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Associations between mental health competence and indicators of physical health and cognitive development in eleven year olds: findings from the UK Millennium Cohort Study.

ABSTRACT: BACKGROUND:Positive mental health may support healthy development in childhood, although few studies have investigated this at a population level. We aimed to construct a measure of mental health competence (MHC), a skills-based assessment of positive mental health, using existing survey items in a representative sample of UK children, and to investigate its overlap with mental health difficulties (MHD), socio-demographic patterning, and relationships with physical health and cognitive development. METHODS:We analysed the UK Millennium Cohort Study (MCS) when children were aged 11?years. Maternal (n =?12,082) and teacher (n =?6739) reports of prosocial behaviours (PS) and learning skills (LS) were entered into latent class models to create MHC measures. Using descriptive statistics, we examined relationships between MHC and MHD, and the socio-demographic patterning of MHC. Associations between MHC and physical health and cognitive development were examined with relative risk ratios [RRR] (from multinomial models): BMI status (healthy weight, overweight, obesity); unintentional injuries since age 7 (none, 1, 2+); asthma symptoms (none, 1, 2+); and tertiles of test scores for verbal ability, spatial working memory and risk-taking. Models were adjusted for potential confounding. RESULTS:Four MHC classes were identified [percentages for maternal and teacher reports, respectively]: high MHC (high PS, high LS) [37%; 39%], high-moderate MHC (high PS, moderate LS) [36%; 26%]; moderate MHC (moderate PS, moderate LS) [19%; 19%]; low MHC (moderate PS, low LS) [8%; 16%]. Higher MHC was less common in socially disadvantaged children. While MHC and MHD were associated, there was sufficient separation to indicate that MHC captures more than the absence of MHD. Compared to children with high MHC, those in other MHC classes tended to have poorer physical health and cognitive development, particularly those with low MHC or high-moderate MHC. For example, children with maternal-report Low MHC were more likely to have experienced 2+ unintentional injuries (RRR: 1.5 [1.1-2.1]) and to have lower verbal ability scores (RRR: 2.5 [1.9-3.2]). Patterns of results were similar for maternal- and teacher-report MHC. CONCLUSION:MHC is not simply the inverse of MHD, and high MHC is associated with better physical health and cognitive development. Findings suggest that interventions to improve MHC may support healthy development, although they require replication.

SUBMITTER: Hope S

PROVIDER: S-EPMC6836461 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Associations between mental health competence and indicators of physical health and cognitive development in eleven year olds: findings from the UK Millennium Cohort Study.

Hope Steven S Rougeaux Emeline E Deighton Jessica J Law Catherine C Pearce Anna A

BMC public health 20191106 1

<h4>Background</h4>Positive mental health may support healthy development in childhood, although few studies have investigated this at a population level. We aimed to construct a measure of mental health competence (MHC), a skills-based assessment of positive mental health, using existing survey items in a representative sample of UK children, and to investigate its overlap with mental health difficulties (MHD), socio-demographic patterning, and relationships with physical health and cognitive d ...[more]

PMID: 31694593

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Project description:PurposePromoting positive mental health, particularly through enhancing competencies (such as prosocial behaviors and learning skills), may help prevent the development of health risk behaviors in adolescence and thus support future well-being. Few studies have examined how mental health competencies in childhood are associated with adolescent health risk behaviors, which could inform preventative approaches.MethodsUsing UK Millennium Cohort Study data (n = 10,142), we examined how mental health competence (MHC) measured at the end of elementary school (11 years) is associated with self-reported use of cigarettes, e-cigarettes, alcohol, illegal drugs, antisocial behavior, and sexual contact with another young person at age 14 years. A latent measure of MHC was used, capturing aspects of prosocial behavior and learning skills, categorized as high MHC, high-moderate MHC, moderate MHC, and low MHC. Logistic and multinomial regression estimated odds ratios and relative risk ratios for binary and categorical outcomes, respectively, before and after adjusting for confounders. Weights accounted for sample design and attrition and multiple imputation for item missingness.ResultsThose with low, moderate, or high-moderate MHC at age 11 years were more likely to have taken part in health risk behaviors at age 14 years compared with those with high MHC. The largest associations were seen for low MHC with binge drinking (relative risk ratio: 1.6 [95% confidence interval: 1.1-2.4]), having tried cigarettes (odds ratio: 2.2 [95% confidence interval: 1.6-3.1]) and tried illegal drugs (odds ratio: 2.0 [95% confidence interval: 1.3-3.1) after adjusting for confounders (which attenuated results but largely maintained significant findings).ConclusionsMHC in late childhood is associated with health risk behaviors in midadolescence. Interventions that increase children's MHC may support healthy development during adolescence, with the potential to improve health and well-being through to adulthood.

