The health of Irish children:findings from recent studies

Prof Kevin P Balanda, FFPH

Director of Research, Institute of Public Health in Ireland

Tirana, Albania April 2014

Policy context

Recent policy context

National Children’s Strategy 2000-2010 (2000)

Series of semi-autonomous government agencies: Programme of Children / Best Health for Children / National Children’s Office

Children and family services some fragmented and disjointed; distributed across several government departments

In 2011, Department of Health & Children (DoHC) split into:• Department of Health • Department of Children and Youth Affairs (DCYA)

A new public health framework “Healthy Ireland 2013–2020 launched in 2013 with a focus on early years and prevention

Responsibilities: • Deliver focused interventions dealing with child welfare & protection,

family support, adoption, school attendance & reducing youth crime. • Harmonise policy and provision across Government and with a wide

range of stakeholders• Oversee the new Child & Family Agency

Minister for Children & Youth Affairs became a full Cabinet minister (previously Minister was a junior minister in DoHC)

Children’s Office became Office of the Minister of C&YA

Child & Family Agency established in January 2014 and brought together a number of service agencies

Department of Children & Youth Affairs

Better Outcomes, Brighter Future 2014-2020

Recent research studies and

information initiatives

• Commenced Growing Up in Ireland (GUI) national longitudinal study of children (2010)

• Continuing support for Health Behaviours of School-aged Children (HBSC) surveys

• Publication of the National Strategy for Research & Data on Children’s Lives (2011-2016)

• Children’s Research Centre (TCD) and Centre for Effective Services (CES)

National Set of Child Well Being Indicators (2005)

• Personal Health Record • Health Information Bill

Some recent research and information initiatives

HBSC Studies

To increase our understanding of young people’s health & well-being, health behaviours & their social context.

Cross-sectional study in 43 European countries & regions (WHO European Region collaboration)

Based on self-completion questionnaires administered in schools

Repeated every 4 years:

Irish HBSC survey:• 1998, 2002, 2006, 2010 and 2014 • In 2010, 67% of invited schools (85% of invited children)

participated.• In 2010, 16,060 children aged 9-17 years from 256 schools

www.nuigalway.ie/hbsc

Growing Up in Ireland (GUI) Study

National longitudinal study of factors that contribute to or undermine the well-being of children in contemporary Irish families

Face-to-face interviews of parents, teachers, principals & carers

Infant cohort (9 months) and Child cohort (9 years).

Two waves of data collection (2007/2008 & 2010): • Infant cohort (at 9 months and 3 years) • Child cohort (at 9 and 13 years).

Infant cohort: 11,100 (quantitative study) & 120 (qualitative study)

Child cohort: 8,500 (quantitative study) & 120 (qualitative study)

Recent findings

State of the Nation’s Children. Ireland 2012

Commitment of National Children’s Strategy

HBSC surveys, GUI study, census data and administrative data

Modelled on national child wellbeing Indicators

Source: Dr Sean Denyer (DCYA and DH)

Risk behaviours (1998 – 2010). HBSC

Cuerrent smoker Cannabis use Been drunk 0

5

10

15

20

25

30

35

21

10

29

19

11

31

15

12

32

12

8

28

1998

2002

2006

2010

Early smoking Initiation (2002 – 2010). HBSC

Positive health behaviours (1998 – 2010). HBSC

Frequent fruit consumption Regular exercise Use seatbelt0

10

20

30

40

50

60

70

80

90

18

47

62

19

53

79

20

51

82

54

41

1998200220062010

Exercise (4+ per week) (1998 – 2010). HBSC

Communication with parents (1998 – 2010). HBSC

Mother Father0

10

20

30

40

50

60

70

80

90

74

48

78

56

81

64

82

67

1998200220062010

Main trends among 9 – 17 year olds (1998 – 2010) : the good news. HBSC

Increases in fruit and vegetable consumption, use of seatbelts, self reports of excellent health, happiness, life satisfaction, tooth brushing, communication with mother and father, liking school and (most) positive school perceptions, local area has good places to go and is a good place to live, and can ask for help from neighbours

Decreases in smoking, drunkenness, bullying others, injuries, consumption of soft drinks and crisps, teenage pregnancies

Main trends among 9 – 13 year olds (1998 – 2010): the not-so-good news. HBSC

Increases in feeling pressured by school work, feeling low, local area is run down

No changes since 1998 in feeling anxious, having been bullied or feeling safe in local area

Decreases in exercise and high levels of overweight and obesity

High levels of binge drinking

Significant social class differences remain the same or are getting worse

Some policy implications (1)

Social gradient in health outcomes appears very early in childhood

Early interventions have the potential to reduce the scale of this gradient e.g speech and language therapy

The amount and type of interaction between a carer and a child has a direct effect on the achievement of developmental milestone.

Strong association between infant temperament and parental stress: supports to parents can reduce this stress

Some policy implications (2)

Children spend significant amounts of time in non-parental child care (particularly from age three): More consideration needs to be given to using these as health promoting opportunities

There has been a very large increase in the numbers of families with financial difficulties

Overweight and obesity occurs very early in childhood. There are few changes between the ages of 9 and 13 in levels of obesity

Thank you

Any questions?