Tag Archives: Children’s Health

Equally protected children: one step closer

In 2015 UCL researchers Anja Heilmann, Yvonne Kelly and Richard Watt produced a report, which showed that there was ample evidence that physical punishment can damage children and escalate into physical abuse. Together with the children’s charities that commissioned the report, they called for urgent action to provide children with the same legal protection against violence that British adults enjoy. The report was at the heart of Scottish MSP John Finnie’s proposed Children (Equal Protection from Assault) Bill which the Scottish Government have just announced that they will support in their programme for the coming year. The Bill would make Scotland the first UK country to outlaw all physical punishment by removing the defence of “justifiable assault” of children, and giving them the same protection as adults. Lead researcher, Anja Heilmann, reflects on the news and what she hopes it might mean for the human rights of children in Scotland and elsewhere.

On 11 May 2017, John Finnie MSP proposed a Bill to the Scottish Parliament to “give children equal protection from assault by prohibiting the physical punishment of children by parents and others caring for or in charge of children”.

After a three month consultation, which received more than 650 responses, the majority positive (75 per cent), that Bill became part of the Scottish Government’s plans for the next year, as Nicola Sturgeon announced she would not oppose it.

If passed, the Bill will prohibit the physical punishment of children by ending the existing common-law position that physical punishment by parents can be defended as reasonable chastisement and therefore be lawful. The Bill will not create a new criminal offence, as the common law offence of assault will apply (with a modification removing the reasonable chastisement defence).

It’s a far cry from similar efforts made in Scotland in 2002 to prohibit the physical punishment of children under the age of three. Back then, not only did a majority of MSPs reject the idea, but it was branded as “ridiculous” and an unwelcome intrusion into family life by many parents and the media.

15 years on it seems attitudes may have changed significantly. In the foreword to the Bill, John Finnie himself said:

“We would no longer consider it acceptable…. to allow our children to roam freely in the back of the car when going on a journey. Neither would we dream of taking them to a cinema if they had to watch a film through a fug of cigarette smoke … Attitudes towards these and many other fundamental societal issues have dramatically changed.”

Those attitudes changed as the result of a clear presentation of the evidence – the hard facts about the damage that those behaviours could cause.

We believe that, in this case, our evidence has made it clear for all to see that hitting children can not only damage them, but it carries the risk of escalation into physical abuse. It is a clear violation of international human rights law and children should and must be afforded the same rights as adults in this respect.

Overwhelming evidence

The evidence for the detrimental effects of physical punishment is vast and consistent. In short, our summary of the available evidence showed that physical punishment was related to increased aggression, delinquency and other anti-social behaviour over time. It also showed the more physical punishment suffered by a child, the worse the subsequent problem behaviour.

There was also a clear link between physical punishment and more serious child maltreatment and negative effects continued into adulthood, including problems of drug and alcohol dependency.

Half-hearted responses to recent human rights rulings condemning the physical punishment of children need to become wholehearted changes to the law, not tinkering that does just enough to meet the minimum requirements of those judgments rather than properly respect the rights of children.

The UN Committee on the Rights of the Child is unequivocal – all forms of corporal punishment of children are unacceptable. Let’s hope the Scottish Parliament can find the courage to make that statement a reality and show the rest of the UK the way.

As Martin Crewe of Barnardo’s Scotland stated:

“This is a huge step forward and sends a very clear message about the kind of Scotland we want to see for our children.”

Personally, I am hoping it’s a kind of Scotland and indeed UK, we WILL see in the not too distant future and I appeal to all MSPs to listen to the evidence and support the Bill.

Equally Protected? A review of the evidence on the physical punishment of children by Dr Anja Heilmann, Professor Yvonne Kelly and Professor Richard G Watt was commissioned by NSPCC Scotland, CHILDREN 1st, Barnardo’s Scotland and the Children and Young People’s Commissioner Scotland.

Why reading is key to giving our kids a great start in life

A growing body of research is pointing to how important and valuable reading is in giving children the best possible start in life, not just for academic success but more broadly including for a child’s mental health and happiness.

