Primary schools and the amplification of social differences in child mental health: a population based cohort study

Louise Marryat, Lucy Clare Thompson, Helen Minnis, Philip Wilson

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Abstract

Background This paper examines socioeconomic inequalities in mental health at school entry and explores changes in these inequalities over the first 3 years of school.

Methods The study utilises routinely collected mental health data from education records and demographic data at ages 4 and 7 years, along with administrative school-level data. The study was set in preschool establishments and schools in Glasgow City, Scotland. Data were available on 4011 children (59.4%)at age 4 years, and 3166 of these children were followed at age 7 years (46.9% of the population). The main outcome measure was the teacher-rated Goodman’s Strengths and Difficulties Questionnaire (4–16 version) at age 7 years, which measures social, emotional and behavioural difficulties.

Results Children living in the most deprived area had higher levels of mental health difficulties at age 4 years, compared with their most affluent counterparts (7.3%vs4.1% with abnormal range scores). There was a more than threefold widening of this disparity over time, so that by the age of 7 years, children from the most deprived area quintile had rates of difficulties 3.5 times higher than their more affluent peers. Children’s demographic backgrounds strongly predicted their age 7 scores, although schools appeared to make a significant contribution to mental health trajectories.

Conclusions Additional support to help children from disadvantaged backgrounds at preschool and in early primary school may help narrow inequalities. Children from disadvantaged backgrounds started school with a higher prevalence of mental health difficulties, compared with their more advantaged peers, and this disparity widened markedly over the first 3 years of school.
Original languageEnglish
Pages (from-to)27-33
Number of pages7
JournalJournal of Epidemiology and Community Health
Volume72
Issue number1
Early online date22 Oct 2017
DOIs
Publication statusPublished - Jan 2018

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Mental Health
Cohort Studies
Population
Vulnerable Populations
Demography
Child Health
Scotland
Health Education
Health Status
Outcome Assessment (Health Care)

Cite this

@article{1a5eb900f1c344ddbe630030d36f8cd9,
title = "Primary schools and the amplification of social differences in child mental health: a population based cohort study",
abstract = "Background This paper examines socioeconomic inequalities in mental health at school entry and explores changes in these inequalities over the first 3 years of school.Methods The study utilises routinely collected mental health data from education records and demographic data at ages 4 and 7 years, along with administrative school-level data. The study was set in preschool establishments and schools in Glasgow City, Scotland. Data were available on 4011 children (59.4{\%})at age 4 years, and 3166 of these children were followed at age 7 years (46.9{\%} of the population). The main outcome measure was the teacher-rated Goodman’s Strengths and Difficulties Questionnaire (4–16 version) at age 7 years, which measures social, emotional and behavioural difficulties.Results Children living in the most deprived area had higher levels of mental health difficulties at age 4 years, compared with their most affluent counterparts (7.3{\%}vs4.1{\%} with abnormal range scores). There was a more than threefold widening of this disparity over time, so that by the age of 7 years, children from the most deprived area quintile had rates of difficulties 3.5 times higher than their more affluent peers. Children’s demographic backgrounds strongly predicted their age 7 scores, although schools appeared to make a significant contribution to mental health trajectories.Conclusions Additional support to help children from disadvantaged backgrounds at preschool and in early primary school may help narrow inequalities. Children from disadvantaged backgrounds started school with a higher prevalence of mental health difficulties, compared with their more advantaged peers, and this disparity widened markedly over the first 3 years of school.",
author = "Louise Marryat and Thompson, {Lucy Clare} and Helen Minnis and Philip Wilson",
note = "Funding The study was funded by the Scottish Government, Glasgow City Council and the Gillberg Neuropsychiatry Centre. LM is supported by the Farr Institute @ Scotland, which is supported by a 10-funder consortium: Arthritis Research UK, the British Heart Foundation, Cancer Research UK, the Economic and Social Research Council, the Engineering and Physical Sciences Research Council, the Medical Research Council, the National Institute of Health Research, the National Institute for Social Care and Health Research (Welsh Assembly Government), the Chief Scientist Office (Scottish Government Health Directorates), (MRC Grant No: MR/K007017/1). LM sits in the Scottish Collaboration for Public Health Research and Policy, which is funded by MRC grant MR/K023209/1. Competing interests None declared. Provenance and peer review Not commissioned; externally peer reviewed. Data sharing statement Data are owned by Glasgow City Council Education Services and are not currently publicly available.",
year = "2018",
month = "1",
doi = "10.1136/jech-2017-208995",
language = "English",
volume = "72",
pages = "27--33",
journal = "Journal of Epidemiology and Community Health",
issn = "0143-005X",
publisher = "BMJ Publishing Group",
number = "1",