Project description:ObjectivesTo examine predictors of partial and full measles, mumps and rubella (MMR) vaccination catch-up between 3 and 5 years.DesignSecondary data analysis of the nationally representative Millennium Cohort Study (MCS).SettingChildren born in the UK, 2000-2002.Participants751 MCS children who were unimmunised against MMR at age 3, with immunisation information at age 5.Main outcome measuresCatch-up status: unimmunised (received no MMR), partial catch-up (received one MMR) or full catch-up (received two MMRs).ResultsAt age 5, 60.3% (n=440) children remained unvaccinated, 16.1% (n=127) had partially and 23.6% (n=184) had fully caught-up. Children from families who did not speak English at home were five times as likely to partially catch-up than children living in homes where only English was spoken (risk ratio 4.68 (95% CI 3.63 to 6.03)). Full catch-up was also significantly more likely in those did not speak English at home (adjusted risk ratio 1.90 (1.08 to 3.32)). In addition, those from Pakistan/Bangladesh (2.40 (1.38 to 4.18)) or 'other' ethnicities (such as Chinese) (1.88 (1.08 to 3.29)) were more likely to fully catch-up than White British. Those living in socially rented (1.86 (1.34 to 2.56)) or 'Other' (2.52 (1.23 to 5.18)) accommodations were more likely to fully catch-up than home owners, and families were more likely to catch-up if they lived outside London (1.95 (1.32 to 2.89)). Full catch-up was less likely if parents reported medical reasons (0.43 (0.25 to 0.74)), a conscious decision (0.33 (0.23 to 0.48)), or 'other' reasons (0.46 (0.29 to 0.73)) for not immunising at age 3 (compared with 'practical' reasons).ConclusionsParents who partially or fully catch-up with MMR experience practical barriers and tend to come from disadvantaged or ethnic minority groups. Families who continue to reject MMR tend to have more advantaged backgrounds and make a conscious decision to not immunise early on. Health professionals should consider these findings in light of the characteristics of their local populations.

Project description:OBJECTIVES:To examine how population-level socioeconomic health inequalities developed during childhood, for children born at the turn of the 21st century and who grew up with major initiatives to tackle health inequalities (under the New Labour Government). SETTING:The UK. PARTICIPANTS:Singleton children in the Millennium Cohort Study at ages 3 (n=15?381), 5 (n=15?041), 7 (n=13?681) and 11 (n=13?112) years. PRIMARY OUTCOMES:Relative (prevalence ratios (PR)) and absolute health inequalities (prevalence differences (PD)) were estimated in longitudinal models by socioeconomic circumstances (SEC; using highest maternal academic attainment, ranging from 'no academic qualifications' to 'degree' (baseline)). Three health outcomes were examined: overweight (including obesity), limiting long-standing illness (LLSI), and socio-emotional difficulties (SED). RESULTS:Relative and absolute inequalities in overweight, across the social gradient, emerged by age 5 and increased with age. By age 11, children with mothers who had no academic qualifications were considerably more likely to be overweight as compared with those with degree-educated mothers (PR=1.6 (95% CI 1.4 to 1.8), PD=12.9% (9.1% to 16.8%)). For LLSI, inequalities emerged by age 7 and remained at 11, but only for children whose mothers had no academic qualifications (PR=1.7 (1.3 to 2.3), PD=4.8% (2% to 7.5%)). Inequalities in SED (observed across the social gradient and at all ages) declined between 3 and 11, although remained large at 11 (eg, PR=2.4 (1.9 to 2.9), PD=13.4% (10.2% to 16.7%) comparing children whose mothers had no academic qualifications with those of degree-educated mothers). CONCLUSIONS:Although health inequalities have been well documented in cross-sectional and trend data in the UK, it is less clear how they develop during childhood. We found that relative and absolute health inequalities persisted, and in some cases widened, for a cohort of children born at the turn of the century. Further research examining and comparing the pathways through which SECs influence health may further our understanding of how inequalities could be prevented in future generations of children.

Dataset Information

Associations between mental health competence and indicators of physical health and cognitive development in eleven year olds: findings from the UK Millennium Cohort Study.

Publications

Associations between mental health competence and indicators of physical health and cognitive development in eleven year olds: findings from the UK Millennium Cohort Study.

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