In this special episode of the Child of our Time Podcast, Professor Yvonne Kelly is joined by Jonathan Douglas, CEO of the National Literacy Trust and researcher Christina Clark, also from the  Trust. They discuss important new evidence about the benefits of reading for individual children and in addressing social inequalities.

Useful links

Screen use at seven: overweight at 11. Why it’s time to say no to a TV in the bedroom for children

Since the launch of the Childhood Obesity Strategy in 2016, there has been much attention focused on the so-called ‘Sugar Tax’. The March 2017 Budget saw confirmation that sugary soft drinks would be taxed in an attempt to combat rising levels of obesity. This is an important move that has been met with widespread approval from public health professionals. Still, obesity is hugely complex and there are many other things at play in addition to the sugary drinks and snacks that children may consume. Researchers at UCL have been looking in detail at different factors associated with obesity and, in a recent paper, find that children who have a television in their bedroom have higher BMI and more body fat than those who do not. Lead researcher, Anja Heilmann, explains the research and why saying no to a TV in the bedroom could be another important strategy in combatting childhood obesity.

As our TV screens have got flatter, our children have got fatter. There is no getting away from it! Screen-based activities play a central role in our children’s lives. At a very young age, they have unparalleled access to television screens, computers, game consoles and a host of mobile devices. Among 5 to 11 year-olds, TV is still the most consumed medium, with gaming coming second.

At the same time, childhood obesity is not just a national, but a global health worry. In 2014/15 a third of 11 year-old children in England were overweight and a fifth were obese.

Research has repeatedly reported a link between TV viewing and obesity, but although some has hinted at the idea that a television in a child’s bedroom might exacerbate the problem, the evidence here has been rather contradictory. Other plausible pathways could include eating unhealthy snacks whilst watching TV, exposure to food advertising and insufficient and poor quality sleep.

Using information from the Millennium Cohort Study (MCS), which has followed the lives of more than 18,000 children born around the turn of the century, we had the opportunity to see whether having a TV in their bedroom when they were age 7 was, in any way, linked with a child being overweight when they were 11 years old. In other words, we wanted to get to grips with whether there were implications over a child’s lifetime of their screen use and if so, what those implications were.

Useful information

Using trained interviewers, the MCS collects a wide range of useful information including the independently measured height, weight and body fat of a child. These provided us with a set of obesity-related measurements: weight, Body Mass Index (BMI) and Fat Mass Index (FMI), a powerful set of measures for overweight and obesity.

When the children were age seven, parents were asked if their son or daughter had a TV in their bedroom, how many hours they spent watching TV or DVDs and how much time they spent playing on a computer.

 At age 7, more than half of the 12,556 boys and girls we looked at in our research had a TV in their room and it was these children who were more likely to be overweight when they turned 11 when we compared them with those without a TV. They were also more likely to have higher BMI and FMI. In total, a quarter of the boys and nearly a third of the girls were overweight at age 11 and the links between having a TV in the bedroom and overweight were stronger for the girls.

Another strength of the research is that we controlled for the child’s BMI at age 3 and maternal BMI, that way adjusting for genetic factors, as well as food environment in the family. We also adjusted for family income and mother’s education – both of which are important as overweight/obesity is socially patterned, as is TV use.

Interestingly, there was no link between overweight and the time a child, whether they were a boy or a girl, spent playing on a computer.

Clear link

So, given the size of our sample and the robustness of the methods employed here, we can say with considerable confidence that there is a clear link between having a TV in the bedroom as a young child and being overweight a few years down the line. For girls, this represents a 30 per cent increase in the risk of being overweight at 11 compared with their peers who do not have one. For boys the risk increases by around 20 per cent.

Another interesting point to note is that the size of this risk or effect is about the same as that of other things shown to be linked with obesity, such as not being breastfed and being physically inactive.

Nevertheless, policy makers looking to create and implement strategies to reduce obesity should certainly consider building access to television screens in children’s bedrooms into their thinking. Specific initiatives focused on young girls could also be important.

Meanwhile, for parents who may consider it a good idea for a young child to have their own TV in their bedroom or feel under pressure to provide one, the message is quite clear: resist the idea and you may be doing even more to set your child on a healthier path into their teenage years and beyond.

