Tag Archives: Well-being

Being drunk – aged 11

Better understanding why very young people start drinking has been a recent focus for the team at the ESRC International Centre for Lifecourse Studies at UCL. Research published earlier this year by the team showed that one in seven 11 year-olds said they had drunk alcohol and indicated strong ties with having friends who drank and also mums who drank. Now the researchers, led by Yvonne Kelly, have taken the work a step further to see which 11 year-olds are binge drinking or getting drunk. The work will be presented next month at an event  for those interested in the links between alcohol and health. 

Young people who drink heavily do worse at school, are more likely to engage in other risky behaviours such as smoking and taking drugs and die earlier than their non drinking peers. That’s been shown. But when we talk about young people, we are mostly referring to people in their late teens and early 20s.

There has been little research looking at drinking among very young adolescents, nor has much been done to look at what factors influence heavy drinking in our children and young people.

Closing the evidence gap

Our work using the Millennium Cohort Study has gone some way to closing that gap in the evidence we need to help us gain a clearer picture of just who is drinking alcohol at a very young age and what might be behind that.

Having looked at how widespread the problem might be, how family and friends fit into the picture and how 11 year-olds perceive the risks, we wanted to dig a little more deeply and focus more closely on the group of children who are binge drinking and getting drunk.

With a study as large as the Millennium Cohort Study, we have detailed information on more than 11,000 children. This means we can look at the individual and family factors connected to the issue in a meaningful and robust way.

It was reassuring to find that only 1.2 per cent (around 120) of 11 year-olds in the study reported having been drunk, with 0.6 per cent (60) of them saying they had drunk 5 or more alcoholic drinks in a single episode.

Many would argue though, that, given the serious health consequences associated with drinking at a young age, the fact that one in every hundred of UK 11 year-olds has been drunk at some point is still a matter of considerable concern.

Who is drunk at 11?

So who amongst our 11 year-old children is getting drunk? Our analysis showed that boys were twice as likely as girls to report being drunk, as were children with social and emotional problems. Truanting children were six times more likely and smokers 15 times more likely to report heavy drinking.

Interesting to us was the fact that neither mum’s nor dad’s drinking seemed to have any influence here. This was interesting in its own right, but also because our earlier research showed quite a strong link between 11 year-olds who drank any alcohol at all and mums who drank moderately or heavily. Heavy drinking was, however, reported by children who said they did not have a close relationship with their mum.

A link that did stay strong as we dug further into this question of who drinks heavily and gets drunk, was that with friends who drank. In other words, children who had friends who drank alcohol were 5 times more likely to get drunk themselves than those children who did not have drinking friends.

Perception of risk

The children we looked at were considerably less likely to get drunk if they believed strongly that drinking 1-2 alcoholic drinks each day could be harmful. So, a heightened perception of the potential harms of drinking alcohol were key here.

Our findings seem to mirror those of a recent school-based survey of 11-13 year olds in the UK, which reported 0.4 per cent had binge drunk. They also seem to point to the fact that heavy drinking in this age group is most likely to occur in peer group settings.

As the Millennium Cohort Study continues to track these children in years to come, we will gain an even clearer understanding of the consequences of heavy drinking at such a young age.

For all those concerned with the health and wellbeing of children today and in the future, there are some pointers here about areas for focus in tackling the problem including helping children understand the potential harms and empowering them to say no to alcohol regardless of any putative benefits they or their friends might perceive.

Request an invitation to the Alcohol and Health policy seminar which takes place on June 21, 2016.

Photo credit: Thom Sanders

 

 

Who are the 11 year old drinkers?

The number of young people who say they drink alcohol has recently fallen. But the teenage years are still the time most of us start drinking. Drinking can be linked to other types of risky adolescent behaviour and, later in life, alcohol remains a major risk factor for illnesses such as heart attacks, cancer and diabetes. Most research to date has focused on the later teenage years, but a new study published in BMC  Public Health has taken a close look at children in early adolescence. Professor Yvonne Kelly at the ESRC International Centre for Lifecourse Studies at UCL examines the circumstances in which children first explore alcohol and what this can tell public health professionals keen to counter the most damaging effects.  

