Northern Ireland Longitudinal Study Research Abstracts 2015-16
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Northern Ireland Longitudinal Study Research Abstracts 2015-16Contents
Northern Ireland Longitudinal Study 3
Relationships between deprivation and the self-reported health of older people in Northern Ireland 4
Residential segregation, dividing walls and mental health: A population-based record linkage study 5
Access to a car and the self-reported health and mental health of people aged 65 and older in Northern Ireland 6
Bereavement after informal caregiving: Assessing mental health burden using linked population data 7
Does conurbation affect the risk of poor mental health? A population based record linkage study 8
Long working hours and risk of coronary heart disease and stroke: a systematic review and meta-analysis of published and unpublished data for 603,838 individuals 9
People and places: Understanding geographical accuracy in administrative data from the census and healthcare systems 11
Religion and the risk of suicide: longitudinal study of over 1 million people 12
Urban/rural variation in the influence of widowhood on mortality risk: a cohort study of almost 300,000 couples 13
Caregiving reduces mortality risk for most caregivers: a census-based record linkage study 14
Caregiving is associated with a lower risk of suicide: a longitudinal study of almost 200,000 15
Contact Details 16
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Northern Ireland Longitudinal Study Research Abstracts 2015-16Northern Ireland Longitudinal Study
The Northern Ireland Longitudinal Study (NILS) has been formally available to researchers since the end of 2006. It comprises two major data linkage studies: the NILS and the Northern Ireland Mortality Study (NIMS). These were developed by the Northern Ireland Statistics and Research Agency (NISRA) and are maintained and managed by them as a resource for research. Dr Ian Shuttleworth is currently Director of the ESRC-funded NILS Research Support Unit (NILS RSU) and is also a member of the NI Census Advisory Group and the ESRC Census Advisory Committee.
The NILS is a large-scale, representative data-linkage study created by linking data from the NorthernIreland Health Card Registration system to the 1981, 1991, 2001 and 2011 Census returns and to administrative data from other sources. These include vital events registered with the General Register Office for Northern Ireland (such as births, deaths and marriages) and the Health Card registration system migration events data. The result is a 30 year plus longitudinal data set which is regularly being updated. In addition to this rich resource, there is also the potential to link further Heath and Social care data in our distinct linkage projects (DLPs).
The NIMS is a large-scale data linkage study that links the 1991, 2001 and 2011 Census returns for the whole of the enumerated population (approximately 1.6 million individuals) to subsequently registered mortality data from the General Register Office (GRO). While larger than NILS it is more limited in scope, focusing only on the linkage of mortality data. It allows researchers to focus on more detailed analyses of specific cause of death, some of which may not be possible in NILS because of small numbers in sub-populations and the analysis of less common causes of death (e.g. accidental death). The NIMS dataset is recommended to researchers whose primary interest is in mortality in Northern Ireland.These data are maintained under the same conditions as the NILS and are accessible only under the same constraints.
This report contains the abstracts from NILS and NIMS publications in 2015/16 that were prepared by the researchers involved. The aim is to give a flavour for the type of research that can be conducted through the two studies.
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Northern Ireland Longitudinal Study Research Abstracts 2015-16Relationships between deprivation and the self-reported health of older people in Northern Ireland
Doebler, S., & Glasgow, N. (2016). Journal of Aging and Health. DOI: 10.1177/0898264316641079
ABSTRACT
Objectives: There are few studies on relationships between deprivation and the self-reported health of people aged over 64 years, and no studies fully representative of Northern Ireland’s older population. This paper addresses this gap.
Methods: Deprivation of older people as reported in the 2001 and 2011 Censuses and the relationship with self-reported health are analyzed over a ten-year span using multilevel modelling. The data are from the Northern Ireland Longitudinal Study (NILS) linked to 2001-11 Census returns. Deprivation measures include housing tenure, property-value, access to a car, educational, employment and area-level income-deprivation.
Results: Older people suffering deprivation face a significant health disadvantage over a ten-year time span.
Conclusions: This health disadvantage is stronger in men than in women, likely due to conservative gender roles prevalent among Northern Ireland’s older population, leading to psychological distress among deprived men. The analysis found strongly significant area-level effects, aggravating the health impact of deprivation.
