title: Multiple health behaviours among mothers and partners in England: Clustering, social patterning and intra-couple concordance.
abstract: Research on multiple health behaviours is increasing but little is known about parental behaviours and how they covary. Our study investigates cigarette smoking, alcohol intake, fruit and vegetable (F&V) consumption and physical activity among mothers and co-resident partners in England. Using the UK Household Longitudinal Study, we examined (i) clustering of health behaviours using observed-expected ratios and latent class analysis (ii) socio-demographic correlates of the derived latent classes and (iii) intra-couple concordance of individual health behaviours and their latent classes. We identified five latent classes for mothers and partners: Never smoked drinkers (28% of mothers; 29% of partners), Abstainers (25%; 17%), Drinkers and ex-smokers (19%; 26%), Unhealthy low frequency drinkers (18%; 16%) and Unhealthiest behaviour group (11%; 12%). These had distinctive social profiles. Never smoked drinkers were more likely than those in other groups to be white and socially advantaged: married, older, and with higher educational qualifications and incomes. Abstainers were non-smokers who never or occasionally drank, and were disproportionately drawn from ethnic minority groups and middle/lower income families. Drinkers and ex-smokers were the most physically active group and were more likely to be socially advantaged. Unhealthy low frequency drinkers were more likely to be disadvantaged and have a limiting long-standing illness. The Unhealthiest behaviour group had the highest proportion of smokers, heavy smokers and binge drinkers and the lowest F&V intake and physical activity levels. They were largely white and socially disadvantaged: younger, non-married and with lower educational levels. Mothers and their partners typically shared the same risk behaviours, and 44 per cent of partners and mothers belonged to the same latent class. Our findings point to the potential for a broadening of research and policy perspectives, from separate behaviours to combinations of behaviours, and from individuals to the domestic units and communities of which they are part.
authors.affiliation: Nutritional Epidemiology Group, Department of Health Sciences, Seebohm Rowntree Building, University of York, YO10 5DD, UK.
authors.forename: Hilary
authors.initials: H
authors.lastname: Graham
authors.affiliation: Nutritional Epidemiology Group, Department of Health Sciences, Seebohm Rowntree Building, University of York, YO10 5DD, UK; School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK.
authors.forename: Jayne
authors.initials: J
authors.lastname: Hutchinson
authors.affiliation: Population, Policy & Practice Programme, UCL Great Ormond Street, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
authors.forename: Catherine
authors.initials: C
authors.lastname: Law
authors.affiliation: Department of Social Policy, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, UK.
authors.forename: Lucinda
authors.initials: L
authors.lastname: Platt
authors.affiliation: Heather Wardle Research Limited, 1 Rymer Street, Herne Hill, London SE24 0NQ, UK.
authors.forename: Heather
authors.initials: H
authors.lastname: Wardle
keywords: Alcohol consumption; Cigarette smoking; Diet; Latent class analysis; Physical activity; Social inequalities