BCS Physical and Mental Health and Wellbeing Barbara Maughan
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1 BCS Physical and Mental Health and Wellbeing Barbara Maughan King s College London Institute of Psychiatry
2 Aims assess key aspects of health and wellbeing informative at age 42 informative from a life-course perspective outcomes of childhood / earlier adult health or exposures early indicators of later health and ageing maintain consistency with past sweeps of BCS70 other studies: NCDS, NSHD, Understanding Society provide basis for examining secular trends / issues of policy concern overweight / obesity mental health alcohol use subjective well-being
3 Physical health
4 CLS Essential Content Physical health self-rating of general health now, and compared with a year ago current health conditions seen Dr about X in last year? registered disabled? whether health limits daily activities activities difficult to do alone health limits on type or amount of work NB keep brief at age 42
5 Additional suggestions re disabilities access to schemes to assist return to work / provide reasonable adjustments at work social model of disability cohort members views on barriers to living the life they want use of personalized forms of self / social care attitudes to role of individual vs state in provision of health care, personal responsibility for health etc
6 CLS Additional topics Physical health priority periods in hospital medium accidents medium diet medium exercise high SF-36 medium height and weight high
7 CLS Additional topics Physical health priority periods in hospital medium accidents medium diet medium exercise high SF-36/ SF-12 high generic, multi-purpose measure of physical function SF-12 used in USoc
8 CLS Additional topics Physical health priority periods in hospital medium accidents medium diet medium exercise high SF-12 high height and weight high essential for studies of overweight / obesity? self-report or measured?
9 Other possibilities for direct measurement (non-medical interviewers) NCDS Biomedical (age 45) sitting height waist and hip measurements lung function blood pressure NSHD age 43 above plus grip strength cognitive function tests
10 Pain 13% UK adults age 18+ report moderate/severe pain 2nd most common reason for work absence & incapacity benefit huge economic cost in lost work days by age 42 report of pain, over all sites, nearing its peak Assessed NCDS age 45 Same questions in BCS70 would allow assessment of trends in reporting of chronic pain in two national samples role of perinatal factors, early childhood health and adverse early life events in development of chronic pain relationship between chronic pain and parental health Instrument 3 questions on pain used in NCDS age 45
11 Assessment of Pain
12 CLS Essential Content Smoking and drinking amount smoked age started / stopped amount drunk + regularity and type Additional questions AUDIT-3 Plus units in past week purchased in shops/supermarkets units consumed on licensed premises? CAGE (alcohol problems) for comparability with prior sweeps
13 Mental health and Wellbeing
14 Mental health and well-being general mental health measures Malaise Inventory used in prior sweeps and with mothers in childhood GHQ (General Health Questionnaire) more specific mental health measures CES-D widely used, 20-item depression symptom inventory HADS (Hospital Anxiety & Depression Scale) 14-item measure of anxiety and depression includes diagnostic cut-points
15 Mental health and well-being CASP (quality of life) designed for older age-groups not appropriate at age 42
16 Mental health and well-being WEMWBS (Warwick-Edinburgh Mental Wellbeing Scale) 14-item positively-worded scale includes hedonic: subjective well-being and life satisfaction eudaimonic: psychological functioning and self-realization short version used in USoc Efficacy / life satisfaction NB important given current policy interest
17 Additional suggestions Personality Big 5 openness, conscientiousness, extraversion, agreeableness, neuroticism high priority now / soon
18 Additional suggestions Childhood adversity strong predictor / mediator of mental health outcomes associations with physical health 17-item retrospective measure included in NCDS financial difficulties parental depression / substance use family discord / parental divorce lack of affection to child neglect abuse (physical and sexual) shorter list included in Whitehall studies
19 Additional suggestions Parental warmth and affection PBI (Parental Bonding Instrument) warmth and affection psychological control extensively used world-wide 7-item versions strong predictor / mediator of mental health outcomes
20 Additional suggestions Attachment style background early relationships influence styles of relationships across the lifecourse styles: secure, avoidant, anxious, dismissing brief questionnaire assessments used in Whitehall II relate to mental health outcomes resilience in face of adversity in BCS70: could explore childhood precursors
21 Additional suggestions Menopause useful to get baseline assessment at age 42? Sexual health men s contraceptive use general indicators of sexual health Mortality recording / flagging age at and cause of death?
22 BCS Physical and Mental Health and Wellbeing
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