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Page 1: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Growing Up in Scotland Conference 2019

@scotgov@growingupinscot#GUS2019

Page 2: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Growing Up in Scotland:

Latest findings from

Scottish Government

reports

Paul Bradshaw, Line Knudsen and Konstantina Vosnaki

ScotCen Social Research

October 2019

Page 3: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Overview

◼ Background to the study

◼ Summary findings from three reports:

◼ Overweight and obesity at age 10

◼ Changes in language ability over the primary school years

◼ Life at age 12

Page 4: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

4

What is GUS?◼ Large-scale longitudinal birth and child

cohort study involving national samples of

children living in Scotland

◼ Three cohorts:

◼ Birth cohort 1: 5217 children, born 2004/05,

aged 10.5 months at 1st interview

◼ Child cohort: 2859 children, born 2002/03,

aged 34.5 months at 1st interview

◼ Birth cohort 2: 6127 children, born 2010/11,

aged 10.5 months at 1st interview

◼ Funded by the Scottish Government and

running since 2005

Page 5: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Ages and stages (so far…)

Child’s age Cohort/Year of data collection

Child cohort Birth cohort 1 Birth cohort 2

10 months 2005/06 2010/11

Age 2 2006/07

Age 3 2005/06 2007/08 2013

Age 4 2006/07 2008/09

Age 5 2007/08 2009/10 2015

Age 6 2008/09 2010/11

Age 8 2012/13

Primary 6 (Age 10) 2015/16

S1 (Age 12) 2017/18

S3 (Age 14) 2019/20

Web survey

Web survey

Web survey2014

2015/16

2013/14

Page 6: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

6

Sources of information at each age point

Source of data

Child’s age/school stage

10mth Age 2 Age 3 Age 4 Age 5 Age 6 Age 8 P6/10 S1/12 S3/14

BC1 &

BC2

BC1 CC,

BC1/2

CC &

BC1

CC,

BC1/2

CC, BC1 BC1 BC1 BC1 BC1

Main carer interview

Partner or Teacher questionnaire

Partner Teacher Partner Partner

Child questionnaire

Child height and weight

measurements

Cognitive assessments

Linked admin data -health records

Linked admin data –education records

Pre-school Primary School Secondary

Page 7: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Growing Up in Scotland:

Overweight and obesity at

age 10

Paul Bradshaw and Stephen Hinchliffe, ScotCen Social Research

Page 8: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Research questions

◼ What proportion of children are overweight/obese at age 10,

compared with age 6?

◼ What proportion move into and out of healthy

weight/overweight/obese categories during that period?

◼ How does overweight/obesity vary amongst 10-year-old children

according to demographic and socio-economic characteristics?

◼ Is there any change in the social gradient of overweight/obesity

between age 6 and age 10?

◼ What other factors are associated with overweight/ obesity at

age 10?

◼ Which factors are associated with a move out of or a move into

overweight and obesity between ages 6 and 10?

Page 9: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

9

Levels of overweight/obesity increase

with ageChildren’s BMI classification by age

2 2 2 2

72 74 7064

15 1314

15

11 11 14 19

0

10

20

30

40

50

60

70

80

90

100

Age 4 Age 6 Age 8 Age 10

%

Obese Overweight Healthy weight Underweight

24%34%

Page 10: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

10

BMI at age 6 strongly associated with

BMI at age 10

BMI classification at age 10 by BMI classification at age 6

29

2

67

79

34

8

12

34

13

4 8

33

79

0

10

20

30

40

50

60

70

80

90

100

Underweight Healthy weight Overweight Obese

%

BMI classification at age 6

Obese Overweight Healthy weight Underweight

Page 11: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

11

Higher levels of and increase in

overweight/obesity amongst more deprived

% of children overweight/obese by SIMD quintile and age

22 24

25

24

31

39

0

5

10

15

20

25

30

35

40

45

Age 6 Age 8 Age 10

Least deprived Most deprived

2

14

Page 12: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

12

Overweight/obesity associated with other

factors% of children overweight/obese at age 10 by factors at age 6/8

24

44

25

38

32

44

26

38

32

37

0

5

10

15

20

25

30

35

40

45

50

1

Maternal

BMI

Healthy

weight

O/wght

/obese

Weekly

screen time

< 14

hrs

14+

hrs

Eats

breakfast

TV in

bedroom

No Yes

Gets enough

sleep

Yes NoOccas/yAlways

+

BMI at

age 6

Page 13: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Summary

◼ There is a notable increase in rates of overweight/obesity in children between ages 6 and 10 and an average increase in BMI score for all children

