% for persistent internalising problems (indirect odds ratio, 1.24; 95% CI 1.15–1.34). There was a small mediating effect of self-concept. Hobby participation and positive parent–child relationship did not mediate these relationships.

Conclusions
Parent–child conflict explains almost half the relationship between childhood adversity and persisting externalising problems in adolescence, and a fifth of the relationship with persisting internalising problems. This suggests parent–child conflict is a good target for interventions in childhood to prevent adolescent psychopathology.

Growing Up in Ireland (GUI) is the national longitudinal study of children and young people in the Republic of Ireland and has followed two cohorts for over ten years to date: Cohort ’98 who were recruited into the study at age nine years and Cohort ’08, recruited at age nine months. The study aims to describe the lives of Irish children and young people in terms of their development, with a view to positively affecting policies and services available for them. Traditionally, data collection involved in-home visits from an interviewer who conducted face-to-face interviews, recorded physical measurements of study participants and administered cognitive assessments. However, with the onset of the COVID-19 pandemic and the associated restrictions, significant adaptations were required to these methods to ensure data collection for the pilot and main fieldwork for Cohort ’08 at age 13 could continue to the expected timeline. Face-to-face interviews with participants were replaced with telephone and web-based modes, interviewer training was conducted online, online resources were made available for interviewers and participants and COVID-19 related items were added to questionnaires. In addition to the scheduled data collection, a special COVID-19 survey was also conducted on both GUI cohorts in December 2020 to explore the impact of the pandemic on participants’ lives. This paper outlines the adaptations made to traditional data collection methods in GUI, highlighting the challenges that were met, but also the benefits of some changes that may be worth incorporating into future waves of GUI.

There has been a good deal of attention in Irish policy discourse to housing supply and affordability. However, there has been less focus on the extent to which the quality of housing impacts the wellbeing of children and their parents. This study addresses this gap in knowledge by using data from Growing Up in Ireland (GUI) Cohort ’08 to explore the influence of housing and neighbourhood quality on parental and child wellbeing. In particular, it looks at how the length of time households have spent experiencing inadequate housing can shape families’ wellbeing. The study adopts a multidimensional approach to measuring inadequate housing, capturing whether the home is unsuitable (in terms of size or problems like damp), whether the household struggles to adequately heat the home, lack of access to a garden or play space, the number of residential moves and the type of tenure. In addition, neighbourhood quality is assessed in terms of local disorder, having low social capital (with few family and friends in the area) and having access to fewer local services. Child wellbeing is measured using the Strengths and Difficulties Questionnaire (SDQ), which captures the extent of children’s socio-emotional difficulties.

This study examines how the presence of outdoor areas such as parks and playgrounds affects children’s well-being and how this effect is moderated by families’ socioeconomic status. Specifically, I aim to answer two research questions. First, does the presence of outdoor areas in children’s neighborhoods affect their well-being? Second, is there a differential effect depending on children’s socioeconomic status? The main part of the study uses data from the International Survey of Children’s Well-Being. The results suggest that the presence of outdoor areas in children’s neighborhoods has a positive effect on their well-being. In addition, the estimated effect of outdoor areas is larger for children from families with low socioeconomic status. Finally, findings from the Growing Up in Ireland data set suggest that children’s mental problems are a plausible mechanism through which outdoor areas affect children’s well-being. These findings have meaningful policy implications. Efforts to provide access to appropriate outdoor areas may be more likely to benefit disadvantaged children and thus reduce inequality in children’s well-being.

The sudden health and economic crisis brought about by the COVID-19 pandemic affords an opportunity to examine the impact of economic disruption to children and families. Any negative effects on the well-being of children are important to consider in relation to both short- and long-term outcomes. Using pre-pandemic and mid-pandemic waves of the longitudinal Growing Up in Ireland study, we examined whether the impact of economic disruption was equivalent for families who were (or were not) financially vulnerable pre-pandemic. We then investigated whether economic disruption was associated with a negative effect on the emotional well-being of 12-year-olds, and if there was evidence for such a negative effect being mediated through a lack of material resources or strain on family dynamics. Our results indicated that middle-income rather than lowest-income families experienced the most economic disruption, likely reflecting the sector-specific nature of business closures in the pandemic. Families who were financially vulnerable pre-pandemic were less likely to have had suitable resources for homeschooling. Both falls in income and strain in family relationships, such as arguing more with their parents, were associated with poorer scores on a measure of the child’s emotional well-being. The emergency income support payment introduced at the start of the pandemic appeared to have a protective effect on the association between family income loss and child well-being, which has wider implications for policy on child poverty.

