NILS Projects

Current Projects

Project 001

Title:                 Mortality amongst residents of nursing and residential homes in Northern Ireland

Researcher(s):   Dr Dermot O’Reilly (lead); Michael Rosato; Mark McCann

Database:          NILS Mortality Database

Project Summary:

It is generally recognised throughout the caring services that mortality is a rather extreme, but vital component of monitoring the quality of care. Mortality statistics are now routinely scrutinized in many branches of the health and social services; examples include the enquiries following maternal deaths stillbirths and deaths of infants in the first year of life; the reporting and analysis of post-operative mortality rates, and the post-Shipman surveillance of patient mortality rates amongst GPs. This research proposes to examine variation in mortality amongst the residents of nursing and residential homes of Northern Ireland.

Project 002

Title:                 Temperature-related mortality and housing in Northern Ireland

Researcher(s):   Dr Chris Morris, Mr Andrew Reilly, Mr Paul Scullion

Database:         NILS Mortality Database

Project Summary:

This project will attempt to assess the impact of housing and housing history on temperature-related mortality in Northern Ireland, taking account of SAP, central heating, insulation, tenure, location, aspect and if possible, elevation.

Project 003

Title:                 A study of the non-match rates to assess the magnitude and implications of any systematic biases in the non-linkage rates.

Researcher(s):   Dr Dermot O’Reilly (lead); Michael Rosato; Sheelah Connelly; Emma Pye

Database:          NILS Mortality Database

Project Summary:

In societies which do not have universal registration systems for monitoring demographic change it is not normally possible to accurately study the process of linking population and mortality data. The NI-LS is unique within the United Kingdom in that it affords such a possibility. The study links the 2001 Census returns to all deaths registered in Northern Ireland in the five years after the Census, with the characteristics of matched and non-matched death records compared using multivariate logistic regression. The attributes of the subjects included in the analysis are as recorded on the death certificate.  

Project 004

Title:                 To explore the relationship between the self-reported health questions (LLTI & General Health in the previous year) and short-term mortality.

Researcher(s):   Dr Dermot O’Reilly (lead); Michael Rosato; Sheelah Connelly; Emma Pye

Database:         NILS Mortality Database

Project Summary:         

[Description to be added]

Project 005

Title:                 A study of the socio-demographic and area correlates of suicides in NI.

Researcher(s):   Dr Dermot O’Reilly (lead); Michael Rosato; Sheelah Connelly; Emma Pye

Database:         NILS Mortality Database

Project Summary:

Suicide rates vary markedly between geographic areas but it is unclear whether or not this is due to differences in the populations of the areas (composition effects) or to factors which operate at an area level (contextual effects). This study uses to NI-LS to examine a number of area level characteristics to determine if they are independently related to suicide risk after adjustment for individual and family characteristics.

Project 006

Title:                 A study of denomination differences in health and short-term mortality in NI.

Researcher(s):   Dr Dermot O’Reilly (lead); Michael Rosato; Sheelah Connelly; Emma Pye

Database:         NILS Mortality Database

Project Summary:

Most research into the relationship between religion and health in Northern Ireland has divided the population dichotomously as Catholic and Protestant, ignoring the inherent diversity of the Protestant community (for example Church of Ireland, Presbyterian Church in Ireland etc). The present study utilises this diversity to examine variation in all cause and cause-specific mortality by this extended religious affiliation.

Project 007

Title:                 The Variation and Determinants of the Admission of Older People to Residential and Nursing Homes in Northern Ireland

Researcher(s):   Dr Dermot O’Reilly (lead), Mark McCann

Database:          Main NILS Database

Project Summary:

The numbers of people aged 65 and over in Northern Ireland is projected to rise markedly over the next 15 years. This will place additional burdens on the Department of Health, Social Services and Public Safety. Good evidence-based research will be required for the development of new community care services which this increase in older people will demand, however at the moment evidence on appropriate health and community care for older people is limited. It is known that admissions to nursing and residential homes are about 20% higher in Northern Ireland than in England and that there is significant variation within Northern Ireland.

