Lifeways Cross-Generational Study
Lifeways Cross-Generation Study is a unique cohort study, designed to capture Irish longitudinal life-course data, by recruiting three generations of the same family.
Cohort studies and life-course epidemiology
Lifeways is a cohort study, which means participants, who are essentially well at baseline, are followed up over time. As outcomes or diseases slowly develop, baseline data are then analysed to identify lifestyle, socio-economic and health service factors, which are associated with these outcomes.
Recent longitudinal cohort investigation of chronic disease, particularly cardiovascular disease and cancer, has focused on not just baseline risk factors, but factors at different critical times across the life-course. This is known as life-course epidemiology and in order to engage in analyses at this level, longitudinal data at different time points are needed.
After the randomised controlled trial, the cohort study is the most sophisticated and powerful observational study design as it is unbiased. The difficulties with longitudinal cohort studies are that they have to be sustained over an extended period of time and therefore require considerable resources.
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1124 Mothers consented at ante-natal clinics in the Coombe Hospital Dublin and in University College Hospital Galway between Oct 2001 and Jan 2003. These pregnancies resulted in 1055 index babies. Additionally, 355 fathers and 1231 grandparents were then recruited.
- To determine health status, diet and lifestyle of the mother, father, index child and grandparents and to establish patterns and links across generations.
- To determine the risk factors for cardiovascular disease in Ireland.
- To document primary care utilisation patterns across the social spectrum and across generations.
- To examine how indicators of social position, particularly means-tested general medical services (GMS), influences health status during the first four to five years of a new-born child’s life.
So far, participants have been followed up for nine years, but we hope to obtain funding for a much longer follow-up period. This study represents an investment into the future and is especially important in that it has the capacity to link health information from the ante-natal stage through childhood. It is the only such dataset on the island of Ireland as neither the Millenium Birth Cohort in the United Kingdom and Northern Ireland and the planned National Longitudinal Study of Children in the Republic has such information.
Lifeways was initially established as part of a Health Research Board (HRB) funded unit for Health Status and Health Gain (1999-2004). It has received further peer-reviewed funding through the HRB’s primary care fellowship scheme, the summer student fellowships, an equipment grant and a project grant in 2005.
What important information does it tell us about childhood in Ireland?
The information from this cohort will contribute to knowledge about health status in a variety of situations and settings, not just in the health sector but also in the education and social and family affairs sectors. We will be able to provide detailed information on why and how GMS eligible families differ from those who are not eligible, not just at cross-sectional time points but over a series of years and in trajectory terms, across generations. We have the scope to provide information about health care utilisation, about influence of income, education and domestic circumstances on health indicators. The peer publication process will ensure widespread dissemination in the national and international literature but also through policy fora. Lifeways is not alone unique in Ireland but highly novel in international terms, being one of few such studies with information across three generations.