Policy implications and a framework of entitlements for the Irish health‐care sector. In Framework for supporting the delivery of integrated health care in Ireland, Part 7, Chapter 15.
Resource Allocation, Financing and Sustainability in Health Care Evidence for the Expert Group on Resource Allocation and Financing in the Health Sector
Briody, J.
2021
Parental unemployment during the Great Recession and childhood adiposity
The incidence of adiposity in the early years of life has outgrown the prevalence in older children and adolescents globally; however, the factors influencing weight gain are predominantly studied in adults. This study examines the relationship between changing economic conditions during the Irish recession and child weight in a nationally representative sample of 10,011 Irish children studied at 9 months, 3 years and 5 years old. This study is the first to use longitudinal anthropometric measurements to estimate the impact of direct parental unemployment on children’s weight. Fixed effect logistic regression is used to examine the effects of parental unemployment on weight using the Growing up in Ireland infant cohort from 2008 to 2013. Weight and length/height measured by trained interviewers and child growth charts are used to quantify children’s weight status according to BMI-for-age and weight-for-age measures. For BMI-for-age, the probability of a child being classified as overweight/obese is 8 percentage points higher if either parent experiences unemployment. A sensitivity analysis of weight-for-age indicates that the probability is of similar magnitude across several alternative growth charts and definitions of adiposity (the WHO standard, British Growth Reference, and Centers for Disease Control). The analysis is repeated, cross-sectionally, for physical activity and diet to clarify mechanisms of effect. The probability of a child consuming healthy food and physical activity with an implied cost is lower if either parent becomes unemployed. A focus on overweight/obesity in the early years is of crucial importance as if current trends are not addressed, a generation of children may grow up with a higher level of chronic disease.
Burke, L.A.
2020
Childhood Psychological Health During the Great Recession in Ireland
The aim of this paper is to quantify the effect of economic, parental and lifestyle factors on the psychological health of children at significant points in recent economic history in Ireland. The paper uses data from the Growing Up in Ireland study and employs a dynamic random effects ordered logistic regression model to test the magnitude of these effects. The results indicate that proxy income variables, such as ability to make ends meet and homeownership, are relevant in predicting child psychological health outcomes. Equally important are intergenerational health associations between the mother and the psychological health of children.
Butler, E., Clarke, M., Spirtos, M., O Keeffe, L.M., Dooley, N.
2024
Pregnancy complications and childhood mental health: is the association modified by sex or adverse social circumstances? Findings from the ‘growing up in Ireland’ national infant cohort study
Specific pregnancy complications, socioeconomic position and sex have all been independently associated with child mental health outcomes, but their combined effects remain unclear. We examined whether total number of complications experienced in the pregnancy associated with mental health at 5 and 9-years, and whether this varied by sex or adverse social circumstances. Pregnancy complications were self-reported at 9-months post-natally from a list of 16 complications. Parents completed the Strengths and Difficulties Questionnaire (SDQ) when their child was 5 and 9-years. The primary outcome was the SDQ-total and scoring in the clinical range (> 16) was a secondary outcome. We applied generalized linear mixed models to a large nationally representative Irish cohort (GUI; n = 11,134). Analyses were adjusted for sex, adverse social circumstances (at 9-months), and gestational smoking. We included an interaction term between pregnancy complications and each variable respectively in separate models to examine if associations varied by sex or adverse circumstances.
After controlling for covariates, total complications associated with mental health at 5 and 9-years. Each additional pregnancy complication conferred a 10% higher total-SDQ score (exponentiated co-efficient 1.10 [95%CI 1.06–1.14], 1.20 [1.15–1.26], 1.20 [1.12–1.29] and 1.34 [1.21–1.48] for 1, 2, 3 and 4 + complications respectively). For the dichotomised outcome, generally increasing odds for clinical levels of mental health difficulties were observed (OR 1complication = 1.89, 95%CI [1.37–2.59]; OR 2complications = 2.31, 95%CI [1.53–3.50]; OR 3complications = 1.77, 95%CI [0.89–3.52]; OR 4 + complications = 6.88, 95%CI [3.29–14.40]). Females had significantly lower odds of exhibiting clinically significant mental health difficulties than males (OR = 0.43, 95%CI[0.32–0.57]).
