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Inequalities in young people’s health and wellbeing: UK and international perspectives

Inequalities in young people’s health and wellbeing: UK and international perspectives. AYPH Conference, March 1 st 2011 ‘Making a difference: Improving health and wellbeing outcomes for young people’ Professor Candace Currie Child and Adolescent Health Research Unit (CAHRU)

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Inequalities in young people’s health and wellbeing: UK and international perspectives

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  1. Inequalities in young people’s health and wellbeing: UK and international perspectives AYPH Conference, March 1st 2011 ‘Making a difference: Improving health and wellbeing outcomes for young people’ Professor Candace Currie Child and Adolescent Health Research Unit (CAHRU) University of Edinburgh

  2. Where is action needed? How do we identify health needs? Examining the evidence for young people’s health improvement

  3. Where is action needed? How do we identify health needs? • Comparative approaches • Detection of inequalities and inequities in health • Social determinants of health – production on inequalities

  4. Health inequalities ‘Measurable differences in health experience and health outcomes’ according to characteristics such as: gender age geography socioeconomic status

  5. Inequalities in Young People’s Health Report from the Health Behaviour in School-Aged Children (HBSC) 2005/06 Survey in 41 countries Currie et al, 2008. WHO, Copenhagen Health Policy for Children and Adolescents, No. 5

  6. Gender and Age United Nations has stated there is an international responsibility to achieve equality between the genders Yet very little attention is given to gender differences in most youth health reports Adolescent age group often merged with younger children or with young adults in health statistics Importance of different stages of puberty, physical and emotional development, growing independence and choice neglected Some health risks already established by age 11, others begin and increase during adolescent years

  7. ‘Where health data on adolescence are available, it is often not disaggregated by sex, age cohort or other factors that could give much-needed details on the situation of adolescents’. UNICEF ‘State of the World’s Children’ Report (2011)

  8. Socioeconomic status socioeconomic inequalities are related to social status and resources such as material possessions there are a number of ways to measure socioeconomic status of adolescents HBSC report uses family material affluence as a measure of socioeconomic status – HBSC FAMILY AFFLUENCE SCALE (FAS)

  9. Iceland Chart showing country variation in levels of family affluence Family affluence low medium high Turkey

  10. Examining the evidence: for young people’s health improvement • how do Scotland, England and Wales compare with each other? • how does health of young people in UK compare with Europe and North America? • what health inequalities do we observe among young people in UK and internationally? • what are the implications for action?

  11. Health fair/ poor (age 15) 6th 7th • UK countries all rank high on fair/poor health • In all countries, girls report poorer health than boys • In most countries, rates of poorer health increase with age especially among girls 8th

  12. Family affluence and self–rated health family affluence fair/ poor health

  13. Daily fruit (age 15) 3rd • UK variation • In UK and all other countries girls > boys • Fruit eating declines with age in almost all countries 20th 21st

  14. Family affluence and daily fruit familyaffluence daily fruit

  15. Weekly smoking (age 15) • England ranks low compared to Wales and Scotland – due to girls • In UK girls > boys; same is true in about half of countries; reverse is true in east Europe 16th 19th 29th

  16. Family affluence and weekly smoking family affluence weekly smoking • in north (Europe and N America) • and western Europe • among girls more commonly • than boys

  17. Drunk at least twice (age 15) 3rd 5th • All UK countries have high rates of drunkenness • In UK girls are as/ more likely to get drunk than boys, unlike most other countries 8th

  18. England relatively positive cf Scotland & Wales Food habits Hours spent TV watching Smoking Cannabis use Condom use England relatively negative cf Scotland & Wales Medically attended injury Daily 60 minutes of physical activity Bullying Picture across UK is similar in terms of prevalence and gender patterns for self-reported health and patterns of alcohol use

  19. Explanations for similarities and differences across UK? • Cultural similarities – eg youth drinking culture across the UK? • Differences found in UK health patterns may be explained by social/demographic factors or differences in policy and practice? • Further analysis of HBSC and other data sources required to answer these questions