◼ Inequality in levels of overweight/obesity between children from different social backgrounds – which already exist at age 6 – have widened by age 10

◼ Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood may help reduce levels of overweight and obesity and later ages.

◼ However, many children of healthy weight at age 6 moved into overweight/obesity. Suggests that prevention in early childhood alone would not be sufficient in reducing later levels of overweight/obesity

Page 14: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Summary (2)

◼ A range of aspects of children’s family environment and

experiences were associated with overweight/obesity at age 10

and with movement between BMI categories, after controlling for

social background

◼ Some similarities with factors found in earlier analysis of

overweight/obesity at age 6 – e.g. maternal overweight/obesity

and frequency of unhealthy snacks related at both time points

◼ However, inactivity – and perhaps particularly a home

environment which facilitates higher levels of inactivity - appears

to play a more important role when children are slightly older.

◼ Poor parental recognition of child overweight/obesity may also be

problematic. The findings suggest that many parents are ill-

informed or find overweight hard to recognise.

Page 15: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Growing Up in Scotland:

Changes in language ability

over the primary school

years

October 2019

Line Knudsen, Eilidh Currie, Paul Bradshaw, James Law and

Rachael Wood

Page 16: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Research questions

◼ Does the gap in expressive language ability between

children from advantaged and disadvantaged

backgrounds change over the primary school years?

◼ What circumstances and experiences are associated

with a relative change in ability? Do these vary

according to social background?

Page 17: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Comparing language development

Child’s age Cohort/Year of data collection

Child cohort Birth cohort 1 Birth cohort 2

10 months 2005/06 2010/11

Age 2 2006/07

Age 3 2005/06 2007/08 2013

Age 4 2006/07 2008/09

Age 5 2007/08 2009/10 2015

Age 6 2008/09 2010/11

Age 8 2012/13

Primary 6 (Age 10) 2015/16

S1 (Age 12) 2017/18

S3 (Age 14) 2019/20

Page 18: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

How we measured language

development

◼ This report focusses on expressive vocabulary

◼ Different but related measures used at each age point

(age5/P1 and age 10/P6)

◼ To allow comparison, the scores from each age point

were standardised into ‘z-scores’.

◼ These are relative scores that tell us how well children

are doing compared with the average for all children

Page 19: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

19

Standardised vocabulary ability score

by household income – Primary 6

-4.00

-3.00

-2.00

-1.00

0.00

1.00

2.00

3.00

4.00

Lowest incomequintile

2nd quintile 3rd quintile 4th quintile Highestincome quintile

Sta

nd

ard

ised

vo

cab

ula

ry s

co

re

0 is the

average for

all children

The line in

the box

represents

the average

score for

that group

The box as a

whole

represents

the middle

50% of

scores for

the group

The lines

represent the

range of scores

outside the

middle 50%

and the highest

and lowest

scores

Page 20: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

20

Standardised vocabulary ability score

by area deprivation – Primary 6

Page 21: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

21

Standardised vocabulary ability score

by highest qualification – Primary 6

Page 22: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

◼ Strong relationship between relative language ability in P1 and P6

◼ If the gap was narrowing, we would expect to see children in less

advantaged circumstances improving at a higher rate than their more

advantaged peers

Has there been a change in the ability

‘gap’?

◼ No evidence of this

◼ To the contrary, results suggest children in more

advantaged circumstances improved at higher rate than

less advantaged peers

◼ If anything, analysis suggests that inequalities have widened rather than

narrowed over the primary school period

Page 23: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

What factors are associated with

improvement in language ability?

