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CHAPTER FIVE Conclusion
5.1 This report provides further evidence of the persistence of inequalities within the circumstances into which Scotland's children are born. The longitudinal nature of GUS will enable the longer term effect of disadvantage to be tracked and also the ameliorating effect of a range of different services. At present, however, we are able to go someway toward identifying more precisely the constellation of factors that pattern that disadvantage.
5.2 The interrelationship between age, young motherhood and a range of measures of socio-economic advantage/disadvantage has been further explored in this report. We have identified some clear differences in the experiences between those mothers who are under 25 at the birth of their first child and those who are over 25, suggesting that the concept of young (and mostly disadvantaged) motherhood should be extended beyond the teenage years. These younger mothers are more likely to be living in lower income households and to be in receipt of state benefits. Younger mothers are also significantly more likely to be lone parents, even though a proportion of them live with other adults, often their own parents. There is, then, a complex interplay of maternal age, lone parenthood and social disadvantage operating.
5.3 Younger mothers were less likely to be working, either full-time or part-time, suggesting that work as a route out of poverty is not embedded in the life circumstances of these women. Younger mothers also have fewer educational qualifications, suggesting that employment, when taken up, is unlikely to have a marked effect on socio-economic position.
5.4 A particularly vulnerable group were lone mothers who were not living with other adults, as they were more likely to be in the lowest income group. Lone mothers were also less likely to be employed and when employed were more likely to be in routine or semi-routine occupations.
5.5 Maternal age and family type are thus interrelated and both closely associated with socio-economic disadvantage across a range of measures, with concentrated disadvantage evident in mothers under 25 and lone parents who do not live with other adults.
5.6 This report has also explored the relationship between social disadvantage, maternal age, family type and three maternal behaviours - smoking, breastfeeding and attendance at ante-natal classes. Differences in likelihood of breastfeeding by maternal age and level of education are notable. Logistic regression showed that education to Higher level or above was the best predictor of breastfeeding.
5.7 Non-attendance at ante-natal classes was associated with younger age, lower income and socio-economic classification and lower educational attainment. Logistic regression suggested that, after parity, maternal age at child's birth was the strongest predictor of attendance at ante-natal classes with older mothers being more likely to attend that younger mothers.
5.8 In relation to smoking, younger mothers, with lower educational attainment and living in more deprived areas, were more likely to report that they smoked. Logistic regression suggested that, although as with the other behaviours reported above, most measures remained significant, social renting emerged as the strongest predictor of maternal smoking. This may be because of a particular range of characteristics of disadvantage are encapsulated in those who rent from the local authority.
5.9 A resilience framework was employed to explore what factors seemed to influence 'positive' behaviours amongst more disadvantaged groups. Analysis focused on two disadvantaged groups: mothers under the age of 25 at the time of birth and lone parents of all ages.
5.10 Those younger mothers who did breastfeed were characterized by relative social and economic advantage: they were more likely to be in couple families, to be owner occupiers and to have a higher level of educational attainment. Lone mothers who breastfed were less likely to be living in areas of deprivation and to be more highly educated than lone mothers who did not breastfeed.
5.11 With regards to attendance at ante-natal classes, younger mothers who attended were characterized by relative social and economic advantage. For lone mothers, being 25 and over was a strong predictor of attendance.
5.12 For younger mothers, maternal education was the strongest predictor of not smoking although living in a couple household, being an owner occupier and having educational qualifications were all independently and positively associated with non-smoking. For lone parents, occupational classification and employment status were more prominent predictors alongside educational attainment.
5.13 It is important to note that the measures of disadvantage that were used in these analyses are only part of the overall picture of what influences maternal health related behaviour. The models that have been used certainly do not fully explain these behaviours. It is clear that there is a complex relationship between social and economic disadvantage and other factors such as maternal age and family type. While the analyses are suggestive of the importance of educational attainment in supporting resilience amongst the two disadvantaged groups of mothers (lone and younger), further multivariate analyses would need to be conducted to explore the data further and to incorporate other factors into the modeling. Nonetheless, the analyses conducted so far would imply that supporting education for young mothers, many of whom are also lone parents, may help develop resilience in the face of other disadvantages and hopefully improve outcomes and life chances for themselves and their children.
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