The Department of Health guidelines are clear; children aged 16 or less should not drink alcohol. But they do and many parents fear absolute prohibition will lead to secret drinking and a loss of trust in the relationship. It would appear to be common sense, too, that a child drinking a small amount of watered-down wine with a family meal would be likely to develop quite different later adolescent behaviours to a child swigging vodka with friends in a bus shelter. Common sense it might be, but there has been little robust research around this.

The broad aim of our research was to examine influences on the emergence of exploratory drinking at the start of adolescence. We focused on two specific questions:

  1. Are parents’ and friends’ drinking important influences on drinking among 11 year-olds?
  2. What is the role of perceptions of risk, expectancies towards alcohol, parental supervision and family relationships on the likelihood of 11 year-olds drinking?

We made use of the detailed and rich data available in the Millennium Cohort Study (MCS), which has followed the lives of nearly 20,000 children born between 2000-2002.

Drinking habits

At age 11, just under 14% of MCS children said they drank alcohol. Based on their own reported drinking frequency, parents were grouped into three categories: non-drinkers, light to moderate drinkers and heavy or binge drinkers. Around 20% of mums and 15% of dads were non-drinkers. Around 60% of mums and dads were light or moderate drinkers. About a quarter of dads and just over a fifth of mums were heavy or binge drinkers. When asked whether their friends drank, 78% of MCS children said “no”.

The children were also asked about other risky behaviours such as smoking or truanting and what they felt about their family. These factors were taken into account to enable us to focus in on the effect of parents’ or friends’ drinking.

Compared to children whose mums did not drink, children whose mums were light or moderate drinkers had a 60% increased risk of drinking at 11, while those whose mums were heavy or binge drinkers had an 80% increased risk. A father’s drinking appeared to have about half as much impact, regardless of whether he was a light to moderate or heavy/binge drinker. Children who said their friends drank were more than four times as likely to drink themselves as those children with friends who didn’t drink.

Home life and perceptions of alcohol

When we looked at home life, predictably those children who reported being happy were less likely to drink than those who reported frequent family battles. Where there were low levels of parental supervision combined with a dad who drank heavily, the risk of the child drinking was, again, higher.

A child’s view about the harms of alcohol also seemed to be an important factor. The more dangerous a child thought alcohol to be, the less likely they were to drink. Children who did not see drinking alcohol as a risky activity and who also had a heavy drinking mum were much more likely to be drinking alcohol at 11.

It is not possible to make statements regarding cause and effect with this sort of study, but the numbers do show us a strong association between 11 year-olds drinking and their friends’ and mothers’ behaviour. Family relationships, perceptions of risk and expectations regarding alcohol are important, too, as are some more general characteristics of the family unit.

So, what does this tell us about the risks of drinking at 11 and how to counter those risks? The fact that likely causes of early drinking are multiple, means that counter measures need, similarly, to be aimed at a number of different aspects of a child’s life. One size will not fit all.

Advice, information and guidance

Children certainly need to have a better understanding of the risks involved in drinking. Schools and parents are clearly well placed to provide the best advice, information and guidance to children of this age, but these robust new findings can play an important role in helping to shape the focus of those discussions.

Whilst the vast majority of children at the age of eleven are yet to explore alcohol, investigating in more detail the context in which children drink – who they drink with, where, when, what they drink and how they acquire alcohol – could help inform effective policy and alcohol harm prevention strategies to mitigate the risk associated with drinking as a young person.

Public health policy should take all these factors into account, driving measures that would address parents and peer groups, popular perceptions, marketing and advertising, pricing, availability and the enforcement of age restrictions.