There was no evidence that the association between pregnancy complications and child’s mental health varied by sex or social circumstances at 5 or 9-years. Males exposed to numerous pregnancy complications in the context of adverse social circumstances had the highest predicted probability of having mental health difficulties in middle childhood.
Butler, M.I., Bastiaanssen, T.F.S., Long-Smith, C.M., et al.
2023
The gut microbiome in social anxiety disorder: evidence of altered composition and function
The microbiome-gut-brain axis plays a role in anxiety, the stress response and social development, and is of growing interest in neuropsychiatric conditions. The gut microbiota shows compositional alterations in a variety of psychiatric disorders including depression, generalised anxiety disorder (GAD), autism spectrum disorder (ASD) and schizophrenia but studies investigating the gut microbiome in social anxiety disorder (SAD) are very limited. Using whole-genome shotgun analysis of 49 faecal samples (31 cases and 18 sex- and age-matched controls), we analysed compositional and functional differences in the gut microbiome of patients with SAD in comparison to healthy controls. Overall microbiota composition, as measured by beta-diversity, was found to be different between the SAD and control groups and several taxonomic differences were seen at a genus- and species-level. The relative abundance of the genera Anaeromassillibacillus and Gordonibacter were elevated in SAD, while Parasuterella was enriched in healthy controls. At a species-level, Anaeromassilibacillus sp An250 was found to be more abundant in SAD patients while Parasutterella excrementihominis was higher in controls. No differences were seen in alpha diversity. In relation to functional differences, the gut metabolic module ‘aspartate degradation I’ was elevated in SAD patients. In conclusion, the gut microbiome of patients with SAD differs in composition and function to that of healthy controls. Larger, longitudinal studies are warranted to validate these preliminary results and explore the clinical implications of these microbiome changes.
Cadogan, S.L., Keane, E., Kearney, P.M.
2014
The effects of individual, family and environmental factors on physical activity levels in children: a cross-sectional study
Background
Physical activity plays an important role in optimising physical and mental health during childhood, adolescence, and throughout adult life. This study aims to identify individual, family and environmental factors that determine physical activity levels in a population sample of children in Ireland.
Methods
Cross-sectional analysis of the first wave (2008) of the nationally representative Growing Up in Ireland study. A two-stage clustered sampling method was used where national schools served as the primary sampling unit (response rate: 82%) and age eligible children from participating schools were the secondary units (response rate: 57%). Parent reported child physical activity levels and potential covariates (parent and child reported) include favourite hobby, total screen time, sports participation and child body mass index (measured by trained researcher). Univariate and multivariate multinomial logistic regression (forward block entry) examined the association between individual, family and environmental level factors and physical activity levels.
Results
The children (N = 8,568) were classified as achieving low (25%), moderate (20%) or high (55%) physical activity levels. In the fully adjusted model, male gender (OR 1.64 [95% CI: 1.34-2.01]), having an active favourite hobby (OR 1.65 [95% CI: 1.31-2.08]) and membership of sports or fitness team (OR 1.90 [95% CI: 1.48-2.45]) were significantly associated with being in the high physical activity group. Exceeding two hours total screen time (OR 0.66 [95% CI: 0.52-0.85]), being overweight (OR 0.41 [95%CI: 0.27-0.61]; or obese (OR 0.68 [95%CI: 0.54-0.86]) were significantly associated with decreased odds of being in the high physical activity group.
Conclusions
Individual level factors appear to predict PA levels when considered in the multiple domains. Future research should aim to use more robust objective measures to explore the usefulness of the interconnect that exists across these domains. In particular how the family and environmental settings could be useful facilitators for consistent individual level factors such as sports participation.
Carroll, E., Keyu, Y., McCoy, S.