In order to further investigate the issues, the research aims are:

1. To examine the determinants of admission to nursing & residential homes in Northern Ireland

2. To explore the nature and level of variation between and within HSS Trusts.

Project 008

Title:                 A study of the effects of emigration from Northern Ireland on the spatial distribution of health within Northern Ireland and on the health of other parts of the UK

Researcher(s):   Dr Dermot O’Reilly(lead), Sheelah Connolly, Michael Rosato

Database:         Main NILS Database

Project Summary:

The Northern Ireland Longitudinal Study (NILS) will be used to describe the characteristics of those that leave Northern Ireland and those that remain.

Project 009

Title:                 A series of linked studies to examine the relationship between unemployment and health, using data from the Northern Ireland Longitudinal Study (NILS)

Researcher(s):   Dr Dermot O’Reilly (lead), Heather Kinnear, Michael Rosato

Database:         Main NILS Database

Project Summary:

Northern Ireland is one of the most deprived areas in the UK and until fairly recently, consistently had the highest rates of unemployment, and long-term unemployment, and lowest proportions of the population of working age defined as economically active, of any of the regions within the UK. Remarkably however, there has been very little research into the relationship between unemployment and ill-health here, due principally to the absence of adequate data sources. Most would agree that research in this area is fraught with methodological difficulties and that many questions surrounding the relationship between unemployment and ill-health still remain unanswered. This proposed study is a series of linked studies using the NILS to examine the relationship between unemployment and ill-health in Northern Ireland.

Pending Projects

Project 010

Title:                 Children and families with long term and complex needs

Researcher(s):   Prof. John Pinkerton (lead), Dr Trevor Spratt, Dr John Devaney, Dr Andrew Percy

Database:          Main NILS Database

Project Summary:

Policy with respect to children and families in the United Kingdom is strongly influenced by the research based assumption that experience of long term and complex needs in childhood is predictive of poor social and economic outcomes in adulthood. In addition it is assumed that children who are the subject of care proceedings or who have had their names added to the child protection register are likely to come from such families and can provide an understanding of the wider population of children with long term and complex needs. Government wishes to target such families for early intervention and prevention. However there is currently no dedicated data source for the identification and profiling of families with long term and complex needs. A possible alternative to setting up such a data base is to combine existing data bases in the manner of the NILS. This study aims to determine the feasibility of this alternative through combining data from the NILS with data from SOSCARE. If it is shown to be methodologically feasible the study will provide data that can be analysed to test claims that data of the engagement of families with social services provides a proxy indicator for the identification of families with long term and complex needs. The data can also be used as a base line for follow up studies measuring the impact of early intervention and prevention with these families.

Project 011

Title:                 Area influences on health: does the extent of community or religious segregation matter?

Researcher(s):   Dr Dermot O’Reilly (lead); Michael Rosato; Sheelah Connelly; Seeromanie Harding

Database:          NILS Mortality Database

Project Summary:

Northern Ireland (NI) is a society spatially segregated along religious denomination lines. This study looks at some of the implications of this for population health in NI. In particular, the study examines (i) health outcomes associated with minority status for groups living within larger ‘other’ communities; and (ii) health outcomes associated with living as part of larger homogeneous communities which may have developed exclusionist social networks and mores - scenarios testable for both positive and negative health outcomes. More generally, while the immediate context for this study is NI, findings of this kind can have implications for the study of health in other minority populations. Indices of community composition will be derived quantifying the major religious denominations at area level. These social settings will be examined in relation to both area characteristics (such as population density) and individual and household socio-demographic and socio-economic factors such as age, sex, marital status, economic position, and social class and measures of social deprivation. The study will focus mainly on the analysis of mortality, though will also include analysis of self-reported health measures. As much as possible lifestyle factors will also be included: indices of tobacco and alcohol consumption will be derived using the Northern Ireland Health and Well-being Survey, and integrated into the main project data for analysis. It is anticipated that this will enhance understanding of both (a) processes of population health formation and maintenance in NI and more generally (b) increase understanding of the health of minority populations.  