Page 24: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Summary and final remarks

◼ Also substantial variation in ability within socio-economic groups

◼ ‘Gap’ in expressive language ability between more and less advantaged

children evident in last years of primary school (P6)

◼ If anything, inequalities appear to widen over primary school period

◼ Socio-economic background may serve as

useful flag for who might be at risk of poorer

outcomes

◼ However, support for learning should not

operate solely on the basis of socio-economic

characteristics

Page 25: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

◼ Higher than average social development difficulties associated with

relative decline in language ability over primary school period

◼ Living in a small town or rural area associated with relative

improvement

◼ Reading/looking at books at home 6+ times per week (at age 8)

associated with relative improvement

Summary and final remarks (2)

◼ Policies aiming to improve educational attainment must

take into account other domains of children’s development

◼ Important to ensure ASNs associated with social and

behavioural development are fully supported during

primary school

Page 26: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Life at Age 12:

Initial Findings from the Growing Up in Scotland Study

October 2019

Konstantina Vosnaki, Paul Bradshaw and Alex Scholes

Page 27: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Areas covered in the report

◼ Experience of school and educational aspirations

◼ Relationships with parents and peers

◼ Healthy weight and perceptions of body weight

◼ Social media and use of the internet

◼ Involvement in risky behaviour

◼ Life satisfaction

Page 28: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Social media and use of the internet

Page 29: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Parents’ knowledge of child’s online activity (M, C)

Online and social media

Risky online behaviours

Time spent on social media/communicating via devices

Online activities

Knowledge about staying safe online

Time spent on social media/communicating via devices

Experiences of being online incl upsetting experiences

Page 30: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Social media and use of the internet

Page 31: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Involvement in risky behaviour

Page 32: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Risky behaviour

Alcohol

Smoking (cigarettes & e-cigarettes)

Anti-social behaviourHave ever been involved in:

• Fighting

• Stealing

• Rowdy

• Shoplifting

• Graffiti

• Vandalism

• Weapon possession

• Robbery

• Breaking & entering

Page 33: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Risky behaviour

17%

Page 34: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Risky behaviour [2]

Page 35: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Risky behaviour [3]

30% had been

involved in at least

one of the activities

listed. Boys (40%)

more likely than

girls to have done

so (21%).

Page 36: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Life satisfaction

Page 37: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Life satisfaction

Life

satisfactionDo you feel you have a good life?

Do you feel you have what you want in life?

Do you feel that your life is just right?

Do you wish your life was different?

Do you feel that your life is going well?

Page 38: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Life satisfaction

Gender

Enjoyment of school

Aspirations for staying on in Education

Ease of making friends

Bullying experiences

Can count on friends

Can count on resident mother

Can count on resident father

Hours per school day on social media

Body image

-

14.8

15.5

14.9

15.5

15.2

14.6

14.0

15.3

14.7

-

18.2

17.1

17.4

17.7

17.6

17.4

17.8

17.3

17.4

Min. Max.

Page 39: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Life satisfaction by social media time

Page 40: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Thank you

0

Page 41: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Amanda Gordon

Getting it Right for Every ChildScottish Government

Page 42: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

‘We grow up loved,

safe and respected

so that we reach

our full potential’

Page 43: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood
Page 44: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood
Page 45: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood
Page 46: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Early Learning and Childcare

From August 2020, all 3 and 4

year old children and eligible 2

year olds will be offered 1140

hours of funded early learning

and childcare.

Page 47: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood
Page 48: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Plans for the Future:

• Perinatal and Infant Mental Health

• Children and Young People’s Mental Health

Page 49: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Thankyou

Amanda Gordon

Getting it Right For Every Child

Scottish Government

[email protected]

https://www.gov.scot/

Twitter: @girfec

Page 50: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Current Data

Developments to

Improve Children's

Outcomes in ScotlandDEVELOPMENTS IN THE CONTEXT OF THE GROWING UP IN SCOTLAND STUDY

Louise Scott

Head of Children and Families Analysis

Scottish Government

Page 51: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

What are the different roles of

data?1. Data

available to monitor

outcomes

2. Data available in digestible

form

3. Data analysed to

answer questions

4. Data used to manage

and redesign

services and policies

5. Data informs which

outcomes are

important to monitor

Improve

children's

outcomes

Page 52: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

How are we developing data?

a) Developing new data

Develop National Performance Framework

measures

b) Providing good quality and consistent

data on children’s outcomes

GUS: Birth cohort 1 older years; new birth cohort?

c) Reducing the time between collecting

data and making it available for analysis

Administrative Data for Research Scotland

1. Data available to monitoroutcomes

Page 53: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

How are we developing data?