Longitudinal associations between television in the bedroom and body fatness in a UK cohort study is research by Anja Heilmann, Patrick Rouxel, Emla Fitzsimons, Yvonne Kelly, and Richard Watt and is published in the International Journal of Obesity.

  • Tvs in the bedroom linked to childhood obesity, study finds, The Guardian

A risky problem: what can keep young people away from alcohol and cigarettes?

Smoking and drinking among very young people has been declining in recent years, but it’s not all good news. There is still a lot of public health concern around the numbers of older children who are consuming alcohol and cigarettes, as these are the young people most likely to come to harm as a result of drinking too much. Their risky behaviours are also likely to persist and intensify into adulthood. So what factors might prevent a young person from smoking and drinking in the first place? New research published in BMC Public Health shows that levels of happiness among children and awareness of the risks may be key to success. Lead author on the research, Noriko Cable, explains more. 

According to Public Health England (PHE), alcohol is now the leading risk factor for ill-health, early mortality and disability among those aged 15 to 49 in England. It wants to “prevent and reduce” the harms caused by alcohol. It also has ambitions to create “a tobacco-free generation” by 2025.

The most recent figures from the Survey of Smoking, Drinking and Drug Use Among Young People in England show that around 90,000 children aged between 11 and 15 are regular smokers and 240,000 have drunk alcohol in the past week. These figures are the lowest they have been since the survey began in 1982.

However, recent research published in BMC Public Health by colleagues at UCL, shows that around one in seven 11 year-olds is drinking alcohol and that having peers who consume alcohol makes them four times more likely to drink that their peers who don’t. We also know that smokers start young, two thirds of them before the age of 18.

So we wanted to examine more closely the sorts of things that might drive young people away from cigarettes and alcohol. In this way we hope to arm policy makers, health practitioners and those working directly with or caring for children and young people with information that can help with the development of clear policies and interventions.

Protective role

We focused on three factors thought to play a protective role in preventing young people from starting to smoke and drink. These were: their awareness of the harms, their well-being or happiness and how supportive their networks of friends and family were.

Information came from Understanding Society, a large UK survey, which, in addition to collecting a wide range of social and economic information from everyone in the household aged 16 and over, has a special self-completion questionnaire for 10-15 year olds. Our sample contained 1,729 boys and girls.

We examined answers at two time points (approximately a year apart) to questions about their smoking and drinking. With these two sets of information, we were able to see whether they had started but then stopped smoking or drinking, whether they were persistent users of cigarettes and alcohol, whether they had started between the first and second surveys (initiation) or whether they had not smoked or drunk alcohol at either point.

The children were also asked about how happy they were with different aspects of their lives, including how they were getting on at school, how they felt about their appearance, family and friends and life in general.

On a scale of 1-4, the children were asked to rate how risky they thought different levels of smoking and drinking were. They were also asked how many supportive friends they had; friends they could confide in.

Harm awareness and happiness

Nearly 70 per cent of the study participants described themselves as persistent non-users of alcohol and cigarettes, and around 13 per cent categorized themselves as persistent users. Persistent non-users scored highest on harm awareness and happiness tests compared to the other groups.

About 8 per cent of the study group labelled themselves as ex-users and about 13 per cent had started using alcohol or cigarettes between the first and second time they completed the survey. Young people aged 10 to 12 were more likely to be in the persistent non-use group, whereas participants aged 13 and above were more likely to be in the persistent user and initiation groups.

We were surprised that while, for most young people, knowledge of the potential and actual harms of alcohol and smoking was linked with them never drinking or smoking, for some it seemed to be associated with them starting to drink or smoke. It is possible that positive expectations from drinking alcohol or smoking cigarettes may, in some way, have overridden their awareness of what harm they could do.

The happier the young person was, and more aware of the harms of alcohol and cigarettes, the more likely they were never to drink or smoke. Having supportive friends to confide in did not play a role in preventing adolescents from using alcohol or cigarettes.