Further information

What influences 11-year-olds to drink? Findings from the Millennium Cohort Study is research by Yvonne Kelly, Alice Goisis, Amanda Sacker, Noriko Cable, Richard G Watt and Annie Britton and is published in BMC Public Health.

  • Read the press release and access contact details if you are a member of the media
  • Listen to Yvonne’s talk on the research at a recent ICLS Policy Seminar
  • Find out about forthcoming ICLS Policy seminar on Tuesday, 21 June 2016, focusing on what evidence longitudinal/lifecourse studies can bring to the current debate on “safe” drinking levels and what drives people to start, stop or cut back on drinking. Email icls@ucl.ac.uk for more information and to be added to the mailing list.

Photo credit: Jes

 

Are our children’s human rights equally protected?

It’s time to stop hitting our children and give them the same human rights protection afforded to adults says an important new report published by the NSPCC today. The report, which reviews all the available evidence on the impacts of physical punishment on children has been compiled by a team of academics at UCL: Dr Anja Heilmann, Professor Richard Watt and Child of our Time co-editor Professor Yvonne Kelly. Consultant paediatrician Dr Lucy Reynolds told us what she makes of the report and the impact she hopes it will have on policy makers, her colleagues in the medical profession, parents and children themselves.

Equally Protected? A review of the evidence on the physical punishment of children was commissioned by NSPCC Scotland, CHILDREN 1st, Barnardo’s Scotland and the Children and Young People’s Commissioner Scotland.

Photo credit: Paediatrician, UW Health

We know enough now to stop hitting our children

Despite a steady decline in recent decades, the physical punishment of children remains common in British homes. The UK is one of only five countries in the European Union which has not committed to outlawing all physical punishment. British children have less protection from physical violence than adults – a clear violation of international human rights law. And, as a new study commissioned by a group of children’s charities shows, there’s ample evidence physical punishment can damage children and escalate into physical abuse. Author of the report, Dr Anja Heilmann from University College London makes the case for urgent action:

Sadly, it’s only the most extreme forms of child maltreatment that have dominated the headlines in recent years. As far as the media is concerned, there is a dearth of in-depth coverage of the issue of physical punishment, whilst UK governments have not implemented the kind of legal reform that has been happening in countries across the world.

Though there are variations between the nations of the UK, broadly all allow a defence of ‘reasonable punishment’ to a parent accused of lesser physical assault of a child in their care. In Scotland, the defence is one of ‘justifiable assault’.

In 2008, the Scottish Government said :

‘the current position ensures that the law gives children sufficient protection without unnecessarily criminalising parents who lightly smack their child.’

This position, however, is at odds with the substantial evidence base.

Much new research

Internationally, the past decade has seen a surge in the number of studies on the prevalence and outcomes of the physical punishment of children. The most recent substantial review in the UK was a 2008 study in Northern Ireland.

Our aim was to summarise the evidence that has become available since then. To do this we reviewed relevant studies published in English between January 2005 and June 2015. For a definition of physical punishment we used that provided by the United Nations Convention on the Rights of the Child:

‘Corporal’ or ‘physical’ punishment is any punishment in which physical force is used and intended to cause some degree of pain or discomfort, however light.’     

We defined a ‘child’ as anyone under 18. Our initial search yielded more than 1500 returns. We narrowed these down to 98 for in-depth review.

Clear evidence of negative effects

The good news is that the physical punishment of children is in decline. One study found that in 1998 in the UK, 61% of young adults reported having been smacked as a child, while in 2009 this was true for 43%.

Public attitudes have also shifted with the use of physical punishment becoming less and less acceptable and a higher proportion of parents doubting its usefulness.

On a less positive note, we found clear evidence of physical punishment continuing to lead to serious negative outcomes for the child. Four-fifths of the relevant studies found physical punishment was related to increased aggression, delinquency and other anti-social behaviour.

One study in Scotland found that children who had been smacked during their first two years of life were more than twice as likely to have emotional and behavioural problems at age 4 than children who had not been smacked. There was evidence that the more physical punishment suffered by a child, the worse the subsequent problem behaviour.