1. Digital infrastructure for survey

administration: Smart Survey Platform

2. Data visualisation to ensure access to

digestible data: RCS, Tableau platforms

3. GUS: infographics, webinars, summary

briefings

4. Building big data analytical capacity:

Data for Children, Collaboration with UNICEF

Page 54: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

How are we developing data?

1. Asking new questions of data: Data

linkage

Access: Research ready data

Capacity

Simplifying the process: Research Data

Scotland (One stop shop)

2. Using data differently: Predictive Analytics:

Children on the Edge of Care

3. GUS: new process for seeking data linkage

permissions through SG, which will work with

Research Data Scotland in due course

3. Data analysedto answer questions

Page 55: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

How are we developing data?

1. GIRFEC Leadership Training

2. New work to explore

developments in Interpreting Data

to Inform Service Planning (eg RCS

consultant; LIST analysts; Insight

Advisers; Improvement Advisers)

4. Data used to manage

and redesign services and

policies

Page 56: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

How are we developing data?

Support to understand which data is

important for monitoring purposes

and minimise confusion

Development of a minimum core

data set for child protection

5. Data informs which

outcomes are

important to monitor

Page 57: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Summary

Data plays a central role in supporting children’s outcomes.

Much of our attention is currently focused on getting high quality data on children’s outcomes and making this available to those designing services and/or policies so that we can work better together.

Developments in GUS align with these developments.

However, a more pressing concern, and a focus for our attention moving forwards, is on data analysis and building capacity, especially at local level, to make sense of data so that it can be fully utilised in planning services to meet the needs of children and young people.

Our expectation is that by continuing to deliver these data improvements, we will make more informed decisions to make services work better for children and their families

This will improve children's and young people’s outcomes and ensure Scotland is the best place to grow up.

Page 58: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Engaging with Youthwork

Dr Ross WhiteheadEvidence for Action, Public Health Sciences

Page 59: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Why look at youthwork?

Page 60: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Background

Page 61: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Facilitators of youth-adult relationship

• Structure to promote regular, informal interaction• Opportunity to ‘find’ adult with shared interests• Youth choice• Safe environment• Genuine empathy• No pressure • Going the extra mile• Non-disclosure / confidentiality

Page 62: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

ALL ROADS LEAD TO YOUTHWORK

Page 63: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

ALL ROADS LEAD TO YOUTHWORK

Page 64: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

The need for ‘hard’ evidence

• Youthwork facing significant resource restrictions

• A need to demonstrate (and quantify) the impact

• Thus far, a lack of cold, hard data!

Page 65: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

• Added youthwork Qs to BC1 / SW9 (2016-17)

• Study child ~ 12-13 yrs

• n = 3,419 (main + boost)

• Data from Main Carer interview (Qs about child)

Page 66: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Analyses

• Prevalence of participation

• Correlates of participation

• Caregivers’ perception of impact

(Analyses weighted & design-adjusted)

Page 67: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Uniformed youth group – 22%

Youth democracy group – 1%

Youth club – 16%

Youth worker (local area) – 3%

Youth worker (online) – 1%

Youth award – 4%

Any (one or more) – 38% / None – 62%

% of sample participating in…

Page 68: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Uniformed youth group – 22%

Youth democracy group – 1%

Youth club – 16%

Youth worker (local area) – 3%

Youth worker (online) – 1%

Youth award – 4%

Any (one or more) – 38% / None – 62%

% of sample participating in…

Page 69: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

% of sample participating in…

Uniformed youth group – 22%

Youth democracy group – 1%

Youth club – 16%

Youth worker (local area) – 3%

Youth worker (online) – 1%

Youth award – 4%

Any (one or more) – 38% / None – 62%

Page 70: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Correlates of (any) participation