Promoting happiness and harms

So it seems that promoting young people’s happiness and well-being and making them aware of the harms of smoking and drinking may be key to keeping them away from alcohol and cigarettes. In terms of possible timings for information and interventions, another takeaway from the study might be that working with children between the ages of 10 and 12, before they start trying cigarettes and alcohol, could be important.

Because the information used in this study is self-reported, we need to interpret the findings with caution, but they do suggest that making adolescents aware of alcohol and smoking related harm can be helpful in preventing them from engaging in risky health behaviors.

Colleagues at the Centre are now getting to grips with the new age 14 data from the Millennium Cohort Study and, in collaboration with Mentor, a charity working on the ground in schools to tackle alcohol and drug abuse, are hoping to develop our growing body of evidence in this area that will help formulate policies and activities to make some of Public Health England’s ambitions around smoking and alcohol a reality.

Further information

What could keep young people away from alcohol and cigarettes? Findings from the UK Household Longitudinal Study is research by Noriko Cable, Maria Francisca Roman Mella and Yvonne Kelly and is published in BMC Public Health.

 

Tackling the childhood obesity epidemic: Can regular bedtimes help?

Nearly one in five 10 and 11-year-olds in England is obese, according to NHS figures. With childhood obesity posing not just a nationwide, but a worldwide health threat, public health researchers around the globe are striving to establish which aspects of a young child’s life might set them on a path to being obese later on. Associate Professor Sarah Anderson from The Ohio State University College of Public Health and colleagues from University College London outline the first research to try to disentangle the role of children’s routines and behaviour at age 3 on obesity at age 11 and show that bedtime routines and learning to manage emotions really do matter.

The UK’s Chief Medical Officer Professor Dame Sally Davies has warned that the health of millions of children is in jeopardy and is concerned that being overweight is becoming the norm. She fears half the population could be obese by 2050 at a cost of billions of pounds to the health service and wider economy.

The latest statistics highlight a stark contrast between the wealthiest and poorest families, with childhood obesity rates in the most deprived areas more than double those in the most affluent areas.

Despite the publication in August 2016 of the Government’s long-awaited childhood obesity strategy, charities and health organisations remain highly critical, describing it as a watered-down effort that puts business interests ahead of those of public health. Even the recent introduction of the so-called ‘sugar-tax’ on soft drinks has been met with scepticism in some quarters.

To help inform public health strategies going forward, our researchers looked at the bedtime, mealtime and tv/video routines of very young children and their emotional and behavioural development to see if, at this early stage, it is possible to identify those most at risk of becoming obese.

The study includes information on nearly 11,000 children collected through the UK Millennium Cohort Study (MCS). When the children were three, their parents reported whether children always, usually, sometimes, or never or almost never had a regular bedtime and mealtime, and the amount of television and video they watched each day.

They were also asked a series of questions about the child’s behaviour during the previous six months. Questions were about how children cope with emotions and their persistence and independence in play, including how easily the child became frustrated and whether they sought help from adults when faced with a difficult task. This was to get an idea of how well the child was able to ‘self-regulate’ their behaviour in these areas.

Regular routines

Children with regular bed and mealtimes and who watched less television were better able to control their emotions than their peers with less regular and consistent routines.

At 11-years-old, 6.2 per cent (682) of the children in the MCS were obese, with obesity more common in lower income and less educated families.

Of the routines we studied, inconsistent bedtime was most strongly associated with the risk of obesity, supporting recent findings by our UCL colleagues which showed that young children who skipped breakfast and went to bed at irregular times were more likely to be obese at age 11, stressing the importance of adequate sleep for preventing childhood obesity.

Even children who ‘usually’ had a regular bedtime were 20 per cent more likely to be obese than those who ‘always’ went to bed at around the same time.

Regular bedtimes and obesity

Surprisingly, toddlers with irregular meal times had a lower risk of obesity at age 11. Once other routines were factored in, television viewing was not related to obesity, although it is important to note that computer use was not taken into account, and the media environment for young children today is different than it was when children in MCS were young.

There was also a clear link between lower levels of emotional self-control in early childhood and obesity later on. Children with poor emotion regulation at age 3 were over 50 per cent more likely to be obese when studied at age 11.