Residential segregation, dividing walls and mental health: A population-based record linkage study
Maguire, A., French, D., & O'Reilly, D. (2016). Journal of Epidemiology and Community Health. DOI: 10.1136/jech-2015-206888
ABSTRACT
Background: Neighbourhood segregation has been described as a fundamental determinant of physical health, but literature on its effect on mental health is less clear. While most previous research has relied on conceptualised measures of segregation, Northern Ireland is unique as it contains physical manifestations of segregation in the form of segregation barriers (or ‘peacelines’) which can be used to accurately identify residential segregation.
Methods: We used population-wide health record data on over 1.3 million individuals, to analyse the effect of residential segregation, measured by both the formal Dissimilarity Index and by proximity to a segregation barrier, on the likelihood of poor mental health.
Results: Using multilevel logistic regression models, we found residential segregation measured by the Dissimilarity Index poses no additional risk to the likelihood of poor mental health after adjustment for area-level deprivation. However, residence in an area segregated by a ‘peaceline’ increases the likelihood of antidepressant medication by 19% (OR=1.19, 95% CI 1.14 to 1.23) and anxiolytic medication by 39% (OR=1.39, 95% CI 1.32 to 1.48), even after adjustment for gender, age, conurbation, deprivation and crime.
Conclusions: Living in an area segregated by a ‘peaceline’ is detrimental to mental health suggesting segregated areas characterised by a heightened sense of ‘other’ pose a greater risk to mental health. The difference in results based on segregation measure highlights the importance of choice of measure when studying segregation.
Access to a car and the self-reported health and mental health of people aged 65 and older in Northern Ireland
Doebler, S. (2016). Research on Aging, 38(4), 453-476. DOI: 10.1177/0164027515590424
ABSTRACT
Objectives: This article examines relationships between access to a car and the self-reported health and mental health of older people.
Methods: The analysis is based on a sample of N=65,601 individuals aged 65 years and older from the Northern Ireland Longitudinal Study (NILS) linked to 2001 and 201 Census returns.
Results: The findings from hierarchical linear and binary logistic multilevel path models indicate that having no access to a car is related to a considerable health- and mental health disadvantage particularly for older people who live alone. Rural-urban health and mental health differences are mediated by access to a car.
Conclusions: The findings support approaches that emphasize the importance of autonomy and independence for well-being of older people and indicate that not having access to a car can be a problem for older people not only in rural, but also in intermediate and urban areas, if no sufficient alternative forms of mobility are provided.
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Northern Ireland Longitudinal Study Research Abstracts 2015-16Bereavement after informal caregiving: Assessing mental health burden using linked population data
Moriarty, J., Maguire, A., O'Reilly, D., & McCann, M. (2015). American Journal of Public Health, 105(8), 1630-1637. DOI: 10.2105/AJPH.2015.302597
ABSTRACT
Objectives:We compared the mental health risk to unpaid caregivers bereaved of a care recipient with the risk to persons otherwise bereaved and to non-bereaved caregivers.
Methods:We linked prescription records for antidepressant and anxiolytic drugs to characteristics and life-event data of members of the Northern Ireland Longitudinal Study (n = 317264). Using a case-control design, we fitted logistic regression models, stratified by age, to model relative likelihood of mental health problems, using the proxy measures of mental health–related prescription.
Results:Both caregivers and bereaved individuals were estimated to be at between 20% and 50% greater risk for mental health problems than non-caregivers in similar circumstances (for bereaved working-age caregivers, odds ratio = 1.41; 95% confidence interval = 1.27, 1.56). For older people, there was no evidence of additional risk to bereaved caregivers, though there was for working-age people. Older people appeared to recover more quickly from caregiver bereavement.
Conclusions:Caregivers were at risk for mental ill health while providing care and after the death of the care recipient. Targeted caregiver support needs to extend beyond the life of the care recipient.
Does conurbation affect the risk of poor mental health? A population based record linkage study
Maguire, A., & O'Reilly, D. (2015). Health and Place, 34, 126-134. DOI: 10.1016/j.healthplace.2015.05.003
ABSTRACT
Objectives & Methods: To determine if urban residence is associated with an increased risk of anxiety/depression independent of psychosocial stressors, concentrated disadvantage or selective migration between urban and rural areas, this population wide record-linkage study utilised data on receipt of prescription medication linked to area level indicators of conurbation and disadvantage.
Results: An urban/rural gradient in anxiolytic and antidepressant use was evident that was independent of variation in population composition. This gradient was most pronounced amongst disadvantaged areas. Migration into increasingly urban areas increased the likelihood of medication.
Conclusions: These results suggest increasing conurbation is deleterious to mental health, especially amongst residents of deprived areas.
