Background to the Research

• There has been much written about inequalities and the effect of poverty on children's health. However, there has been little research examining the measurement of children's health and health behaviours with their family circumstances.
  

Research Approach

• A representative sample of 6-7 year olds and their families within the EHSSB area was obtained by selecting one in four families with children born during 1989 within EHSSB. The Child health System was used as a sampling frame, as it holds routine health care information on all children from birth until school leaving age. The database was ordered by date of birth, sex and community trust area. Every fourth child was selected.
• Three questionnaires were designed:
• The child health and lifestyle questionnaire was administered by a health visitor directly to a parent. This contained standardised questions from the 1991 Census, Continuous Household Survey and other health studies. Information related to the structure and socio-economic circumstances of the family, children's experience of health services and general health, as well as on accidents, safety, diet and lifestyle, environment and behaviour, and family health and lifestyle.
• The child health questionnaire parent report was a self completion questionnaire, and covered parental, child and family details, plus aspects of children's health.
• The child questionnaire was administered by the health visitor and contained closed and open-ended questions to allow children to express themselves on friendships, contentment, family relationships, health behaviours, diet and general influences.
• Physical measurements (height and weight) were also taken.
  

Main Findings

• Information was obtained for 748 boys and 761 girls (response rate of 69%). The majority of parents completing the questionnaires were mothers (98%).
• Average family size was 5, with 3 children. Single parent families made up 13% of families.
• 69% of families were from a non-manual social class background, based on current or last occupation.
• 25% of families had no direct income from employment. 29% of children were eligible for free school meals.
• Children from North and West Belfast, and Down and Lisburn had poorer health and health behaviours than other children. Educational achievement, as well as levels of income and employment were also lower in these areas.
• The most widespread children's health problem was poor dental health. Asthma was the most named health condition, and was more prevalent among boys than girls.
• The health behaviours of parents were reflected and reinforced in children, which causes concern given low levels of exercise and high rates of smoking among many parents.
• Risk factors for later disease included high salt and sugar intake, low levels of exercise, poor dental hygiene and smoking.
• There were clear links between family socio-econom circumstances and the health status and health behaviours of children. Information on family health status, health related behaviour and health outcomes can provide a more accurate picture of factors affecting children's health that geographic analysis alone.
• The baseline data on children's health and lifestyle that has been gathered can provide guidance for future health initiatives.