Sex

• Females – 41%

• Males – 34%

Page 71: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Correlates of (any) participation

Sex

• Females – 41%

• Males – 34%

Page 72: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Correlates of (any) participation

Equivalised household income (quintile)

0%

10%

20%

30%

40%

50%

60%

1 2 3 4 5

Page 73: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Correlates of (any) participation

Equivalised household income (quintile)

0%

10%

20%

30%

40%

50%

60%

1 2 3 4 5

Page 74: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Correlates of (any) participation

Equivalised household income (quintile)

0%

10%

20%

30%

40%

50%

60%

1 2 3 4 5

~80% report paying for some/all activities

Page 75: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Correlates of (any) participation

Equivalised household income (quintile)

0%

10%

20%

30%

40%

50%

60%

1 2 3 4 5

~80% report paying for some/all activities

Interaction between sex and SES –Weaker relationship for males

(stronger for females)

Page 76: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Correlates of (any) participation

Urban/Rurality

• Non rural – 37%

• Rural – 41%

Page 77: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Correlates of (any) participation

Urban/Rurality

• Non rural – 37%

• Rural – 41%

Page 78: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Correlates of (any) participation

Youth wellbeing (SDQ)

• Overall

• Emotional symptoms

• Conduct problems

• Hyper-activity

• Peer problems

• Pro-social

No significant association

Positively associated with (any) participation

Page 79: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Correlates of (any) participation

Youth wellbeing (SDQ)

• Overall

• Emotional symptoms

• Conduct problems

• Hyper-activity

• Peer problems

• Pro-social

No significant association

Positively associated with (any) participation

Page 80: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Correlates of (any) participation

Youth wellbeing (SDQ)

• Overall

• Emotional symptoms

• Conduct problems

• Hyper-activity

• Peer problems

• Pro-social

No significant association

Positively associated with (any) participation

Not evidence that youthwork has no effect on these outcomes!

Page 81: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Correlates of (any) participation

Youth wellbeing (SDQ)

• Overall

• Emotional symptoms

• Conduct problems

• Hyper-activity

• Peer problems

• Pro-social

No significant association

Positively associated with (any) participation

Those that DO participate have similar outcomes to those that

don’t.

Page 82: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Caregiver’s perception of impact…

Access to info/advice can’t get from friends/teachers

Makes them happy

Makes them feel safe

Gives them confidence

Helps them learn

Helps them understand others

Helps them get on with others

Helps them make friends

Helps them feel included

Helps them deal with problems

Helps them express themselves

None of these

Page 83: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Caregiver’s perception of impact…

Access to info/advice can’t get from friends/teachers

Makes them happy

Makes them feel safe

Gives them confidence

Helps them learn

Helps them understand others

Helps them get on with others

Helps them make friends

Helps them feel included

Helps them deal with problems

Helps them express themselves

None of these

These recorded foreach type of participation

(% agreeing)

Page 84: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

% Agreeing UniformYouth

DemocracyYouth Club

Local area /

OnlineAward

Advice/info 41 67 29 58 39

Happy 91 76 94 67 78

Safe 46 36 44 47 32

Confidence 90 93 82 77 91

Learning 70 62 39 53 65

Understand 62 67 51 52 50

Get on 81 66 77 52 63

Friends 86 66 87 53 63

Included 69 59 65 59 60

Deal problems 33 42 28 39 30

Express self 58 75 43 43 55

None 1 1 2 3 4

Page 85: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

% Agreeing UniformYouth

DemocracyYouth Club

Local area /

OnlineAward

Advice/info 41 67 29 58 39

Happy 91 76 94 67 78

Safe 46 36 44 47 32

Confidence 90 93 82 77 91

Learning 70 62 39 53 65

Understand 62 67 51 52 50

Get on 81 66 77 52 63

Friends 86 66 87 53 63

Included 69 59 65 59 60

Deal problems 33 42 28 39 30

Express self 58 75 43 43 55

None 1 1 2 3 4

Page 86: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

% Agreeing UniformYouth

DemocracyYouth Club

Local area /

OnlineAward

Advice/info 41 67 29 58 39

Happy 91 76 94 67 78

Safe 46 36 44 47 32

Confidence 90 93 82 77 91

Learning 70 62 39 53 65

Understand 62 67 51 52 50

Get on 81 66 77 52 63

Friends 86 66 87 53 63

Included 69 59 65 59 60

Deal problems 33 42 28 39 30

Express self 58 75 43 43 55

None 1 1 2 3 4

Page 87: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Barriers to participation