Project 012

Title:                 An exploratory analysis of child dental health and use of dental care services in Northern Ireland

Researcher(s):   Prof Ciaran O’Neill (lead), Michael Donaldson

Database:          Main NILS Database

Project Summary:

This study will link data from the 2001 Census, the General Registrars Office and the Central Service Agency relating to NHS dental service use to explore measures of oral health status and variations in service use among children aged 10. It will compare measures of oral health based on decayed, missing and filled teeth (DMFT) with those based on the state of first permanent molar teeth in children using CSA data. It will describe differences by social class in dental health and in use of dental services; it will explain variations in service use within the context of a constrained utility maximising model of behaviour. Health and service use will be related to parental socio-economic and demographic characteristics, as well as access to dental services and area characteristics.

For this study dental health will be defined using two measures: DMFT and the state of first permanent molars possessed by the child at age 10. These measures will be derived from the cumulative service use by children in the years preceding 2006/07. The relationships between dental health/service use and the range of explanatory variables will be estimated using multivariate analyses of data from the CSA linked to that from the Census, GRO and area based characteristics. Children not registered with a dentist will have dental health predicted using the estimated coefficients from the regression analyses of those where such data exists and their profile of socio-economic and demographic characteristics taken from the Census and GRO.

Project 013

Title:                 Why some areas have mortality levels either higher or lower than their levels of material deprivation might suggest: does resilience provide an explanation?

Researcher(s):   Dr Dermot O’Reilly (lead); Michael Rosato; Sheelah Connelly

Database:          NILS Mortality Database

Project Summary:

It is accepted that material deprivation is crucial in determining health status. However, it is also clear that other factors are important and some of these are thought to operate at an area level. Examples of these include urban/rural residence, the quality of the social and physical environment and levels of social support. If area-level factors are found to significantly affect health then this would suggest a useful role for policies aimed at changing area level characteristics. The proposed research will use the NILS datasets to identify small geographical areas with mortality levels that are consistently higher or lower than what would be expected given the levels of deprivation experienced by the individuals and households within these areas. The characteristics of these areas will be compared using other population survey datasets (such as the Northern Ireland Health & Wellbeing Surveys) to see if these apparently anomalous variations are influenced by either identifiable area-level characteristics or by behavioural or lifestyle characteristics that cannot be captured by datasets such as the NILS. These latter characteristics will be derived as a series of indices using other relevant (and timely) survey data from Northern Ireland and linked to the NILS (using individual and household indices such as age, sex, social class or economic position) for analysis.

Project 014

Title:                 Educational, social and economic precursors and concomitants of teenage pregnancy in Northern Ireland.

Researcher(s):   Dr Sarah Allen (lead), Dr Ben Stiles

Database:          Main NILS Database

Project Summary:

The United Kingdom, including Northern Ireland, has among the highest teenage pregnancy rates in western Europe.  Teenage pregnancy is associated with significant adverse effects for both parents and children and its reduction is the focus of national and regional strategies.  Up until now it has not been possible to explore, on a scale as large as this, the factors associated with teenage pregnancy within a specifically Northern Ireland context.  This study will identify a sample of teenage mothers and explore their background in terms of their parents’ educational, social and economic status with the aim of identifying significant antecedents of teenage pregnancy.  In addition the teenage parents’ own educational, social and economic status will be examined to explore the concomitants of teenage pregnancy.  Regression modelling will be used to yield patterns that characterise teenage mothers. In these models, interactions between aspects of an individual’s background and being a teenage mother might reveal circumstances that alleviate potential problems in their educational, social and economic development.  It is hoped that this analysis will result in the production of useful and salient information that can be used to inform local policy and compared to national data to inform UK wide policy.

Project 015

Title:                 The socio-economic and cultural influences on the perception and reporting of self-reported health in Northern Ireland

Researcher(s):   Dr Dermot O’Reilly (lead); Michael Rosato; Sheelah Connelly

Database:         NILS Mortality Database

Project Summary:

Census-based measures of self-reported health are widely used throughout the UK to assess need and as part of resource allocation formulae to distribute HPSS resources. It is important to know that such measures are not significantly biased by social or cultural factors. The proposed study aims to use the NILS-Mortality Linkage Study to examine the relationship between self-reported health in the 2001 census and subsequent mortality in the following five years to see if this relationship is modified because of the individual respondent’s religious affiliation, country of birth, or by levels of chronic unemployment in the area in which they live. These associations are strongly indicated by other research evidence. The results from the proposed research should help determine the direction and extent of any cultural and socio-economic factors influencing the reporting of SRH in Northern Ireland.