The evidence suggests that physical punishment is still harmful even when administered in a generally loving and positive family environment – the “loving smack” might be a myth. In addition, all studies that tested it found a link between physical punishment and more serious child maltreatment.

The negative effects continue into adulthood. Again, four out of five relevant studies suggest a link between childhood physical punishment and adult aggression and antisocial behaviour. One large study in the US found that participants who had been physically punished as children were 60% more likely to suffer alcohol or drug dependence.

Legislate and communicate

Though the UK is in a minority in allowing physical punishment, it is not alone. We also looked at five European countries with varying legislative regimes. In all we found a large and growing majority of parents striving to rear their children without physical punishment.

Those countries which had both legislated to give children equal protection against assault and promoted intensive, long-term campaigns of public education had been more effective in changing attitudes and behaviours than those which had pursued either strategy alone.

The international approach to children’s rights is clear: they should be equal to those of adults. The United Nations Convention on the Rights of the Child, which states that all steps to protect children from physical violence should be taken, has been ratified by the UK. And the UK’s continuing failure to explicitly prohibit all corporal punishment in the home has been criticised by the committee that monitors implementation of the Convention.

Act now

“Further research needed” is often one recommendation coming out of a study like this. And there is still a need to know more, for instance, about the efficacy of measures to reduce the incidence of childhood physical punishment.

But no more research is needed to tell us that physical punishment has the potential to damage children and carries the risk of escalation into physical abuse. Our conclusions only reinforce the findings of the 2008 Northern Ireland study.

We need legislation now. And legislation backed up by a large-scale information and awareness campaign.

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.

Photo credit: ellyn.

 

Can racism towards a mum hurt her children?

Racial discrimination affects people in a range of ways. We know, for instance, that it can lead to poor health. We know, too, that our lives are linked, particularly with those of family members. So, can racism suffered by a parent affect a child? Are the negative effects of social ills transmitted within families? If so, how? And how might we be able to break negative links? A new study reveals some interesting patterns and possible explanations, as Dr Laia Becares from the University of Manchester, explains:

Understanding how our lives are linked is an essential part of understanding how society works. We know that racial discrimination affects the health and life chances of an individual, and it leads to inequalities in health among ethnic minority people, compared to the White majority population.

We know, too, that racial discrimination experienced by one individual impacts not only on that particular person, but on family members of the same generation, and those of previous and future generations. For example, if someone is discriminated against at work in terms of a promotion to a better position, or even in terms of getting hired, this has clear important financial consequences for that person, but also for her/his children, and older family members who may be under their care.

This is one of the ways in which the harm of racial discrimination is perpetuated across generations. Socioeconomic circumstances are strongly linked to health, so this example also shows how racial discrimination leads to poor health indirectly – via socioeconomic inequalities.

Racism and our health

But what about the direct association between racial discrimination and poor health, and the way this harm is transmitted across generations?

The Millennium Cohort Study (MCS), a representative study of children born in the UK between September 2000 and January 2002, offers a quality and quantity of data that, with the right interrogation, offers some important suggestions.

To ask the right questions of the data we needed a hypothesis. Drawing on well-established literature, we chose to focus on two potential mechanisms of transmission.

First we looked at the possible impact of racial discrimination on a mother’s mental health and then at the possible impact on parenting practice, particularly the possibility of it increasing harsh discipline tactics. These two mechanisms are centred on increased stress experienced by the mother following experiences of racial discrimination.

We also looked at three different types of exposure to racial discrimination – that suffered by the mother, that suffered by the family as a whole and that affecting the whole neighbourhood.

Information about the MCS children has been collected at various points since the start of the study. We used data collected when the children were between five and eleven years old.

Measuring discrimination

Racial discrimination was measured in terms of the mother’s experience of racially motivated insults, disrespectful treatment, or unfair treatment. We also used measures of whether family members had been treated unfairly, and whether the family lived in a neighbourhood where racial insults or attacks were common.