• For the 62% that report engagement in none of activities….

• Why not?

Page 88: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Barriers to participationYP doesn’t want to 69YP too young 3YP needs not accommodated 1YP too busy 25YP too tired 4Not available in area 11Caregiver doesn’t want them to 1Too expensive (correl with SES/SIMD) 4Too difficult (time/transport) 6YP not confident enough 7YP does too many activities 16YP doesn’t feel welcome 2YP doesn’t feel safe 1Cultural / religious reasons 1Other 7

Page 89: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Barriers to participationYP doesn’t want to 69YP too young 3YP needs not accommodated 1YP too busy 25YP too tired 4Not available in area 11Caregiver doesn’t want them to 1Too expensive (correl with SES/SIMD) 4Too difficult (time/transport) 6YP not confident enough 7YP does too many activities 16YP doesn’t feel welcome 2YP doesn’t feel safe 1Cultural / religious reasons 1Other 7

Page 90: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Barriers to participationYP doesn’t want to 69YP too young 3YP needs not accommodated 1YP too busy 25YP too tired 4Not available in area 11Caregiver doesn’t want them to 1Too expensive (correl with SES/SIMD) 4Too difficult (time/transport) 6YP not confident enough 7YP does too many activities 16YP doesn’t feel welcome 2YP doesn’t feel safe 1Cultural / religious reasons 1Other 7

Page 91: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Longitudinal analyses to come…

• SW9 plus SW10 data

• 4 permutations between SW9 & SW10• Maintains participation• Begins participation• Ceases participation• Never participated

• How have outcomes *changed* in each of these groups?

Page 92: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Adverse Childhood Experiences in

Scottish children

Dr. Louise Marryat

Dr. Alexandra Blair

Professor John Frank

Page 93: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

What are ‘Adverse Childhood Experiences?’

Image: Scottish Government

Page 94: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Welsh ACE Study: Compared with people

with no ACEs, those with 4+ ACEs are:

➢ 4x more likely to be a high-risk drinker

➢ 6x more likely to have had or caused unintended

teenage pregnancy

➢ 6x more likely to smoke e-cigarettes or tobacco

➢ 11x more likely to have smoked cannabis

➢ 14x more likely to have been a victim of violence over

the last 12 months

➢ 15x more likely to have committed violence against

another person in the last 12 months

➢ 16x more likely to have used crack cocaine or heroin

➢ 20x more likely to be incarcerated

Public Health Wales, 2015

Page 95: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Criticism of the ACEs model

• Too narrow a definition of adversity

– E.g. focussed on the home

• Some included items are questionable

• Historic context

• Recall issues

• ‘Routine enquiry’

• Blurring the boundaries of

‘normal’ adverse experiences

• Determinism

Page 96: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Exploring ACEs in GUS

• Used Birth Cohort 1 – born 2004/5

• Data from sweeps 1-7 (10 months to age 8)

• Calculated ACE scores using data from every sweep

• Maximised the use of data

• 3119 children

Page 97: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Data availability

Page 98: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Proportions of children experiencing different ACEs by

cohort

35.4

32.1

22.220

14

9.1

0.4

18.8

10.8

25.6

12.5

3.4

14

22

19

1517

5

0

5

10

15

20

25

30

35

40

Mental healthproblems

Parents everdivorced orseparated

Physical abuse emotionalneglect

Drug or alcoholmisuse

Domesticviolence

Parent in prison

GUS KP Wales

Page 99: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Numbers of ACEs reported by study