Project 016

Title:                 The distribution of cancer deaths in Northern Ireland by population and household type.

Researcher(s):   Dr Anna Gavin (lead), Dr Finian Bannon; Dr David Donnelly

Database:          NILS Mortality Database

Project Summary:

The Northern Ireland Cancer Registry (NICR) is a population-based registry covering Northern Ireland. It collects comprehensive information on all new cases of cancer and cancer deaths occurring in a defined population, however the information collected focuses more on medical aspects and limited information about cancer patients other than basic demographics is collected. While the patient’s sex, age and area of residence provide valuable information there is an increasing demand to know more about the social characteristics of cancer patients.

Efforts to improve collection of information such as ethnicity have recently started but will take time to implement. However The NI longitudinal study, which links a large sample of information from the GRO, Census and other data sources, provides significant information on the NI population that could be used to plug the knowledge gap.

Legal aspects prevent the matching of cancer incidence data to the NILS dataset however the characteristics of persons who have died from cancer are already examinable and a detailed breakdown of persons dying from cancer in Northern Ireland is possible.

This research project aims to use NILS to produce a report on cancer mortality in Northern Ireland focusing upon patient characteristics which will be publicly available for use by health professionals, policy makers and the general public. In addition two detailed research projects will be conducted: One on ethnicity and migration and one to perform a multivariate logistic analysis to isolate social factors contributing to cancer mortality.

Project 017

Title:                 A comparative study of the relationship between deprivation and health status in Northern Ireland and Scotland

Researcher(s):  Dr Dermot O’Reilly (lead); Michael Rosato; Sheelah Connelly

Database:         NILS Mortality Database

Project Summary:

Both Northern Ireland and Scotland have been shown to be more deprived and to suffer higher levels of morbidity and mortality than other regions in the UK. Previous work comparing Scotland to England and Wales showed that even after controlling for deprivation, Scotland still experienced an excess of mortality, a phenomenon which has become known as the “Scottish effect”.  To date, no detailed comparisons of the relationship between deprivation and health in Northern Ireland and Scotland have been conducted. However, the recent introduction of longitudinal studies, based on the censuses, in both Northern Ireland and Scotland allow such comparisons to be made. Such comparisons will increase understanding of the associations between deprivation and health status along a number of fronts. Firstly, they will identify similarities and variations in the relationship between deprivation and health status in Northern Ireland and Scotland. Secondly, they will show if the “Scottish effect” continues to hold when Northern Ireland is used as the comparison and after suitable adjustment for any differences in levels of deprivation. Finally, by reference to respective health surveys, see what other factors (such as life style or behavioural factors) might explain any excess poor health in Scotland.

Project 018

Title:                 Lone mothers at time of birth: who are they? An exploration of their socioeconomic and household characteristics.

Researcher(s):   Prof. Helen Dolk (lead), Karen Casson; Evie Gardner

Database:          Main NILS Database

Project Summary:

Lone mothers are at excess risk of poor pregnancy outcomes in Northern Ireland and elsewhere. The majority live in deprived areas, and a large proportion are teenage mothers. The aim of this project is to explore the socioeconomic and household characteristics of women who were “lone mothers” at the time of birth of their children. The objectives are:

(1) To compare the socioeconomic and household characteristics of births where the birth is registered to the mother alone (sole registration), to the mother and father at different addresses, to the mother and father at the same address (married and unmarried).

(2) To categorise “lone mothers” into subcategories based on socioeconomic and household characteristics and composition and sole registration status.

(3) To determine the number and characteristics of sole registrants cohabiting with the father of the baby.

(4) To determine the number and characteristics of mothers who have multiple sole registration births.

Our population will be babies of less than one year at the time of the 2001 census, in three groups: babies, mothers and fathers who are NILS members. This sample will contain 1,000 sole registrants. The year following the census may also be added.

