Childhood family placement history and behaviour problems in 6-year-old children.

The relationship between childhood family placement history and maternal/teacher reports of child behaviour at 6 years was studied in a birth cohort of New Zealand children. Children who had experienced a marital breakdown showed a tendency to increased aggressive/antisocial behaviour. Within the group of children experiencing a family breakdown, behavioural outcomes varied with the child's subsequent family history and children whose parents reconciled or whose mother remarried appeared to suffer more behavioural difficulties than children who remained in a single-parent family. Multivariate analysis suggested that these differences arose from social and contextual factors associated with differing family situations.

Morbidity during the preschool years.

The prevalence of illness was studied in a birth cohort of Christchurch children during the period from birth to 5 years. By 5 years children had made an average of 18.0 family doctor consultations for morbidity and a further 4.7 for preventive health care procedures; 38% had been admitted to hospital on at least one occasion and 62% had made one or more attendances at a hospital outpatient department. The majority of general practitioner consultations involved four major groups of conditions: respiratory illness; integumental lesions; gastrointestinal illness and accidents. Hospital admissions were dominated by six groups of conditions: respiratory illness, minor surgery, accidents, feeding and management problems, admissions relating to the child's home environment and gastrointestinal illness. Two thirds of hospital outpatient attendances were accounted for by five groups of conditions: accidents; musculoskeletal conditions; respiratory illness; vision problems and congenital heart murmur.

Early hospital admissions and subsequent behaviour problems in 6 year olds.

The relation between admission to hospital during the preschool years and teacher and maternal ratings of child behaviour problems at age 6 years was studied in a birth cohort of New Zealand children. There was a slight but consistent trend for reported behaviour problems to increase with increasing length of hospital stay, however, control for family and social factors suggested that this correlation was spurious. Children admitted to hospital tended to come from socially disadvantaged backgrounds and from families reporting large numbers of life events, and independently of this social background and life events were related to childhood behaviour problems. When the effects of family social background and life events were controlled for, there was no significant association between duration of hospital stay and reports of child behaviour problems. It is concluded that there is little evidence to suggest that in a modern paediatric setting, admission to hospital has any significant effect on the child's subsequent behavioural pattern.

The utilisation of preschool health and education services.

The distribution of the utilisation of health and education services during the period from birth to 5 years was studied in a birth cohort of New Zealand children. Overall patterns of service utilisation showed the presence of considerable inequities with children in the lowest 8% of the distribution receiving seven or fewer of the available services in contrast to the children in the top 8% of the distribution who received in excess of 15 services. Patterns of service utilisation showed a clear tendency to vary with the child's social and familial characteristics with children from socially disadvantaged home backgrounds, unplanned and later born children, children from economically depressed home environments and children in families facing various forms of stress and adversity showing a clear tendency to receive less care than other children. Path modelling of the results suggested that the child's family social background and family composition made the largest direct contributions to variations in rates of service utilisation with family economic situation and levels of adversity having smaller but nonetheless statistically significant effects. It is concluded that the findings provide a clear case study of the way in which well intentioned social policies may emphasise rather than eliminate inequities in the care received by children.