2022
Educationally maintained inequality? The role of risk factors and resilience at 9, 13 and 17 in disabled young people's post-school pathways at 20
While Ireland has the highest level of participation in higher education (HE) in Europe, it also has one of the widest participation gaps between disabled and non-disabled young people. Using a large-scale longitudinal dataset, we assess how disabled young people compare with non-disabled peers in accessing a range of post-school educational pathways. Extending the effectively maintained inequality perspective to disability research, our results highlight important qualitative differences in disabled people’s trajectories. Ultimately, we find greater progression to Further Education and Training, and lower participation in Level 8 degrees in universities, all else being equal. Entry to HE is lower among those with socio-emotional difficulties, even after controlling for key characteristics, while attendance among young people with an intellectual disability or specific learning difficulty is mediated by academic performance. The results highlight the importance of school attendance, engagement and achievement during the primary and early secondary years, and parental expectations, raising important implications for inclusive education. The multiple challenges facing disabled young people in Ireland are evident, reflecting the direct and indirect impact of socio-economic disadvantage, at family, school and community levels. Stronger linkages across the tertiary landscape and stronger HE transition supports, particularly for young adults with socio-emotional/psychological difficulties, are needed.
Carroll, E., McCoy, S., Mihut, G.
2022
Exploring cumulative disadvantage in early school leaving and planned post-school pathways among those identified with special educational needs in Irish primary schools
Reflecting the neglect of childhood disability in social stratification research, there is a notable dearth of research on the mechanisms underpinning disability differentials in educational outcomes. Drawing on rich longitudinal data collected at 9, 13 and 17 years as part of Ireland’s ‘Growing Up in Ireland’ study, we look at the impact of special educational needs (SEN) identification in primary school on upper secondary outcomes. A bioecological framework and the Process–Person–Context–Time model allow us to understand how interactions with family, teachers, friends and school—as proximal processes—relate to early school leaving and post-school planned pathways after accounting for personal and context characteristics. Overall, young people identified at age 9 as having SEN are at increased risk of early school leaving and are more likely to plan to attend further education and training, rather than higher education. However, after accounting for proximal processes and personal and context variables, students identified at age 9 as having SEN are no longer distinct in terms of secondary attainment and post-school planning. Instead, these young people are more likely to experience forms of vulnerability that are important in shaping these outcomes. These key educational outcomes are strongly shaped by family and school-related factors—both proximal processes and context characteristics—suggesting that efforts to support retention and pathway planning should be underpinned by an ecological understanding of young people’s trajectories and the cumulative disadvantages they face.
Key insights
What is the main issue that the paper addresses? Using a bioecological framework and Growing Up in Ireland data, this paper explores early school leaving and post-school plans among young adults identified in primary school as having special educational needs (SEN). This is a key topic, as young people with SEN are at greater risk of early school leaving and less likely to attend higher education.
What are the main insights that the paper provides? As a group, young people identified in primary school as having SEN are more likely to experience economic vulnerability and to attend schools with a socioeconomically vulnerable profile. After accounting for these and other key personal and contextual characteristics, childhood SEN status is no longer a significant factor in early school leaving or post-school plans.
Casey, A., Layte, R., Lyons, S., Silles, M.
2012
Home computer use and academic performance of nine-year-olds
A recent rise in home computer ownership has seen a growing number of children using computers and accessing the internet from a younger age. This paper examines the link between children’s home computing and their academic performance in the areas of reading and mathematics. Data from the nine-year-old cohort of the Growing Up in Ireland survey is adopted for this study. The survey reveals that searching for information is a more popular activity among the children than communicating online. Through regression analysis we find that using a computer is positively and significantly associated with children’s reading and mathematics scores in standardised tests. This result holds after controlling for multiple determinants of school performance. In addition, we investigate the effects of using various applications on the computer. Surfing the internet for fun, doing projects for school and emailing are associated with higher reading and maths test scores, while those who are permitted to use the computer unsupervised tend to have higher maths test scores. Instant messaging and downloading music or watching movies are negatively associated with both reading and maths scores. The results indicate that some forms of early computer use have significant associations with academic performance among children in primary school, although we could not establish the direction of causation definitively.