Children’s level of persistence and independence was not linked to later obesity, however, and it is possible that this could be explained by the relative immaturity of the parts of the brain responsible for a child’s cognitive compared with their emotional development at this young age.

Strongest risk

Our study is the first to look at the relationship between a child’s routines, their ability to regulate their emotions and behaviour and how these factors work together to predict obesity.

The two strongest risk factors for obesity were irregular bedtime and a poor ability to control emotions and these were completely independent of each other. In other words, the link between bedtimes and obesity could not be explained away by a child’s inability to regulate their emotions.

There is a need to look more closely at the timing and regularity of children’s mealtimes and how they impact obesity later on, as we think there may be a lot more factors at play than we have considered here. We also need to better understand how the development of emotional and cognitive self-regulation interacts with metabolic, behavioural and social pathways to obesity.

However, our study supports previous research showing that children’s emotional regulation develops within a family context which includes routines.

One message from our study is crystal clear. To be effective, obesity strategies must target early childhood, and must find a way to support parents, especially those from the most deprived areas, to introduce and maintain consistent bedtimes and other home routines, as well as help children regulate emotions and respond to stress.

Another key message is that one size does not fit all. There is a lot going on in children’s lives that is important for their health and development. Saying that, it would seem that getting our children to bed at the same time every night could be a simple, cost-effective tool in the tool-kit to get them off to a good start and maybe in the larger battle against obesity.

Self-regulation and household routines at age three and obesity at age 11: Longitudinal analysis of the Millennium Cohort Study is research by Sarah Anderson from The Ohio State University College of Public Health; Amanda Sacker and Yvonne Kelly from University College London and Robert Whitaker of Temple University, Philadelphia.

Reducing harm from alcohol consumption

Child of our Time editor Yvonne Kelly has shared her latest research findings on very young drinkers with policy makers, senior health professionals and third sector groups.

Yvonne was  part of a high profile panel presenting research and taking questions from MPs and others with an interest in the creation of a strategy to reduce harm from alcohol consumption.

The event, organised by The All-Party Parliamentary Health Group and CLOSER (the UK Longitudinal Studies Consortium), comes as a recent report from Public Health England stated that among those aged 15 to 49 in England, alcohol is now the leading risk factor for ill-health, early mortality and disability and the fifth leading risk factor for ill health across all age groups.

It has also been acknowledged that the harmful effects of heavy alcohol consumption go well beyond the implications for public health, presenting both serious economic and social challenges: current estimates of the annual cost to society of alcohol consumption range from 1.3% to 2.7% of annual GDP. In addition, around half of all violent incidents involving adults are alcohol-related.

Photo credit: Jes 

You can find more articles about Yvonne’s research on young people and alcohol by typing ‘alcohol’ into our blog Search bar.

Be prepared: the mental health benefits of scouting and guiding

Being a scout or a guide when we are young might be a good experience for us in all sorts of ways, but can those positive effects be long lasting though our lives and if so, how? Research using the 1958 Birth Cohort shows a strong link between being a scout or a guide when young and better mental health later in life. Professor Richard Mitchell from the University of Glasgow talks to the Child of our Time Podcast about the research, what he and colleagues from Edinburgh found and what he thinks it tells us.

Photo credit: One-and-Other Girl Guides UK

Cyberbullying – the long term effects

For all the wonderful opportunities and connectivity that the internet has brought in recent decades, it seems likely that 2016 will be the year that the internet is mostly remembered for trolling and cyberbullying. It’s a growing phenomenon, not least among school-aged children. In 2015/16 the children’s charity Childline reported a 2 year increase of 88 per cent in calls from children about cyberbullying and the Government recently funded an app aimed at helping pupils report incidents. Meanwhile, a team of researchers at Queen Mary University of London has been looking for the first time at how cyberbullying affects the mental health of young people later on in their lives. Dr Amanda Fahy explains more.

There are three Ps which distinguish cyberbullying from what we might think of as more ‘traditional’ face-to-face forms of bullying: permanence, publicity and permeability.