35 34.8

19.6

7.5

3

49.5

24.9

12.5

6.9 6.2

53

20

13 14

0

10

20

30

40

50

60

None 1 2 3 4 or more

GUS Kaiser Permanente Wales

2-3 ACES

Page 100: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Numbers of ACEs by income quintile

8

26.633.8

42.252.8

27

33.6

38.6

36

32.7

34.5

26.1

18.317.1

11.1

19.7

10.68.3

4.2 2.310.8

3.2 1 0.5 1

BOTTOM INCOME QUINTILE

2ND QUINTILE 3RD QUINTILE 4TH QUINTILE TOP INCOME QUINTILE

None 1 2 3 4 or more

Page 101: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Having 3+ ACEs at age 8 was associated with:

Being male (O.R.=1.5)

Having a mother aged <20 at the birth of 1st child

(O.R.=2.1)

Living in a household in

lowest income band (O.R.=6.5)

Living in an urban area (O.R.=1.8)

Page 102: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Is access to community resources associated with

incidence of ACEs and can it reduce inequalities?

• 5 community resources identified:

– Self-reported access to:

1. Stable housing

2. A local park or play-park

3. Transportation

4. Childcare

5. In person breastfeeding support

Page 103: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Associations between ACEs and community resources

• For households living above the poverty line:

– access to housing, transportation, and breastfeeding

education associated with lower ACE incidence

• For households living below the poverty line:

– Access to transportation associated with lower ACE

incidence

Estimated that if access totransportation was held fixed across the entire population, c.21% of income-based inequality in cumulative incidence of 3+ ACEs could be eliminated.

Page 104: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Benefits of access to transportation

• Can allow access to health or social services and other service use (Whetten et al., 2006)

• Enable access to employment, food and leisure activities (Markovichand Lucas, 2011)

• May help parents gain a sense of control over their lives (Syme1996)

• Inadequate transportation is a stressor in itself – lack of flexibility, time, and fatigue (Bostock, 2001)

• May enable parents (particularly mothers) to remove themselves and children from adverse situations (Bambra, 2007)

Page 105: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Reimagining ACEs

• Adolescent accumulation of ACEs – an important time for girls?

• What ACEs are important in the Scottish context?

• Are there sensitive periods in experiencing ACEs?

• To what extent can we explore ‘capabilities’? (Smith, 2018)

• Interrupting intergenerational cycles of adversity.

Page 106: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Conclusions

• Two-thirds of Scottish children have 1+ ACE by age 8;

• 10% experience 4+ ACEs

• Clear that many Scottish children are experiencing far from

ideal childhoods

• Experience of ACEs was strongly associated with living in

poverty → redistribution of resources? Basic Income scheme?

• Access to good transportation may alleviate some of the

burden on families → free & improved public transport

scheme for most disadvantaged households?

Page 107: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Acknowledgements

• Co-authors Dr Alexandra Blair and Prof. John Frank;

• Children and families who participated, & continue to participate, in GUS;

• The GUS team at ScotCen and CRFR, particularly Paul Bradshaw and Lesley Kelly;

• Sara Dodds and colleagues at the Scottish Government;

• Funders: Farr Institute @ Scotland; Canadian Institutes of Health Research (CIHR) Michael Smith Travel Supplement and by a CIHR Vanier Doctoral Scholarship

Page 108: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

References

Blair, A., Marryat L. & Frank J. (2019) How community resources mitigate the association

between household poverty and the incidence of adverse childhood experiences International

Journal of Public Health https://link.springer.com/article/10.1007%2Fs00038-019-01258-5#Tab1

Marryat, L., & Frank. J. (2019) Factors associated with adverse childhood experiences in

Scottish children: a prospective cohort study. BMJ Paediatrics Open,.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6361326/

Smith, M. (2018). Capability and adversity: reframing the “causes of the causes” for mental

health. Palgrave Communications, 4(1), 13. https://www.nature.com/articles/s41599-018-

0066-z

Page 109: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

What next for GUS?