Mental health was assessed using the Kessler-6 scale – a well-established scale based on how often an individual has felt such things as depression and nervousness over the past month.

We measured harsh parenting practices by using records of how often parents had smacked or shouted at their children. And we measured the child’s socioemotional development by using another well-established scale – the Strengths and Difficulties Questionnaire developed by Robert Goodman and others.

We adjusted for complicating factors such as mother’s age at time of birth, mother’s educational attainment, household income, whether the mom was born in the UK, and the language most often spoken in the home.

For each factor we used data gathered at relevant stages. So, the measure of racial discrimination is based on data collected when the children were five years old, the mother’s mental health and parenting practices when the children were seven years old and the outcome when the children were aged eleven. The sample was pooled from all UK ethnic minority groups.

Racism and mental health

Around the time of the child’s fifth birthday almost a quarter (23%) of ethnic minority mothers reported having been racially insulted. There was a strong association with less good mental health for the mother two years later.

Both increased maternal psychological distress and increased harsh parenting practices were associated with increased socioemotional difficulties for the child at age 11. A worsening of the mother’s mental health had the most consistent indirect effect on a child’s socioemotional difficulties six years later.

Our results also showed some direct effects of racial discrimination on children. Family experiences of unfair treatment all had a direct effect on a child’s later socioemotional development.

We have to acknowledge some limitations of the study. We restricted ourselves to discrimination faced by mothers and its consequences. There are other things going on in families that affect children’s health. Plus ethnic minority children are likely to experience discrimination directly at school. And, of course, ethnic minority families are more likely to live in deprived areas and to suffer from other social inequalities.

Damage over time underestimated

The study does, however, offer strong support to our hypothesis that a mother’s experience of racial insults, of being treated disrespectfully by shop staff and broader family experience of unfair treatment, harms children over time as a result of the mother’s worsening mental health. This has been underestimated in the past.

If we are to break cycles of deprivation and begin to redress the imbalances in health between the majority and minority populations, policy-makers would do well to put more emphasis on mothers’ mental health.

Whatever is done to reduce a child’s direct experience of racial discrimination – at school, for instance – the mother’s experience and its effect on her is now shown to be important factor in the health of ethnic minority children. That said, the main implication of this study is that racial discrimination is harmful to individuals, families, and societies, and so efforts should be targeted at eliminating it.

A longitudinal examination of maternal, family, and area-level experiences of racism on children’s socioemotional development: Patterns and possible explanations is research by Dr Laia Becares, Professor James Nazroo and Professor Yvonne Kelly and is published in Social Science and Medicine.

Photo credit: moinuddin forhad

How racism hurts

Three compelling short films showing the devastating impact of racism on the health and development of children and adults have been published as part of a project funded by the University of Manchester. The videos, which use performance poetry and film to share the findings from important recent research, are a collaboration between performance poet, Yusra Warsama, researcher, Laia Becares and visual artist, Mauro Camal. The team hopes the films will raise awareness of the harm caused by racial discrimination and that they will contribute to equal health and life chances for all. 

Screaming Targets

Calloused Tongue

You keep digging from your throne

Photo credit: VoxEfx

Parenting before and after separation

Do more involved dads have more contact with their child in the event of a separation? And does a mother’s confidence in her ability as a parent take a knock on separation? Researchers Professor Lucinda Platt from the London School of Economics and Political Science and Dr Tina Haux from the University of Kent  have been investigating these questions, using the Millennium Cohort Study, in a Nuffield Foundation funded research project looking at parenting before and after separation.

 

Photo credit: Dani Vazquez

Middle-aged couch potatoes ‘planted’ 30 years earlier

Parents should routinely switch off the TV and take young children out for a walk or some other exercise in order to increase their chances of growing up to be fit, healthy adults, new research suggests.

And if it isn’t feasible to go outside, children could perhaps be encouraged to play interactive video games that involve physical activity.

