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Health inequalities and parenting

Health inequalities and parenting. Phil Wilson GP, Battlefield, Glasgow Senior Lecturer University of Glasgow. Health inequalities and parenting. Focus on relative economic deprivation Because we know deprivation is linked to poor health and mortality Focus on child behaviour

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Health inequalities and parenting

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  1. Health inequalities and parenting Phil Wilson GP, Battlefield, Glasgow Senior Lecturer University of Glasgow

  2. Health inequalities and parenting • Focus on relative economic deprivation • Because we know deprivation is linked to poor health and mortality • Focus on child behaviour • Because we know parenting and child behaviour are inextricably linked • Because child behaviour is easier to assess than parenting • Because we know child behaviour problems are linked to poor health outcomes • Because we know measures which improve child behaviour can reduce health risks (smoking, problem alcohol/drug use etc)

  3. Glasgow Evaluation Principles • Use of standardised tools • Data should be useful for: • Professional decision making • Needs assessment • Performance management • External evaluation

  4. Universal HV contacts Pilot data - West Glasgow July-Dec 2009 • 13 month assessment evaluating parent-child interaction and emotional wellbeing of parent • 30 month assessment of parenting stress, child behaviour and language development

  5. 13 month contact • Adult wellbeing scale: • Anxiety • Depression • Externally-directed irritability • Internally-directed irritability • Observational assessment of parent-child interaction* • “may be problems / “probably no problems” * Wilson, Thompson, McConnachie, Puckering, Holden, Cassidy, Gillberg . Community Practitioner 2010: 83(5): 22-5

  6. 13m: Adult Wellbeing Scale • Good response (88%) and completion rates (77.9%) • Scores reflect known social patterning of depression, but not anxiety • Irritability relatively uncommon. No clear relationship to deprivation

  7. 30 month assessment • Parenting Daily Hassles • Richman Behaviour Checklist • Language screen

  8. 30-month visit - language • Half the children with language delay are in “core” risk category • No clear social patterning

  9. Strengths and Difficulties Questionnaire at school entry • For all children entering primary school in Glasgow, starting in 2010 • Completed by Child Development Officers as part of routine Transition Documentation • Data available on SEEMIS database and linkable to NHS and GROS data

  10. The SDQ • A brief behavioural screening questionnaire for use with 3-16 year olds. • 25 questions used to measure five aspects of the child’s development: • emotional symptoms • conduct problems • hyperactivity/inattention • peer relationship problems • pro-social behaviour.

  11. SDQ and deprivation

  12. Explaining the patterns • Differing respondent thresholds • Neighbourhood effects • Variation in service provision • “Social drift” • Ill health • Genetic factors • Poverty distracts attention away from the child...

  13. What next for Glasgow? • Routine 30 month check – with SDQ, language, parental mental wellbeing assessment • School-based SDQs at 7 and 10 years • Linkage of health and education data: • Will be able to plot trajectories from 2 to 10 years • Identify effects of area, nursery, school, family on these trajectories • Start trials of interventions (eg for language delay, early onset conduct problems) with long term follow up

  14. Acknowledgements Lucy Thompson Matt Forde, Cathy Holden, and the Glasgow West CHCP Health Visitors John Butcher, Amanda Kerr, Michele McClung, Morag Gunion and City of Glasgow Education Services Kim Jones & Kelly Chung Paula Barton Christine Puckering and Helen Minnis Claire Wilson and Alex McConnachie

  15. Thank you.philip.wilson@glasgow.ac.uk

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