Long working hours and risk of coronary heart disease and stroke: a systematic review and meta-analysis of published and unpublished data for 603,838 individuals
Kivimäki, M., Jokela, M., Nyberg, ST., Singh-Manoux, A., Fransson, EI., Alfredsson, L., Bjorner, JB., Borritz, M., Burr, H., Casini, A., Clays, E., De Bacquer, D., Dragano, N., Erbel, R., Geuskens, GA., Hamer, M., Hooftman, WE., Houtman, IL., Jöckel, KH., Kittel, F., Knutsson, A., Koskenvuo, M., Lunau, T., Madsen, IEH., Nielsen, ML., Nordin, M., Oksanen, T., Pejtersen, JH., Pentti, J., Rugulies, R., Salo, P., Shipley, MJ., Siegrist, J., Steptoe, A., Suominen, SB., Theorell, T., Vahtera, J., Westerholm, PJM., Westerlund, H., O'Reilly, D., Kumari, M., Batty, GD., Ferrie, JE. & Virtanen, M. (2015). The Lancet, 386(10005), 1739-1746. DOI: 10.1016/S0140-6736(15)60295-1
ABSTRACT
Background: Long working hours might increase the risk of cardiovascular disease, but prospective evidence is scarce, imprecise, and mostly limited to coronary heart disease. We aimed to assess long working hours as a risk factor for incident coronary heart disease and stroke.
Methods: We identified published studies through a systematic review of PubMed and Embase from inception to Aug 20, 2014. We obtained unpublished data for 20 cohort studies from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) Consortium and open-access data archives. We used cumulative random-effects meta-analysis to combine effect estimates from published and unpublished data.
Results: We included 25 studies from 24 cohorts in Europe, the USA, and Australia. The meta-analysis of coronary heart disease comprised data for 603,838 men and women who were free from coronary heart disease at baseline; the meta-analysis of stroke comprised data for 528,908 men and women who were free from stroke at baseline. Follow-up for coronary heart disease was 5.1 million person-years (mean 8.5 years), in which 4768 events were recorded, and for stroke was 3.8 million person-years (mean 7.2 years), in which 1722 events were recorded. In cumulative meta-analysis adjusted for age, sex, and socioeconomic status, compared with standard hours (35–40 h per week), working long hours (≥55 h per week) was associated with an increase in risk of incident coronary heart disease (relative risk [RR] 1.13, 95% CI 1.02–1.26; p=0.02) and incident stroke (1.33, 1.11–1.61; p=0.002). The excess risk of stroke remained unchanged in analyses that addressed reverse causation, multivariable adjustments for other risk factors, and different methods of stroke ascertainment (range of RR estimates 1.30–1.42). We recorded a dose–response association for stroke, with RR estimates of 1.10 (95% CI 0.94–1.28; p=0.24) for 41–48 working hours, 1.27 (1.03–1.56; p=0.03) for 49–54 working hours, and 1.33 (1.11–1.61; p=0.002) for 55 working hours or more per week compared with standard working hours (ptrend<0.0001).
Conclusions: Employees who work long hours have a higher risk of stroke than those working standard hours; the association with coronary heart disease is weaker. These findings suggest that more attention should be paid to the management of vascular risk factors in individuals who work long hours.
People and places: Understanding geographical accuracy in administrative data from the census and healthcare systems
Shuttleworth, I. and Martin, D. (2015) Environment and Planning A, DOI: 10.1177/0308518X15618205
ABSTRACT
Objectives: Administrative systems such as health care registration are of increasing importance in providing information for statistical, research, and policy purposes. There is thus a pressing need to understand better the detailed relationship between population characteristics as recorded in such systems and conventional censuses.
Methods: This paper explores these issues using the unique Northern Ireland Longitudinal Study (NILS). It takes the 2001 Census enumeration as a benchmark and analyses the social, demographic and spatial patterns of mismatch with the health register at individual level.
Results: Descriptive comparison is followed by multivariate and multilevel analyses which show that approximately 25% of individuals are reported to be in different addresses and that age, rurality, education, and housing type are all important factors.
Conclusions: This level of mismatch appears to be maintained over time, as earlier migrants who update their address details are replaced by others who have not yet done so. In some cases, apparent mismatches seem likely to reflect complex multi-address living arrangements rather than data error.
Religion and the risk of suicide: longitudinal study of over 1 million people
O'Reilly, D., & Rosato, M. (2015). The British Journal of Psychiatry, 206(6), 466-470. DOI: 10.1192/bjp.bp.113.128694