Researchers at University College London have reached these conclusions after comparing the TV viewing habits of more than 6,000 British people at age 10 and age 42.

The study revealed that children who watched a lot of TV at age 10 were much more likely to spend more than three hours a day in front of the screen at age 42 than those who had watched relatively little television in childhood.

Eighty-three per cent of the 1,546 cohort study members who reported watching more than three hours of TV at 42 had also watched TV “often” at age 10.

The study also showed that 42-year-olds who watched TV for at least three hours a day were more likely to be in only “fair” or “poor” health and to report that they were either overweight or obese.

They were also more likely to have had fathers who were overweight and in routine or manual jobs at the age 10 survey. The sons and daughters of manual workers were, in fact, twice as likely as managers’ children to watch more than three hours of TV a day at 42, even after their own educational qualifications had been taken into consideration.

The researchers analysed information collected by the British Cohort Study, which is following the lives of people born in England, Scotland and Wales in the same week of 1970. The cohort study is managed by the IOE’s Centre for Longitudinal Studies (CLS) and is funded by the Economic and Social Research Council.

“The problems that we have identified are not experienced exclusively by working-class families,” Dr Mark Hamer, one of the UCL researchers, will tell the CLS research conference in London today (March 16).

“However, parents from a lower socio-occupational class are more likely to be physically active at work and may compensate for this by spending more time sitting down during their leisure hours. Their children may then model their mothers’ and fathers’ leisure activity patterns.

“It is important that children keep active. And if they can be encouraged to participate in sports, so much the better.”

Previous research has suggested that parental participation in physical activity may be a predictor of childhood activity levels. The UCL study is, however, believed to be the first to use a large, representative birth cohort to identify childhood factors that are associated with television viewing habits in middle age.

“Our work indicates that parents’ health-related behaviours may at least partly influence children’s TV viewing habits more than three decades later,” Dr Hamer says. “This has important implications for policy and practice.

“It suggests that interventions to reduce passive TV viewing time should target children and their parents. Such initiatives could not only help today’s children but help to reduce passive TV viewing in future generations.

“That could be extremely beneficial as research has also shown that TV viewing is associated with other health-risk behaviours, such as the consumption of energy-dense foods and cigarette smoking. Prolonged TV viewing has also been linked to type 2 diabetes and cardiovascular disease.”

The paper that will be presented at the CLS conference is “Childhood correlates of adult TV viewing time: a 32-year follow-up of the 1970 British Cohort Study”, by Lee Smith, Ben Gardner and Mark Hamer of UCL’s Department of Epidemiology and Public Health. It will be published in a future issue of the Journal of Epidemiology and Community Health.

Photo credit: clarkmaxwell

What teenage girls eat

Teenage girls have the poorest diets of all according to the National Diet and Nutrition Survey with less than one in ten girls eating the recommended five-a-day fruit and vegetables.

At an ESRC International Centre for Lifecourse Studies Policy Seminar, researcher Laura Weston presents preliminary evidence from NatCen Social Research on adolescent girls’ nutrient intake and the factors that influence it.

Photo credit: Magdalena O

Further information and links

Read a full transcript of the presentation

National Diet and Nutrition Survey

Can a child’s ethnicity tell us something about asthma?

Asthma and wheezing illness are some of the most common childhood illnesses, and appear to have been on the rise in many developed countries. In the ongoing battle against them, considerable research has looked at the links with the surroundings we live in. From the effects of cold weather to dusty homes and living in polluted cities, hundreds of academics and health professionals have tried to put their finger on what external factors might be playing a role in children’s poor health.

Few researchers have looked to see whether there may be a story to tell about links with a child’s ethnicity and whether certain ethnic groups are at higher risk of wheezing illnesses. But now, as part of a wide-ranging ethnicity research project, a team based at the ESRC International Centre for Lifecourse Studies at UCL has been doing just that, as Lidia Panico explains.