}

TY - JOUR

T1 - Primary schools and the amplification of social differences in child mental health

T2 - a population based cohort study

AU - Marryat, Louise

AU - Thompson, Lucy Clare

AU - Minnis, Helen

AU - Wilson, Philip

N1 - Funding The study was funded by the Scottish Government, Glasgow City Council and the Gillberg Neuropsychiatry Centre. LM is supported by the Farr Institute @ Scotland, which is supported by a 10-funder consortium: Arthritis Research UK, the British Heart Foundation, Cancer Research UK, the Economic and Social Research Council, the Engineering and Physical Sciences Research Council, the Medical Research Council, the National Institute of Health Research, the National Institute for Social Care and Health Research (Welsh Assembly Government), the Chief Scientist Office (Scottish Government Health Directorates), (MRC Grant No: MR/K007017/1). LM sits in the Scottish Collaboration for Public Health Research and Policy, which is funded by MRC grant MR/K023209/1. Competing interests None declared. Provenance and peer review Not commissioned; externally peer reviewed. Data sharing statement Data are owned by Glasgow City Council Education Services and are not currently publicly available.

PY - 2018/1

Y1 - 2018/1

N2 - Background This paper examines socioeconomic inequalities in mental health at school entry and explores changes in these inequalities over the first 3 years of school.Methods The study utilises routinely collected mental health data from education records and demographic data at ages 4 and 7 years, along with administrative school-level data. The study was set in preschool establishments and schools in Glasgow City, Scotland. Data were available on 4011 children (59.4%)at age 4 years, and 3166 of these children were followed at age 7 years (46.9% of the population). The main outcome measure was the teacher-rated Goodman’s Strengths and Difficulties Questionnaire (4–16 version) at age 7 years, which measures social, emotional and behavioural difficulties.Results Children living in the most deprived area had higher levels of mental health difficulties at age 4 years, compared with their most affluent counterparts (7.3%vs4.1% with abnormal range scores). There was a more than threefold widening of this disparity over time, so that by the age of 7 years, children from the most deprived area quintile had rates of difficulties 3.5 times higher than their more affluent peers. Children’s demographic backgrounds strongly predicted their age 7 scores, although schools appeared to make a significant contribution to mental health trajectories.Conclusions Additional support to help children from disadvantaged backgrounds at preschool and in early primary school may help narrow inequalities. Children from disadvantaged backgrounds started school with a higher prevalence of mental health difficulties, compared with their more advantaged peers, and this disparity widened markedly over the first 3 years of school.

AB - Background This paper examines socioeconomic inequalities in mental health at school entry and explores changes in these inequalities over the first 3 years of school.Methods The study utilises routinely collected mental health data from education records and demographic data at ages 4 and 7 years, along with administrative school-level data. The study was set in preschool establishments and schools in Glasgow City, Scotland. Data were available on 4011 children (59.4%)at age 4 years, and 3166 of these children were followed at age 7 years (46.9% of the population). The main outcome measure was the teacher-rated Goodman’s Strengths and Difficulties Questionnaire (4–16 version) at age 7 years, which measures social, emotional and behavioural difficulties.Results Children living in the most deprived area had higher levels of mental health difficulties at age 4 years, compared with their most affluent counterparts (7.3%vs4.1% with abnormal range scores). There was a more than threefold widening of this disparity over time, so that by the age of 7 years, children from the most deprived area quintile had rates of difficulties 3.5 times higher than their more affluent peers. Children’s demographic backgrounds strongly predicted their age 7 scores, although schools appeared to make a significant contribution to mental health trajectories.Conclusions Additional support to help children from disadvantaged backgrounds at preschool and in early primary school may help narrow inequalities. Children from disadvantaged backgrounds started school with a higher prevalence of mental health difficulties, compared with their more advantaged peers, and this disparity widened markedly over the first 3 years of school.

U2 - 10.1136/jech-2017-208995

DO - 10.1136/jech-2017-208995

M3 - Article

VL - 72

SP - 27

EP - 33

JO - Journal of Epidemiology and Community Health

JF - Journal of Epidemiology and Community Health

SN - 0143-005X

IS - 1

ER -