Keywords
COVID-19, pandemic, economic resources, financial strain, child well-being, family relationships, homeschooling

This chapters addresses digital inequalities in young people’s daily lives and well-being. The chapter examines how adolescents’ digital engagement differs across family socioeconomic status (SES) and gender, and how it relates to their mental health outcomes. Analyses use longitudinal data from the Growing Up in Ireland study from age 9 to 18, combined with cross-national data from the Health Behaviour in School-Aged survey on adolescents aged 11-15 across 35 industrialised countries. Longitudinal analyses reveal that low-SES adolescents and girls experience higher mental health problems as they increase their time using digital devices, compared to high-SES adolescents and boys. Cross-national analyses indicate that, while boys spend more time in digital activities, girls are at higher risks of experiencing mental health problems from engaging with digital activities. However, the magnitude of these gendered patterns differs markedly across national contexts. Cross-country comparisons on SES yield mixed results: in some countries low-SES adolescents are mentally more harmed by their digital engagement (i.e., Switzerland, Austria, Norway), but in other countries high-SES adolescents are those at higher mental health risks from using digital devices (i.e., Portugal, Czech Republic, Bulgaria). The chapter findings are discussed within the existing literature on digital inequalities and young people’s well-being.

Importance Birth weight percentiles (BWPs) are often dichotomized at the 10th percentile and show statistically significant association with later cognitive performance, for both preterm and term-born children. However, research testing nonlinear associations between BWPs and cognitive performance is scarce.

Objective To investigate culturally invariant, nonlinear associations of BWPs and gestational age with later cognitive performance.

Design, Setting, and Participants In this cohort study, participants with valid neonatal and cognitive data were combined from 4 observational cohorts, including the Millennium Cohort Study, the National Longitudinal Survey of Youth 1979 Child and Young Adult cohort, Growing Up in Ireland, and the Longitudinal Study of Australian Children, with children born between 2000 and 2002, 1980 and 2010, 2007 and 2008, and 2003 and 2004, respectively. Neonatal data were parent reported before age 1 year. At approximately 5 years of age, multiple cognitive tests were performed. Follow-up at 5 years of age was the predominant focus. Data were analyzed July 17, 2023.

Exposure The parent-reported neonatal data were used to calculate BWPs according to the Fenton growth chart.

Main Outcome and Measure Scores for IQ were created from multiple measures of cognition, which were z standardized separately within each cohort.

Results Of 30 643 participants (50.8% male), 7.5% were born preterm (before 37 weeks gestation) and 92.5% were term born (between 37 and 42 weeks gestation). In the pooled data using multivariate adaptive regression splines, IQ linearly increased by 4.2 points as BWPs increased from the first to the 69th percentile before completely plateauing. For gestational age, IQ linearly increased by 1.3 points per week up until 32 weeks, with the association reducing to 0.3 points per week after 32 weeks. The association of BWP with IQ was not moderated by gestational age. For term-born infants, the estimated IQ score was only clinically meaningfully lower than average when birth weight was below the third percentile. Consistent results were found when instead using multivariable regression where gestational age and BWPs were categorized into groups.

Conclusions and Relevance In this cohort study, lower BWPs and gestational age were independently associated with lower IQ. For term-born infants, a cutoff of the third percentile would be more appropriate than the traditionally used 10th percentile when the aim is estimating meaningful cognitive differences.

Importance As young people’s mental health difficulties increase, understanding risk and resilience factors under challenging circumstances becomes critical.

Objective To explore the outcomes of the COVID-19 pandemic on secondary school students’ mental health difficulties, as well as the associations with individual, family, friendship, and school characteristics.

Design, Setting, and Participants For this cohort study, follow-up data from the My Resilience in Adolescence (MYRIAD) cluster randomized clinical trial were collected across 2 representative UK cohorts. Mainstream UK secondary schools with a strategy and structure to deliver social-emotional learning, with an appointed head teacher, and that were not rated “inadequate” in their latest official inspection were recruited. A total of 5663 schools were approached, 532 showed interest, and 84 consented. Cohort 1 included 12 schools and 864 students, and cohort 2 included 72 schools and 6386 students. COVID-19 was declared a pandemic after cohort 1 had completed all assessments (September 2018 to January 2020), but cohort 2 had not (September 2019 to June 2021).