About one in five British children has been diagnosed with asthma by a doctor, according to figures from the Health Survey for England, which also shows that wheezing is most common among Black Caribbean children, while Bangladeshi and Black African children suffer least.

A systematic review of UK studies has also found that South Asian children have lower rates of asthma and wheezing illnesses than the general population. In the US, Black children are twice as likely to suffer from asthma than White children. So why do these ethnic differences exist and can they inform our efforts to tackle the problem?

There are quite a few challenges around research in this area and real evidence is thin on the ground, especially when it comes to very young children. Studies have tended to group children from different ethnic backgrounds together or focus only on school age children. Numbers aside, very few studies have been able to go a step further and try to look at what might be behind any observed differences.

Background and biological factors

In our research, we made use of the Millennium Cohort Study, which has been following the health and development of some 20,000 children born in the UK around the turn of the century. This fantastic study has lots of data. This enabled us to look at a host of background and biological factors that might be at play. We looked at the children when they turned 3 years old.

We were able to look at household income, whether mum and dad had jobs and what those jobs were, mum’s age when she gave birth to the child and whether mum lived on her own.

When it came to potential biological causes, we could look to see if parents were smokers, whether the child shared his or her home with other siblings, potentially increasing the risk of catching common infections, furry pets and whether the child had been breastfed.

Other things taken into consideration were whether English was spoken at home and parents’ migration status.

Survey respondents (usually the mother) were asked whether the child had ever suffered from asthma and whether they had had problems with wheezing in the previous 12 months.

Facts and figures

Around one in ten of the children had suffered from asthma at some point while two in ten had wheezed in the last year. Around a fifth of those who had been wheezy in the last year had had more than four attacks in that period with nearly a quarter of them had their sleep disturbed by wheeze on a weekly basis.

As far as ethnic differences were concerned, Black Caribbeans were around 70 per cent more likely than their White counterparts to have had asthma ( 16.2 per cent compared with 11.6 per cent), while Bangladeshis were much less likely at 5.6 per cent.

When we looked at wheezing in the previous 12 months, more than a quarter of Black Caribbean children had suffered compared with one in five White children, so around 40 per cent more likely. Around half of the disadvantage could be explained by social and economic factors, in particular income and the receipt of benefits.

Once again Bangladeshi children were least likely to have wheezed at less than one in ten , especially if their mother was born abroad and if they were living in a bi-lingual or non-English speaking household.

Black African children had lower asthma and wheezing rates than White children, while Indian and Pakistani children had similar rates to White children.

Lower reported rates

Our research team is inclined to think that the apparent South Asian “advantage” might be due to lower reported rates among the Bangladeshi group and should not be attributed to all Asian groups.

With work in the UK and US suggesting South Asians are more likely to be hospitalised with asthma than White children, there is either a story around levels of severity or under reporting/ under diagnosis among these ethnic groups.

Our data suggests that households that would have the most problems communicating with British health services, (new migrants/those who don’t speak English a home or need the survey translated) are least likely to report asthma and wheeze.

By contrast the Black African group which has a similar migration history to the Bangladeshi group, but where English is spoken more frequently, do not show signs of under-reporting.

Migration status and language are key

In order to avoid potentially misleading reports of low asthma and wheezing illness prevalence in some ethnic groups, we should look carefully at migration history and levels of spoken English, particularly in primary care settings.

Ethnic groups are diverse in terms of the prevalence of asthma and wheezing and in their social and economic profiles.

It is also clear that child health provision needs to be carried out within the unique social, economic and cultural context of each group if progress is to be made.

Further information

Lidia Panico is a researcher based at the French Institute for Demographic Studies.

Ethnic variation in childhood asthma and wheezing illnesses: findings from the Millennium Cohort Study is research published in the International Journal of Epidemiology by Lidia Panico, Mel Bartley, Michael Marmot, James Nazroo, Amanda Sacker and Yvonne Kelly.

Photo credit: KristyFaith