Keywords: home computer use, elementary education, academic performance
Castro, P.D., Kearney, J., Layte, R.
2014
A study of early complementary feeding determinants in the Republic of Ireland based on a cross-sectional analysis of the Growing Up in Ireland infant cohort
Objective
Early complementary feeding has been shown to increase the risk of overweight, obesity and chronic diseases later in life. Poor compliance with current guidelines on complementary feeding has been reported by Irish studies. The aim of the present paper is to identify predictors of early complementary feeding in order to help health professionals target population groups in greater need of dietary intervention as well as to provide effective advice.
Design
Cross-sectional analysis of the national, longitudinal Growing Up in Ireland study.
Setting
Data were derived from the first wave (2007–2008) of the Growing Up in Ireland infant cohort.
Subjects
A cohort of mothers (n 11 134) from the Republic of Ireland, interviewed when their infants were 9 months of age.
Results
Of the infants, 1469 (13·5 %) had been regularly taking solids in the period between 12 and 16 weeks; this percentage increased to 47·0 % of the sample in the period between 16 and 20 weeks. Timing of formula feeding commencement, high maternal BMI and choosing a relative as the infant’s minder were strongly associated with early introduction of solids both in bivariate and multivariate analysis. Those infants who started formula feeding at >4 months were 88·4% less likely to be introduced to solids early compared with those who started at <2 months (OR = 0·116; 95% CI 0·072, 0·186; P < 0·001).
Conclusions
The results demonstrate that biological, social and behavioural aspects exert an important role in infant feeding practices. These findings are relevant to the design of policies and intervention programmes aimed at educating parents.
Keywords
Complementary feeding, Infant’s diet, Early weaning
Ceatha, N., Gates, G. J., Crowley, D.
2023
LGBT+ Self-Identification Among Youth in Ireland Aged 17-18 Years: A Research Brief
In 2016, for the first time, a nationally representative survey of 6216 respondents, Growing Up in Ireland (GUI), included measurement of sexual orientation and gender identity (SOGI) among young people. Irish LGBTI+ youth and inclusion strategies identified collection of SOGI data as a policy objective, prioritizing analyses of GUI. In line with policy objectives, this research brief reports previously unpublished LGBT+ self-identification for youth in Ireland from Cohort ’98 born five years after decriminalization of homosexuality, with their coming-of-age coinciding with the marriage equality referendum, and legislation providing for greater gender recognition (2015). Ten percent of youth in Ireland, at 17-18 years, identify as lesbian, gay, bisexual, transgender, questioning, asexual or describe their gender as other. Female youth are significantly more likely to identify as a sexual minority, and to be bisexual than their male peers. A quarter of LGBT+ youth are questioning their sexual orientation. This finding supports the inclusion of a ‘questioning’ response in surveys collecting SOGI data, and also suggests sexual orientation self-identification is a dynamic process. A small percentage identify as asexual (0.2%). Just over 1% of young people identify as transgender or describe their gender as other. As the first generation in Ireland to grow up in an environment with increased LGBT+ visibility and social acceptance, these findings of a relatively high proportion of sexual and gender minorities among young people likely reflect improved social and legal climates. The importance of publication of SOGI estimates is underscored. GUI are committed to ensuring visibility of LGBT+ youth populations in data collection. Suggestions for improved SOGI placement and phrasing will be considered in the questionnaire with Cohort ’08 at age 17, currently being drafted. The findings from these analyses will inform future policy and research. GUI offers rich possibilities for future comparative cross-cohort analyses.
Ceatha, N., Koay, A. C. C., Kelly, A., Killeen, T., McCabe, K., Murray, J., Pope, J., Scully, N., Buggy, C., Crowley, D.
