A quarter of children in Wales live with at least one parent who has a long-term health condition, yet no one has systematically tracked how this shapes children’s own health and use of NHS services. This matters because family clustering of long-term conditions—driven by shared genes, environment, and caregiving strain—is well documented in adults, but the knock-on effects on children remain a blind spot. Without population-level data, policymakers cannot target support where it is most needed. The project will link the 2021 Wales Census with routine health records, energy performance certificates, and housing data to map family structures, neighbourhood conditions, and children’s planned and unplanned healthcare use. If successful, the research could change how the NHS and social services identify and support children in families affected by multiple long-term conditions. Instead of treating each family member’s illness in isolation, services could anticipate higher demand for GP visits, A&E attendances, or hospital admissions among children whose parents are managing chronic disease. This is applied, policy-facing work—not fundamental science—with direct implications for how health systems allocate resources and design family-centred care.
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Long-term conditions (LTCs) are increasingly common in both children and adults, often clustering in families due to shared genetics and environment. Family support is usually important for people with LTCs, but caring can also adversely affect carers health and wellbeing. The effects on adult family members are increasingly understood, but the impact of parental LTCs on children remains underexplored at a population level and more research is needed to understand its extent and consequences. Aim Assess the prevalence of LTCs among members of families living in Wales, describe their household and neighbourhood environments, and examine how living with parents/carers with LTCs is associated with children’s own experience of LTCs and healthcare use. Objectives Objective 1. Develop robust methods to measure and categorise family structures and LTCs in parent/carers and children. The 2021 Wales Census will be used to identify households with children and establish kinship links, and new reproducible phenotyping algorithms for childhood LTCs in routine data will be developed. Objective 2. Describe the frequency of different family types and their housing and neighbourhood environments linking data from Energy Performance Certificates, the Welsh Demographic Service Dataset, and other sources. Bayesian profile regression will be used to explore associations between environmental factors and family health patterns. Objective 3. Examine associations between parent/carer LTCs and children’s planned and unplanned healthcare use using multistate survival models with household random effects. Public Involvement Regular engagement with CYPPPI panels will ensure the research remains grounded in real-world experiences and responsive to family needs.
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