Nina Lucas

Risk Factors for Childhood Mental Health Symptoms: National Longitudinal Study of Australian Children

OBJECTIVE: To determine predictors of child externalizing (behavioral) and internalizing (emotional) symptoms in a national population sample. METHODS: Data were collected in 3 biennial waves (2004, 2006, and 2008) from 2 cohorts in the Longitudinal Study of Australian Children, initially including 5107 children 0 to 1 year of age and 4983 children 4 to 5 years of age. The primary outcomes were child externalizing and internalizing symptoms. Relationships between potential risk factors and child mental health outcomes were described by using linear regression. RESULTS: In unadjusted analyses, childrens mental health symptoms were predicted by a large number of risk factors. In multivariate models, early childhood factors (birth through 5 years) explained 30% and 18% of variations in externalizing and internalizing symptoms, respectively, at 4 to 5 years of age. Middle childhood (5–9 years of age) factors explained 20% and 23% of variations in externalizing and internalizing symptoms, respectively, at 8 to 9 years of age. Harsh discipline was a strong consistent predictor of externalizing symptoms in both age groups, whereas poorer child physical health, maternal emotional distress, harsh discipline, and overinvolved/protective parenting (younger cohort only) predicted internalizing symptoms consistently. CONCLUSIONS: National data on predictors of child mental health symptoms highlighted a small number of significant risk factors, situated in the family context and present from a very young age. This knowledge is informing population-level, randomized, prevention trials of family support programs.

Socioeconomic inequality profiles in physical and developmental health from 0–7 years: Australian National Study

Background Early and persistent exposure to socioeconomic disadvantage impairs childrens health and wellbeing. However, it is unclear at what age health inequalities emerge or whether these relationships vary across ages and outcomes. We address these issues using cross-sectional Australian population data on the physical and developmental health of children at ages 0–1, 2–3, 4–5 and 6–7 years. Methods 10 physical and developmental health outcomes were assessed in 2004 and 2006 for two cohorts each comprising around 5000 children. Socioeconomic position was measured as a composite of parental education, occupation and household income. Results Lower socioeconomic position was associated with increased odds for poor outcomes. For physical health outcomes and socio-emotional competence, associations were similar across age groups and were consistent with either threshold effects (for poor general health, special healthcare needs and socio-emotional competence) or gradient effects (for illness with wheeze, sleep problems and injury). For socio-emotional difficulties, communication, vocabulary and emergent literacy, stronger socioeconomic associations were observed. The patterns were linear or accelerated and varied across ages. Conclusions From very early childhood, social disadvantage was associated with poorer outcomes across most measures of physical and developmental health and showed no evidence of either strengthening or attenuating at older compared to younger ages. Findings confirm the importance of early childhood as a key focus for health promotion and prevention efforts.

Psychological Distress in Non-Drinkers: Associations with Previous Heavy Drinking and Current Social Relationships

AIMS The aim of this paper is to investigate two possible explanations for the higher levels of psychological distress observed among alcohol abstainers relative to light and moderate drinkers, and to investigate possible moderating effects of age on this association. The possible explanations were that: (i) the higher level of psychological distress among abstainers is due to the presence of a subset of former heavy drinkers in this group; and (ii) abstainers have poorer social relationships than light/moderate drinkers. METHODS A national cross-sectional survey yielded data from 2856 Australians aged 20-22, 30-32 and 40-42 years (response rate 15.9%). RESULTS The sample was representative for many socio-demographic factors but under-represented people not in the labour force and over-represented those with university qualifications. In the oldest but not the younger age groups, abstainers reported significantly higher psychological distress relative to light/moderate drinkers. While abstainers in the oldest age group who were former heavy drinkers showed the highest levels of distress, excluding them from the analysis did not account for differences in distress between current abstainers and light/moderate drinkers. Abstainers aged 40-42 years were less socially integrated, less extraverted and had lower social support than light/moderate drinkers, and controlling for these factors partially explained their increased distress. CONCLUSIONS Significantly increased psychological distress of abstainers compared to light/moderate drinkers was demonstrated only in the oldest age group (40-42 years). The higher distress reported by abstainers in this age group was partially explained by abstainers having poorer social relationships than light/moderate drinkers.

Primary healthcare costs associated with sleep problems up to age 7 years: Australian population-based study

Objectives In Australian 0–7-year olds with and without sleep problems, to compare (1) type and costs to government of non-hospital healthcare services and prescription medication in each year of age and (2) the cumulative costs according to persistence of the sleep problem. Design Cross-sectional and longitudinal data from a longitudinal population study. Setting Data from two cohorts participating in the first two waves of the nationally representative Longitudinal Study of Australian Children. Participants Baby cohort at ages 0–1 and 2–3 (n=5107, 4606) and Kindergarten cohort at ages 4–5 and 6–7 (n=4983, 4460). Measurements Federal Government expenditure on healthcare attendances and prescription medication from birth to 8 years, calculated via linkage to Australian Medicare data, were compared according to parent report of child sleep problems at each of the surveys. Results At both waves and in both cohorts, over 92% of children had both sleep and Medicare data. The average additional healthcare costs for children with sleep problems ranged from

Oral health inequalities in a national sample of Australian children aged 2–3 and 6–7 years

141 (age 5) to

Healthcare costs associated with language difficulties up to 9 years of age: Australian population-based study.

43 (age 7), falling to

Community-based healthcare costs for children born low birthweight, preterm and/or small for gestational age: Data from the longitudinal study of Australian children

98 (age 5) to

The cost of healthcare for children with mental health difficulties

18 (age 7) per child per annum once family socioeconomic position, child gender, global health and special healthcare needs were taken into account. This equates to an estimated additional

Health-care costs of underweight, overweight and obesity: Australian population-based study

27.5 million (95% CI

Primary health-care costs associated with special health care needs up to age 7 years: Australian population-based study

9.2 to