2023
LGBT+ Youth Perspectives on Sexual Orientation and Gender Identity Questions in the Growing Up in Ireland Survey: A Qualitative Study
The increasing importance of identifying lesbian, gay, bisexual and transgender (LGBT+) populations is a key driver in changes to demographic data collection in representative surveys of youth. While such population-based data are rare, Growing Up in Ireland (GUI), an Irish, government-funded, longitudinal survey, includes sexual orientation and gender identity (SOGI) measurements. This qualitative study responds to a query from the GUI study team and aims to identify how best to collect SOGI data in future waves of GUI. A university Human Research Ethics Committee granted approval for online consultations with LGBT+ youth (n = 6) with experiential expertise in policy making. The research is underpinned by rights-based public patient involvement (PPI) with recorded discussions, which were transcribed and imported into NVivo 12, generating the theme “recognition in research, policy and society”. This co-created article, with the LGBT+ young PPI Panel members, commends the inclusion of SOGI data in GUI and recommends changes in question placement and phrasing. Aligning with best practice, the PPI members provide a template for wording on consecutive sex and gender questions, expanded sexual orientation identity categories and maintaining the existing well-phrased transgender question from GUI. This offers potential to improve the quality of the SOGI data collected and the experience of those completing the questionnaire. These findings extend beyond GUI, with relevance for surveys with youth populations. This paper underscores the potential and benefits of participatory approaches to research with youth and views their role beyond simply as sources of data.
Keywords: LGBT+, sexual minority youth (SMY), gender minority youth (GMY), Growing Up in Ireland (GUI), SOGI measurement, quantitative, qualitative, survey design, PPI
Cheevers, C., O’Connell, M.
2013
Developing an Index of Well-Being for Nine-Year-Old Irish Children
This paper outlines the development of an index of child well-being using data from the first wave of the Child Cohort in the Growing up in Ireland study. This national longitudinal study explores children’s lives by collecting data from 8,568 nine-year-old children, their caregivers and their teachers. Well-being indices are useful to describe children’s circumstances, to monitor child outcomes, and to create and assess the efficacy of social polices involving children. Traditionally, macro-level data has been used in the construction of child well-being indices. However, micro-level data is used in this paper to provide a child-centered perspective on their well-being. This index is comprised of three domains; physical health, social & emotional functioning and educational attainment. Fourteen measures were used in the creation of these domains utilising data from children, caregivers and teachers on the child’s current development. The domain content, protocol followed and confirmatory pro-cess used in creating this index are discussed. Evidence is provided supporting the inclusion of the domains and the factorial structure of the index. A child well-being index of this sort is valuable as it manages to efficiently summarize the richness of information provided by multiple informants on the multidimensional nature of child well-being into a single index. Consequently, it can be easily used and understood by the various stakeholders involved in services related to child welfare.
Conica, M., Nixon, E., Quigley, J.
2022
Interparental Relationship Satisfaction from Nine Months to Nine Years and Children’s Socioemotional Competencies at Nine Years
The quality of the interparental relationship bears important implications for children’s socioemotional development. Given evidence that relationship satisfaction among parents tends to decline over time this study examined how change in parents’ relationship satisfaction from nine-months-old until nine-years-old related to children’s socioemotional difficulties at nine-years-old. Participants were 2074 mothers, fathers, and their child (55.1% male) recruited through random sampling of the Child Benefit Registrar by Growing Up in Ireland cohort study. Mothers ranged in age from 18 to 40 years (M = 31.06, SD = 4.70) and fathers ranged in age from 18 to 60 years (M = 33.50, SD = 5.54). Mothers and fathers completed the Dyadic Adjustment Scale at nine-months-old and at nine-years-old whereas child socioemotional development was assessed via teacher report on the Strengths and Difficulties Questionnaire at nine-years-old. Residualised change analysis indicated that both parents experienced declines in relationship satisfaction from nine-months-old until nine- years-old. However, in families where initial levels of relationship satisfaction were high, there was no significant association between decline in satisfaction and child socioemotional difficulties. Conversely, in couples where initial levels of satisfaction were low, mothers, but not fathers, who experienced further declines had female, but not male, children with more socioemotional difficulties at nine years (β = −0.22, p = 0.01; R2 = 0.15, F = 2.31, p = 0.02). These findings highlight the need for carefully tailored interventions aimed at promoting couple relationship satisfaction during transition to parenthood such that the negative impact on children of any decline experienced over time can be mitigated.
