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Child Health Indicators in the Context of Child Wellbeing The EU CHILD Project

Child Health Indicators in the Context of Child Wellbeing The EU CHILD Project. Michael Rigby Professor of Health Information Strategy Keele University, UK. Health and Wellbeing. Health is essential for wellbeing Wellbeing is essential for health

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Child Health Indicators in the Context of Child Wellbeing The EU CHILD Project

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  1. Child Health Indicators in the Context of Child Wellbeing The EU CHILD Project Michael Rigby Professor of Health Information Strategy Keele University, UK

  2. Health and Wellbeing • Health is essential for wellbeing • Wellbeing is essential for health • Health domain needs to move beyond ‘health’ as ‘illness’, and recognise it is ‘physical, mental, and social wellbeing’ [WHO] • Child wellbeing domain needs to see health as integral

  3. CHILD Project • 2000 – 2002 • 17 Countries • 15 Member States (EU15) • + Norway, Iceland

  4. CHILD Philosophy • Health Status, Outcome • Death, illness, etc. - important; too late • Health Determinants • Preventive, more important • Burden of Illhealth • Illness, social cost, loss of education • Determining Priority

  5. Core Principles of CHILD • Topics must be important health issues • Must be underlying scientific evidence • Comparability between countries • Routine data sources preferable • Ability for continuity and time series

  6. Lack of influence and participation Lack of day-care Harmful environment Negative market forces Deficient law Day-care School Social services Disease and injury Parenting Conditions for Positive Child Health and Development Unemployment Health care Social life Negative media Child-oriented culture Financial support to families Socially isolated living Adverse cultural development Poverty Uncertain future prospects Adapted by Gunnlaugsson G and Rigby M from Skolhälsovården 1998. Underlag för egen kontroll och tillsyn. Stockholm: Socialstyrelsen, 1998. Breadth of Determinants

  7. Structure of CHILD Health Determinants • Demographic and Socio-economic • Health Status and Well-being • Determinants of Health, Risk, and Protective Factors • Health Systems and Policy

  8. Topics ·    Demography ·    Socio-Economic ·    Marginalised Children ·    Well-being, Quality of Life  ·    Mental Health  ·    Lifestyles ·    Nutrition and Physical Growth ·    Development (inc. Intellectual and Social ·    Mortality, Morbidity, Injuries ·    Environment  ·    Health Promoting Policies ·    Access and Utilisation of Services 

  9. Short-Listing Criteria • Significance of Burden to Society • Significance of Burden to Family • Significance of Burden to Individual • Objective, based on research • Representative of Large Population Groups • Regularity and Repeatability (trend analysis) • Amenable to Effective Action • Data Availability • Understandable to broad audience

  10. CHILD Results 38 indicators - some traditional some novel thematic spread 17 areas need research - current evidence not adequate

  11. Aspects Measured C 12 Environmental Determinants D 7, D 8, D 9, D 10 A 1, A 2, A 3, A 4, A 5, D 5 Social Determinants D 6 C 3 C 9 C 11 Family Determinants C 1 C 2 D 1 1o Prevention D 3 D 2 2o Prevention Outcome : Process : Determinants D 4 3o Prevention B 8, B 9, B 10 Personal Behaviour B 11 C 5, C 7 Well-being C 6 C 4 C 8 B 7 B 7 B 3, B 4, B 5, B 6 C 10 Illness Disability B 1, B 2 Death (Birth) 10 years 1year 5 years 1week 18 years 6 months 15 years Age Spread of CHILD Indicators

  12. CHILD Indicators A. Demographic & Socio-Economic A 1 Socio-economic Circumstances A 2 Children in Poverty A 3 Parental Educational Attainment A 4 Child in Single Parent Households A 5 Asylum Seekers B. Child Health Status, Well-being Child Mortality B 1 Child Mortality Rates B 2 Selected Cause-specific Mortality Child Morbidity B 3 Cancer B 4 Diabetes B 5 Asthma B 6 Infectious Diseases B 7 Dental Morbidity Injuries to Children B 8 Burns Necessitating Admission B 9 Poisoning Necessitating Admission B 10 Fracture of Long-bones Mental Health of Children B 11 Attempted Suicide C. Health Determinants, Risk, and Protective Factors Parental Determinants C 1 Breastfeeding C 2 Household Environmental Tobacco C 3 Parental Support Child Lifestyle Determinants C 4 Physical Activity C 5 Tobacco Smoking C 6 Alcohol Abuse C 7 Substance Misuse Other Factors C 8 Overweight and Obesity C 9 Children in Care C 10 Early School Leavers C 11 Educational Enrolment C 12 Air Pollution Exposure D. Child Health Systems & Policy Health Systems Policy D 1 Marginalised Children’s Health Care D 2 Parental Inpatient Accompaniment Health System Quality D 3 Immunisation Coverage D 4 Leukaemia 5-year Survival Social Policy Indicators D 5 Physical Punishment D 6 Anti-bullying policies in schools Physical Protection Policy D 7 Child Transportation Safety D 8 Exposure to Lead D 9 Exposure to Hazardous Noise D 10 Environmental Tobacco Smoke

  13. CHILD Further Research Areas Child Abuse Childhood Behaviour Disorders Learning Disorders/Intellectual Disability Educational Development Perceived Well-being, Quality of Life and Positive Mental Health Children with Permanent or Severe Disability Family Cohesion and Social Cohesion Nutritional Habits Health Care Access Inpatient Service Quality Health Service Access for Socially Restricted Children Medication Play and Leisure Assessment of Children with Special Needs Integration of Children with Special Needs Healthy Parenting Mental Health Education

  14. Application of CHILD Indicators • EU ECHIM data set • Small use except mortality and other published items • Countries • Not coordinated; use through literature • Hungary; Sweden; NOMESCO; Ireland; UK; etc. • WHO • European Health Report 2005

  15. Hospital admissions for burns, per 100 000, 5-9 years olds <= 50 <= 40 <= 30 <= 20 <= 10 EUROPE No data No data 2000 Min = 0 WHO Compilation of CHILD Data

  16. 25.0-49.9 50.0-74.9 75.0-99.9 >=100 Burns and scalds necessitating hospital admission in 2000: HUNGARY by County Incidence per 100.000 individuals

  17. A 100,00 A A A A A A 75,00 A A A A Incidence of burns and scalds A A A 50,00 A A A A A 25,00 A 1000 1500 2000 2500 GDP National Institute of Child Health

  18. A 100,00 A A A A A A 75,00 A A A A Incidence of burns and scalds A A A 50,00 A A A A A 25,00 A 1000 1500 2000 2500 GDP National Institute of Child Health

  19. Other European Health Indicators • Perinatal Health (PERISTAT) • Child Safety (CSAP) • Children and Environment (CEHAPE) • Nutrition and Exercise Behaviour • Inter-personal Violence

  20. Contact and References m.j.rigby@keele.ac.uk • Rigby M, Köhler L (editors). Child Health Indicators of Life and Development (CHILD): Report to the European Commission; Centre for Health Planning and Management, Keele, UK, for European Commission Health and Consumer Protection Directorate; 2002 (98pp). (also available on http://www.europa.eu.int/comm/health/ph/programmes/monitor/fp_monitoring_2000_frep_08_en.pdf) • Rigby MJ, Köhler LI, Blair ME, Mechtler R. Child Health Indicators for Europe – A Priority for a Caring Society; European Journal of Public Health, 2003, 13, 3, Supplement, 38-46.

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