The thinking behind our study was that all these factors may well mean that the mental wounds and scars inflicted on young people who experience this type of bullying, run even deeper. Certainly it has been identified in numerous quarters as a matter of serious public health concern.

Whilst one or two international studies have demonstrated a link between being a cybervictim and signs of depression, there is little evidence in the UK to show who is affected and how over time. Our research looks at young people who are bullied, those doing the bullying and those who are both bullying and being bullied and goes onto examine their mental health one year down the line.

Regeneration study

The research made use of information collected initially from more than 3,000 Year 7 (aged 11-12) students who participated in the Olympic Regeneration in East London (ORiEL) study which was designed to evaluate the impact of the urban regeneration associated with the London 2012 Olympic Games.

When the students in the study moved into Year 8 (Aged 12-13) they were asked some questions about their experiences of cyberbullying in the preceding 12 months. These included how often they had received rude or nasty comments from someone, become the target of rumours spread online or received threatening or aggressive comments.

The same students were asked if and how often they had been a perpetrator of cyberbullying. Had they sent rude or nasty comments to anyone, spread rumours or sent aggressive or threatening messages online?

A year later when the students had entered Year 9 (aged 13-14) students were asked a range of questions about their experiences and feelings from the previous two weeks and this information was used to create scores for signs of depression, social anxiety and poor mental well-being.

Involvement in cyberbullying

More than 40% of the students reported involvement in cyberbullying in the previous 12 months – 13.6% as cybervictims, 8.2% as cyberbullies and 20.4% as cyberbully-victims. Girls were a lot less likely than boys to fall into the latter category.

Around a quarter of all the young people interviewed showed signs of depression and/or social anxiety and here, with girls more likely than boys to report these symptoms and have lower levels of well-being.

Victims of cyberbullying were almost twice as likely as the completely uninvolved youngsters to show signs of depression even after taking a range of background factors into account. The effect stayed strong even after we accounted for them having poor mental health when they joined the study age 11-12.

Those who reported both being bullied and doing the bullying were more than twice as likely as those who were completely uninvolved to be depressed, whilst those who said they had only been involved in bullying were no more or less depressed than their uninvolved peers.

Damaging effects

The findings for social anxiety and lower levels of well-being were similar to the findings for depression, providing us with a clear picture of the damaging psychological impacts of cyberbullying for victims and for those who were both bullied and perpetrators themselves of cyber bullying.

With 4 out of ten children of this age involved in some way with cyberbullying and given that our results showed that even low level experiences of cyberbullying can have harmful effects over time, it is key that all those involved in the care, education and well-being young adolescents have a grasp of the issues involved and the tools to reduce and prevent its occurrence where possible. Our research indicates that boys and young people who are both victims and bullies are important groups to target.

Longitudinal Associations Between Cyberbullying Involvement and Adolescent Mental Health is research by Amanda Fahy, Stephen Stannsfeld, Melanie Smuk, Neil Smith, Steven Cummins and Charlotte Clark. It is published in the Journal of Adolescent Health.

Photo credit: bad-cyberbully, Winning Information

Giving children the best possible start – what matters most?

Child of our Time Editor Yvonne Kelly spoke to a 500-strong audience of politicians and professionals in Gothenburg recently on what matters when it comes to giving children the best possible start in life.

Yvonne was the keynote speaker at the conference hoping to identify the best strategies for making Gothenburg a more equal and socially sustainable city.

Yvonne, Professor of Lifecourse Epidemiology at the ESRC International Centre for Lifecourse Studies at UCL  explained which factors are most closely linked with a child’s health and well-being and presented her research findings on children’s verbal skills, behaviour, bedtimes, reading and obesity.

Putting a SPRING in the step of mums-to-be

Making sure that mums-to-be are in the best possible health is key to ensuring their baby gets the best possible start in life. But what sorts of things can help them achieve that? In this episode of the Child of our Time Podcast, Professor Hazel Inskip from the MRC Lifecourse Epidemiology Unit at the University of Southampton, talks about an ongoing trial making use of healthy conversations and Vitamin D supplements to try to improve the diet of just pregnant women.

Photo credit: Pregnant, Frank de Kleine