Benelux – Nordic countries meeting on Child Indicators

Introduction

Erik Jan de Wilde

2

Content

• Purpose of this meeting

• The well-being indicator debate

• A local example: the Rotterdam Youth Monitor

• The programme: what to expect?

Purpose of this meeting

• To be updated: – state of the art debate of indicators of well-

being

• To be informed and inspired:– practices from other countries

Your companions these three days: – policymakers on different levels, – scientists, – facilitators.

Empirical cycle

hypothesis

evaluation

observation

test

Clinical cycle

Treatmentplan

evaluation

Problem assessment

Treatment

Policy cycle

Policy formulation

Policyevaluation

Agendasetting

Policy Implemen-

tation

PDSA cycle

Plan

Study

Act

Do

The Well-being indicators debate• Started around late ’40’s• Rapid development 1980-2005

– UNICEF’s “State of the World’s Children” annual report published since 1979.

– The United Nation’s Convention on the Rights of the Child

– A number of national and multi-national projects and studies (e.g., Annie E. Casey Foundation’s Kids Count (early 90’s).

• ISCI

Issues with indicators

• Well-being vs well-becoming

• Self-report vs other-report

• Positive vs negative measures

• Data-driven vs theory-driven

• Child-centered vs other

• Age

Two major studies:

UNICEF OECD

0 5 10 15 20 25 30

Portugal

Italy

Greece

Latvia

UK

Spain

Slovakia

Germany

Poland

France

Bulgaria

Netherlands

Romania

Austria

Switzerland

Norway

Croatia

Lithuania

Finland

Slovenia

Sweden

Estonia

Ireland

Suicide rates for adolescents aged 15-19 per 100,000 – 2006

Source: Eurostat

Well-Being indicatorSuicide rank

femalesSuicide rank

malesOECDMaterial Well-being -.526* -.665**Housing and Environment

-.625* -.781**

Educational Well-being -.826** -.795**Health and Safety -.015 -.068Risk Behaviours .182 -.087Quality of School Life -.324 -.389Overall rank -.635** -.799**

UNICEFMaterial Well-being -.275 -.547*Health and Safety .064 -.166Educational Well-being -.671** -.638*Family and Peer Relations

.375 .263

Behaviours and Risk -.236 -.372Subjective Well-Being .118 -.257Overall rank -.214 -.520*

The Netherlands: A beautiful country!

But is it?

Youth care in the Netherlands

OBSTACLES• 12.000 children on waiting lists

for specialized help

• raise in specialized help 5% every year

• lack of effective programs for prevention of psychosocial problems

• no systematic screening

• fragmented services

Cause?

18

A local example: the Youth Monitor Rotterdam

The Rotterdam youth situation:

• Significant problems in a complex population

• Low resources in schools

• Shortage of mental youth care

• Many actors in the field

A method in YHC

What is the Rotterdam

Youth Monitor?

Initial goals of the RYM

• Collecting data on the (mental) health and its determinants

• Determining risk groups for interventions

• Feedback the individual and aggregated results to those involved in youth policy: parents, children and adolescents, schools, various parts of the municipality.

• Supporting all those involved in starting, designing, executing and maintaining action.

Youth Health Care in the Netherlands• Below 4 yrs: “babyclinics” monitor

growth development and vaccination status

• 4-19 yrs: monitoring children’s health in general

Youth Health Care in the Netherlands

last century this century

What is the Rotterdam

Youth Monitor?

parentquestionnaire

teacher questionnaire

school doctor

individualfeedback

anonymousdatabase

individualaction

school/neigh-bourhood fb

municipalityfeedback

districtfeedback

collectiveaction

parent/childfeedback

routing YMR primary education

• 18 months parents, nurses

• 30 months parents, nurses

• 5-6 yr. parents, teachers, school doctors

• 9-10 yr. pupils, parents, teachers

• 12-13 yr. pupils, school nurses

• 14-15 yr. pupils, school nurses

• 16-17 yr. pupils

Measurements / data sources

pupil questionnaire

analysis

individualanalysis

school nurse

individualaction

anonymousdatabase

schoolfeedback

municipalityfeedback

districtfeedback

collectiveaction

parent/child feedback

routing YMR Secondary Education

two-step-screening

longitudinal screening

An intervention

Research infrastructure

A screening instrument

A policy instrument

A method in YHC

What is the Rotterdam

Youth Monitor?

Some results

0

10

20

30

40

50

suicidegedachten meisjes

suicidepogingen meisjes

suicidegedachten jongens

suicidepogingen jongens

Van de Looij, 2003

Suïcidaal gedrag bij VO-3 leerlingen in Rotterdam

Carrying a weapon

overschie

ijsse lm

cen

h il/sch

fe ij

p r. a lex

kra/c ro

charl

hoogv l

noo rd

>20%

16 - 20%

10 - 15%

Figuur 3.14 Percentage 14-15 jarigen dat af en toe of (b ijna) dagelijks een wapen draagt

20

19

21

19

23

2424

22

20

2112

25

5459

80

88

57

49

7

2217

48

64

19 20

0

10

20

30

40

50

60

70

80

90

100

Dutch

Surina

m

Antilli

an

Mar

occa

n

Turkis

h

Capev

erdi

anOth

er

%boys

girls

% 15-yrs old that do not want homosexuals as their friends

Why starting a youth monitor?• To collect data on the (mental) health and

behaviour, and its determinants

• To determine risk groups for interventions

• To feedback the individual and aggregated results to those involved in youth policy: parents, children and adolescents, schools, various parts of the municipality.

• To support all those involved in starting, designing, executing and maintaining action.

Key players:

• local government(s) / local services

• schools

• parents

• children and adolescents

A few results: new angles in Rotterdam youth policy• Focus on weapon possession

• Focus on parenting support

• Focus on depression

• Focus on overweight and diabetes

Is it a succes?

Criteria for succes:• Is the cycle running?• Have policies changed because of

the indicators?• Will it run again? • And again?

Is it a succes (2)?

And above all:• Is there an increase in well-being?

And, by the way:• Is that increase attributable to the

use of indicators?

YMR: What looks good?

• the structural nature

• involvement of primary process

• action-invoking character

• involvement of other actors in the local system of youth health policy

Issues yet undebated (?)

• Theory of well-being

• Reliability/validity of other-report

• What report is needed on what level?

• What kind of report?

• Sustainability of indicators?

The program:

• Today, after this talk: dinner!

• Monday:

– Morning: state of the art (plenary)

– Afternoon: Country examples (workshops)

• Tuesday

– Morning: Lessons learned & Future perspectives (plenary)

Have a good timeIn Amsterdam!