Project 019

Title:                 Individual, household and area variations in alcohol related deaths in Northern Ireland

Researcher(s):   Dr Dermot O’Reilly (lead); Michael Rosato; Sheelah Connelly

Database:          NILS Mortality Database

Project Summary:

Over the past decade there has been a marked increase in levels of alcohol consumption in society, both in terms of the proportion of the population who drink alcohol and in the amount of people who regularly drink above the recommended level. At the same time the number of people dying from alcohol related causes in Northern Ireland has been rising. Recent evidence has shown that alcohol related deaths rates in Northern Ireland, while traditionally being similar to those experienced in England and Wales are now increasing at a faster rate, and as a result the alcohol related death rate in Northern Ireland has exceeded those in England and Wales for a number of years. While it is known that males death rates from alcohol related causes are higher than those for females and that deprived areas suffer a disproportionate amount of these deaths, little else is known about the characteristics of the individuals or areas in the UK most likely to experience high rates of alcohol related deaths.  This is essential information if appropriate and timely policies are to be enacted to tackle this growing problem. The aim of this piece of work is to identify the characteristics of those individuals, households and areas most likely to be effected by alcohol related deaths.

Project 020

Title:                 Describing and Modelling Internal Migration in NI 2001-2006 using the NILS: Individuals, Households and Places

Researcher(s):   Dr Ian Shuttleworth (lead), Gemma Catney

Database:          Main NILS Database

Project Summary:

Internal migration between places (wards and/or SOAs) in NI has been under researched.  In particular, there have been few quantitative analyses.  This project aims to address this gap by exploring migration patterns using selected individual, household and ecological variables.  The study has two focuses: community background and health status.  Particular issues the project seeks to explore include the extent to which individuals living in areas where they are the ‘minority community’ are more likely to move after controlling for selected individual and household characteristics; whether there are differential mobility patterns for people with health problems by the type of area in which they live; and what types of movers are associated with upwards (or downwards) social mobility, as measured by variables such as housing conditions and neighbourhood deprivation.  The first stage of the proposed work programme will be a descriptive analysis of migration by the selected explanatory variables.  The second stage of the work will apply formal modelling approaches such as logistic regression to explore the determinants of mobility.  If time permits, more sophisticated multi-level and geographically-weighted approaches will be considered. 

Project 021

Title:                 A series of projects to explore the difficulties and benefits of linking health-service related data to the NILS

Researcher(s):   Dr Dermot O’Reilly (lead); Prof. Liam Murray; Prof Carmel Hughes; Michael Rosato; Sheelah Connelly

Database:         Main NILS Database

Project Summary:

The utility of the NILS data can be greatly extended by linkage to health-service related databases which offer a greater frequency of events that are likely to have more HPSS policy relevance. The proposed study aims to test the feasibility and difficulties of linking the NILS dataset to three HPSS-related datasets. The potential benefits of such linkages will be illustrated by undertaking three projects (i) a study of deliberate self-harmers; (ii) a study of the pharmacoepidemiology of antidepressant usage in Northern Ireland, and (iii) an examination of variations in the uptake of breast and cervical cancer screening in Northern Ireland.

Project 022

Title:                 Predicting Short Run Changes in Fertility in Northern Ireland

Researcher(s):   Dr Pat McGregor (lead), Prof. Ciaran O’Neill; Patricia McKee

Database:         Main NILS Database

Project Summary:

Northern Ireland has in recent years shared the slight upturn in fertility evident in some European countries. This contrasts with the steady fall in fertility from the peak of the ‘baby boom’ in the 1960s that is associated with increased female participation in the labour market and delay in the age of child bearing. Any change in the pattern of fertility has profound consequences for the provision of public services, particularly in education and health care.

This study seeks to explain the level of fertility by using the individual level data available in the NILS sample. Various regression models will be employed to explain births in the period 1997 – 2006 by three sets of variables. The first of these comprises the characteristics of the potential mother in 2001 and will be based upon the census. The second consists of the characteristics of the area where the potential mother resides. This is a measure of the environmental factors upon individual fertility and will be based upon NINIS. The final set of variables takes account of the background of the potential mother and will be based upon the linked 1991 census records.

Based upon the explanation of births 1997 – 2006 a forecasting model will be constructed.

Completed Projects

No projects yet completed