Exposures Cohort 2 was exposed to the COVID-19 pandemic, including 3 national lockdowns. Associations of individual, family, friendship, and school characteristics with students’ mental health were explored.

Main Outcomes and Measures Changes in students’ risk for depression (Center for Epidemiological Studies-Depression scale); social, emotional, and behavioral difficulties (Strengths and Difficulties Questionnaire); and mental well-being (Warwick-Edinburgh Mental Well-Being Scale).

Results Of the 7250 participants included, the mean (SD) age was 13.7 (0.6) years, 3947 (55.4%) identified as female, and 5378 (73.1%) self-reported their race as White. Twelve schools and 769 of the 864 students (89.0%) in cohort 1 and 54 schools and 2958 of the 6386 students (46.3%) in cohort 2 provided data and were analyzed. Mental health difficulties increased in both cohorts but to a greater extent among students exposed to the pandemic, including for risk of depression (adjusted mean difference [AMD], 1.91; 95% CI, 1.07-2.76); social, emotional, and behavioral difficulties (AMD, 0.76; 95% CI, 0.33-1.18); and mental well-being (AMD, −2.08; 95% CI, −2.80 to −1.36). Positive school climate, high home connectedness, and having a friend during lockdown were protective factors during the pandemic. Female gender and initial low risk for mental health difficulties were associated with greater mental health deteriorations. Partial school attendance during lockdown was associated with better adjustment than no attendance when returning to school.

Conclusions and Relevance This cohort study of secondary school students demonstrated that to promote mental health and adjustment, policy interventions should foster home connectedness, peer friendship, and school climate; avoid full school closures; and consider individual differences.

Importance Understanding which children in the general population are at greatest risk of poor functional outcomes could improve early screening and intervention strategies.

Objective To investigate the odds of poor outcomes in emerging adulthood (ages 17 to 20 years) for children with different mental health trajectories at ages 9 to 13 years.

Design, Setting, and Participants Growing Up in Ireland is a longitudinal, nationally representative population-based cohort study. Data collection began in August 2007 and was repeated most recently in September 2018. All results were weighted to account for sampling bias and attrition and were adjusted for socioeconomic factors. Data analysis took place from October 2022 to April 2023.

Exposure Four latent classes captured variation in mental health in children aged 9 and 13 years, based on the parent-completed Strengths and Difficulties Questionnaire. Classes included no psychopathology, internalizing, externalizing, and high (comorbid) psychopathology. Those who remained in the same class from ages 9 to 13 years were included.

Main Outcomes and Measures Poor functional outcomes in emerging adulthood were measured at approximate ages 17 years (range, 16 to 18 years) and 20 years (range, 19 to 21 years). Outcomes included poor mental health, poor physical health, social isolation, heavy substance use, frequent health service use, poor subjective well-being, and adverse educational/economic outcomes.

Results Of 5141 included participants, 2618 (50.9%) were male. A total of 3726 (72.5%) were classed as having no childhood psychopathology, 1025 (19.9%) as having persistent externalizing psychopathology, 243 (4.7%) as having persistent internalizing psychopathology, and 147 (2.9%) as having persistent high psychopathology. Having any childhood psychopathology was associated with poorer functional outcomes in emerging adulthood. The internalizing group had elevated odds of most outcomes except for heavy substance use (range of odds ratios [ORs]: 1.38 [95% CI, 1.05-1.81] for frequent health service use to 3.08 [95% CI, 2.33-4.08] for poor mental health). The externalizing group had significantly elevated odds of all outcomes, albeit with relatively small effect sizes (range of ORs: 1.38 [95% CI, 1.19-1.60] for frequent health service use to 1.98 [95% CI, 1.67-2.35] for adverse educational/economic outcomes). The high psychopathology group had elevated odds of all outcomes (nonsignificantly for frequent health service use), though with wide confidence intervals (range of ORs: 1.53 [95% CI, 1.06-2.21] for poor physical health to 2.91 [95% CI, 2.05-4.12] for poor mental health). Female participants with any psychopathology had significantly higher odds of poor physical health and frequent health service use compared with male participants with any psychopathology.

Conclusions and Relevance In this longitudinal cohort study, childhood psychopathology was associated with a widespread pattern of functional impairment in emerging adulthood. Findings point to the need for a wider range of preventive interventions in child and adolescent mental health services.

Objective
Childhood chronic illness can have a high impact on the child’s quality of life. The foundations of health are established in early life, and are shaped by biological, psychosocial, spiritual and environmental processes and influences. The objectives of this presentation are twofold: firstly to describe the prevalence of chronic illness in 9-year-olds in Ireland, secondly to illustrate how chronic illness influences the psychological and social development of the children.