  20. UNICEF Innocenti Report Card 9: ‘Children left behind’ (2010) • Compares the gap in well-being between the median (average) and worst off children in richest (OECD) countries • Considers three aspects of well-being: material, educational, health • Asks ‘how far are children being allowed to fall behind?’ in each country

  21. Measuring bottom end inequality in health • Three indicators are used: • self-reported health complaints • healthy eating • and frequency of vigorous physical activity • All three are well-established markers for children’s current and future health - data are derived from the 2005-2006 HBSC Survey

  22. In UK and internationally also observe marked differences in social contextual dimensions which may explain help to explain health inequalities Social determinants of health

  23. Easy to talk to their mother (15 year olds) • England ranks 26th (Wales is 23rd and Scotland 32nd ) • In most countries boys find it easier to talk to their mother than do girls 23rd 26th 32nd

  24. Three or more close friends (at age 15) 3rd 4th • England ranks 4th (Wales is 6th and Scotland 3rd) • No gender difference in UK but in some countries boys > girls 6th

  25. Like school a lot (age 15) • England ranks highest and Scotland ranks lowest • No gender difference in England and Wales but girls> boys in around half of countries 13th 20th 28th

  26. Variation in supportive social contexts in UK • England is doing well in terms of positive socioeconomic environment and in terms of liking school cf other UK countries • All UK countries score high on friendships with peers • Family support appears weaker in UK than many other countries

  27. Pressured by schoolwork (age 15) 2nd 3rd • Wales and England more pressured than Scotland • In most countries girls more likely to feel pressured 24th

  28. 4+ evenings out with friends (age 15) 7th • Scotland ranks highest and England lowest in UK • Boys > girls in most countries 12th 15th

  29. Young people in England & Wales report high level of pressure stemming from schoolwork – can impact on mental health Being out in evening with friends 4+ nights a week is a known factor in risk taking behaviour – less prevalent in England than other UK countries Variation in ‘risky’ social contexts in UK

  30. Inequalities in health of young people across the UK • variation in different dimensions of health experience across UK – need to understand more about underlying causes • common sources of inequality are seen to prevail related to gender, age and family affluence • overall these are similar to inequalities experienced by young people throughout Europe and North America but gender/ socioeconomic patterns do vary

  31. Implications for policy and practice to safeguard and enhance health of adolescents • Need to take into account prevailing age, gender and socioeconomic inequalities • Evidence vital for priority setting and for developing approaches to prevention/ intervention • Identifying areas of need indicates where need to build assets to support health

  32. ‘In the global effort to save children’s lives, we hear too little about adolescence’ ‘Surely, we do not want to save children in their first decade of life only to lose them in the second’ Investing in health of young people

  33. INVESTING IN YOUNG PEOPLE TO SECURE SCOTLAND’S FUTUREMarch 22, 2011 from 9AM until 5PM • Speakers include: • Vivian BarnekowWorld Health Organisation • Leonardo MenchiniUnicef • David McQueenIUHPE • Clive NeedleEuro Health Net • Dominic RichardsonOECD • David PattisonInternational Devt. Health Scotland • Gerry McCartney Public Health Observatory • Louise Warde-HunterAction for Children Conference Fee: FREE, Please register as soon as possible as places are limited. Venue: John McIntyre Conference Centre, Edinburgh Full programme and registration: www.education.ed.ac.uk/cahru

  34. INVESTING IN YOUNG PEOPLE TO SECURE SCOTLAND’S FUTUREMarch 22, 2011 from 9AM until 5PM • Topics include: • Young peoples’ health in international context • Challenges to Scotland’s health • Young peoples’ health over the last 20 years • Sexual health in Scotland • Mental Health, Transitions and Violence • Children left behind • Investment in young people • Social inequalities & creating a healthy community Conference Fee: FREE, Please register as soon as possible as places are limited. Venue: John McIntyre Conference Centre, Edinburgh Full programme and registration: www.education.ed.ac.uk/cahru

  35. Thank you Further information on HBSC and its publications at www.hbsc.org

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