Corrigan, O.
2013
See how they grow: Solo and unmarried-cohabitant parenthood and crisis pregnancy in Ireland. An analysis of the Growing Up in Ireland 9-month old infant cohort data
Cosgrove, J., McKeown, C., Travers, J., Lysaght, Z., Ní Bhroin, O., Archer, P.
2014
Educational Experiences and Outcomes for Children with Special Educational Needs: A Secondary Analysis of Data from the Growing Up in Ireland Study (NCSE Research Report No. 17).
Cosgrove, J., McKeown, C., Travers, J., Lysaght, Z., Ní Bhroin, O., Archer, P.
2018
Educational Experiences and Outcomes for Children with Special Educational Needs, Phase 2 from age 9-13: A Secondary Analysis of Data from the Growing Up in Ireland Study. (NCSE Research Report No. 25).
Background
Abnormal body mass index (BMI) has been associated with development of psychopathology. This association in children is well documented, for both overweight and underweight children. However, the association between change in BMI and the development of psychopathology has been less investigated.
Aim
To investigate the association between change in BMI between childhood and adolescence and psychopathology in adolescence.
Methods
Data from the Growing Up in Ireland cohort were used. We investigated the ’98 cohort (also known as the child cohort) at age 9/13. BMI, defined using internationally recognised definitions as underweight, healthy or overweight, was used as the exposure, and abnormal Strength and Difficulties Questionnaire scores were used as the outcome. Logistic regression was undertaken for the analysis. All analyses were adjusted for confounders.
Results
A change to overweight from healthy BMI was significantly associated with increased risk of psychopathology (adjusted OR 1.66; 95% CI 1.19–2.32). Both change from underweight to healthy (adjusted OR 0.12; 95% CI 0.03–0.43) or from overweight to healthy (adjusted OR 0.47; 95% CI 0.79–0.8) was associated with a significantly reduced risk of developing psychopathology.
Discussion
As a child’s BMI returns to within the healthy range, their risk of adolescent psychopathology is reduced. Interventions to restore healthy BMI, in both underweight and overweight, children may reduce their risk of adolescent psychopathology.
Keywords
adolescence, body mass index, childhood, psychopathology, weight change
Cotter, S., Healy, C., Ní Cathain, D., Williams, P., Clarke, M., Cannon, M.
2019
Psychopathology and early life stress in migrant youths: an analysis of the 'Growing Up in Ireland' study
Objectives
Migrant youths endure many challenges. Such challenges can be stressful and lead to psychological difficulties. We investigated the relationship between migration, psychopathology and stressful events in children and adolescents. We hypothesised that migrant youths would show higher levels of psychopathology and more stressful life events than non-migrant youths.
Method
Using the Child cohort (Cohort ‘98) of the ‘Growing up in Ireland’ study we investigated psychopathology, as measured by the Strengths and Difficulties questionnaire (SDQ) at age 9 and 13 and stressful life events in migrant and non-migrant youths.
Results
There was no significant difference between the proportion of migrant and non-migrant youths reporting psychopathology in childhood (p>0.05) or adolescence (p>0.05). Analysis of the SDQ subscales revealed that a significantly greater proportion of migrant youths had hyperactivity problems in childhood (p = 0.04) but a greater proportion of non-migrant youths had emotional problems in early adolescence (p = 0.04). We found that migrant youths experienced significantly more stressful life events than their non-migrant counterparts (p<0.01), however, once ‘Moving house/country‘ was removed as a stressor, there was no difference between the groups (p>0.27).
Conclusions
Contrary to our hypothesis, we observed that there were few differences between migrant and non-migrant youths in the levels of psychopathology. Migrant youths experienced a greater number of stressful life events, however, this was attributable to stressors relating to moving. An increased understanding of the factors promoting resilience, as demonstrated by the migrant youths, could aid health professionals and policy makers to effectively tailor interventions for mental health promotion.
Keywords
Early life stress, immigration, migrants, psychopathology
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