Methods
Analysis was based on data of 8570 9-year old children, and their families who participated in Growing Up in Ireland—the National Longitudinal Study of Children. The sample was generated through the primary school system. A representative sample of 910 schools participated; the sample of children and their families was randomly selected from within the schools. Questionnaires were administered in schools; and after completion of this phase, the project interviewers visited the families of the 9-year olds in their homes and administered core questionnaires to the Study Child and his/her carers who provided either home-based or centre-based care on a regular basis.

Results
The overall prevalence of chronic illness reported by mothers among the 9-year old cohort was 11% (gender-specific prevalence for boys: 13%, and significantly lower for girls: 10%). Respiratory illnesses accounted for almost half (46%) of all chronic illnesses, followed by mental and behavioural conditions with 19% (high gender dysbalance: reported for boys in 24%, for girls in 12%). Children with a reported chronic illness had significantly more emotional, conduct, hyperactivity, peer-based and prosocial difficulties when compared with children without a reported chronic illness. Abnormal scores, based on the Strengths and Difficulties Questionnaire were found in 20% in children with a chronic disease, and in 5.5% in children without a chronic disease. Socio-economic Status was associated with poorer health outcomes. Furthermore, primary care givers’ views and perceptions regarding the chronic illness of the child were found to be a significant factor on child strengths and difficulties in a multivariate model.

Conclusions
The majority of 9-year old children can be assessed as healthy. The most common chronic illness in this large cohort was respiratory disease and overall, chronic conditions were found to have a negative impact on the child’s emotional and social state.

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.

Background
Globally, childhood obesity is a significant public health problem associated with adverse health and economic consequences. To tackle the problem, we need a comprehensive understanding on how the environment in which we live may influence obesity related behaviours and weight status. Thus, we explore if distance to and number of food outlets ([1] supermarkets and [2] convenience stores) in the local area impact on either dietary quality or body mass index (BMI) in 9-year-old children whilst controlling for socio-economic characteristics of the family.

Methods
Cross sectional analysis of the Growing Up in Ireland (GUI) Study, a two-stage clustered sample of 8568 nine year old children from the Republic of Ireland. Children were recruited from schools (response rate 82%) and age eligible children (response rate 57%) were invited to participate. Height and weight measurements were used to calculate BMI. Diet was assessed using a short food frequency questionnaire and a dietary quality score was generated based on Irish healthy eating guidelines. Socio-economic status was measured using parent reported household class, household net equivalised income and highest level of maternal education. Food access was measured as network distance to (in quintiles) and number of (within 1000km) convenience stores and supermarkets to each participant’s household within the local area. Separate fixed effects regression models were used to assess the impact of local area food access on (1) dietary quality and (2) BMI, stratified by gender.

Results
After controlling for socio-economic characteristics of the household, distance to the nearest supermarket was not associated with dietary quality in boys (Q5 v Q1; B = 0.84, 95% CI, –0.49 to 2.18) or girls (Q5 v Q1; B = –0.41, 95% CI, –1.60 to 0.77). Distance to the nearest convenience store was associated with dietary quality in boys (Q5 v Q1; B = 1.01, 95% CI, 0.13 to 1.89) but not in girls (Q5 v Q1; B = 0.04, 95% CI, –0.71 to 0.80). The number of convenience stores or supermarkets within 1000m of the household did not impact on dietary quality. Access to food outlets was not associated with BMI in girls or boys.

Conclusion
There was little evidence to suggest that access to food stores impact dietary quality or BMI in children. From a population health perspective, strategies tackling environmental factors associated with making poor lifestyle choices are needed. Thus, further research on the association between food access and obesity risk is needed.

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 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, and 3, 5, 9 years. We used group-based multitrajectory cluster modelling to classify trajectories of poverty. Using multivariable logistic regression, adjusted with separate child and mother confounders, we assessed the association of poverty trajectories from 9 months to 9 years with child outcomes (overweight, any longstanding illness and psychopathology) at age 9 years and the same poverty trajectories over the same 9-year period with mother outcomes (overweight, any longstanding illness and depression).

Results
Of 11 134 participants, 4 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 those in never in poverty experienced higher odds of being overweight at 9 years (adjusted OR (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 parents (99.7% were mothers) were as follows: having 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 well-being in late childhood for children and their mothers in Ireland.