Page 110: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Data collection – overview (1)

Child’s age Cohort/Year of data collection

Child cohort Birth cohort 1 Birth cohort 2

10 months 2005/06 2010/11

Age 2 2006/07

Age 3 2005/06 2007/08 2013

Age 4 2006/07 2008/09 2014

Age 5 2007/08 2009/10 2015

Age 6 2008/09 2010/11

Age 8 2012/13

Primary 6 (Age 10) 2015/16

S1 (Age 12) 2017/18

S3 (Age 14) 2019/20

2015/16

2013/14

Page 111: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Data collection – overview (2)Child’s age Cohort/Year of data collection

Child cohort Birth cohort 1 Birth cohort 2

10 months 2005/06 2010/11

Age 2 2006/07

Age 3 2005/06 2007/08 2013

Age 4 2006/07 2008/09 2014

Age 5 2007/08 2009/10 2015

Age 6 2008/09 2010/11

Age 8 2012/13

Primary 6 (Age 10) 2015/16

S1 (Age 12) 2017/18

S3 (Age 14) 2019/20

Age 17 (S6) 2021/22

2015/16

2013/14

Page 112: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Data collection: BC1 – S3/Age 14 - summary

◼ Five main data collection components:

◼ Main carer questionnaire

◼ Child questionnaire

◼ Child height and weight

◼ Child language assessment

◼ Partner questionnaire

◼ Key questionnaire topics:

◼ Main carer: school, parenting & parent-child relationship, child health, own physical and mental health, parent ACEs

◼ Child: time use and activities, school (inc subject choice), life satisfaction, health and wellbeing, relationships with friends and family, gender identity, sexual relationships, risky behaviours

◼ Partner: school, parenting, own physical and mental health, parent ACEs

Page 113: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Data availability – overview

Child’s age Cohort/Year of data collection

Child cohort Birth cohort 1 Birth cohort 2

10 months 2005/06 2010/11

Age 2 2006/07

Age 3 2005/06 2007/08 2013

Age 4 2006/07 2008/09

Age 5 2007/08 2009/10 2015

Age 6 2008/09 2010/11

Age 8 2012/13

Primary 6 (Age 10) 2015/16

S1 (Age 12) 2017/18

S3 (Age 14) 2019/20

All survey data (special licence)

+

Revised geography variables (datazone, intermediate

geography, local authority – secure licence)

Page 114: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Data availability: BC1 – S1/Age 12 – summary

◼ Five main data collection components:

◼ Main carer questionnaire

◼ Child questionnaire

◼ Child height and weight

◼ Child language assessment

◼ Partner questionnaire

◼ Key questionnaire topics:

◼ Main carer: transition to secondary school, parenting, activities, child health, involvement in anti-social behaviour

◼ Child: life satisfaction, health and wellbeing, school, friends, online activities and tech, smoking and drinking, anti-social behaviour, parenting

◼ Partner: parenting, involvement in anti-social behaviour, health and wellbeing

Page 115: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Data availability – linked admin data

◼ Linked health data – BC1, CC and BC2

◼ Minimum dataset – birth to 2014 - including: hospital attendance/admission; birth details; immunisations; pre-school and school health assessments; dental health; A&E attendance

◼ Data currently held on NSS National Safe Haven. Access mechanism under review.

◼ Linked education data

◼ Draft P1 minimum dataset including:

◼ Pupil level data: attendance and absence; exclusions; ASN;

◼ School level data: roll and class sizes; denomination; school level attendance and FSM; teacher numbers

◼ Mechanism for release of education data is under review

◼ Linked Care Inspectorate data

◼ BC1 & BC2, average inspection grades over period of attendance on: care and support; environment; staffing and management and leadership

Page 116: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood
Page 117: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

For more information, please visit our website:

www.growingupinscotland.org.uk

Or contact:

The ScotCen team - [email protected]

The Scottish Government team - [email protected]

You can also follow us on twitter: @growingupinscot

Thank you

Page 118: Growing Up in Scotland Conference · Overweight/obesity at age 6 strongly associated with overweight/obesity at age 10. Suggests that tackling/preventing overweight in early childhood

Maree Todd MSP, Minister for Children and Young People

@MareeToddMSP |@scotgov @growingupinscot #GUS2019