peter goldblatt
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Are social inequalities affecting the health of young people: taking a life course approach to health outcomes . Peter Goldblatt. The Commission on Social Determinants of Health (CSDH) – Closing the gap in a generation. Strategic Review of Health Inequalities in England: - PowerPoint PPT PresentationTRANSCRIPT
Are social inequalities affecting the health of young people: taking a life course approach to
health outcomes
Peter Goldblatt
The Commission on Social Determinants of Health (CSDH) – Closing the gap in a generation
Strategic Review of Health Inequalities in England:The Marmot Review – Fair Society Healthy Lives
Review of Social Determinants of Health and
the Health Divide in the WHO European Region
• Social justice• Material, psychosocial,
political empowerment • Creating the conditions
for people to have control of their lives
www.who.int/social_determinants
Key principles
A. Give every child the best start in lifeB. Enable all children, young people and adults to
maximise their capabilities and have control over their lives
C. Create fair employment and good work for allD. Ensure healthy standard of living for allE. Create and develop healthy and sustainable places
and communitiesF. Strengthen the role and impact of ill health
prevention
Fair Society: Healthy Lives: 6 Policy Objectives
Prenatal Early Years Working Age Older Ages
Family building
Accumulation of positive and negative effects on health and wellbeing
LIFE COURSE STAGES
MACROLEVEL CONTEXT
WIDER SOCIETY SYSTEMS
Perpetuation of inequities
Prenatal Early Years Working Age Older Ages
Family building
Accumulation of positive and negative effects on health and wellbeing
LIFE COURSE STAGES
MACROLEVEL CONTEXT
WIDER SOCIETY SYSTEMS
Perpetuation of inequities
Prenatal Early Years Working Age Older Ages
Family building
Accumulation of positive and negative effects on health and wellbeing
LIFE COURSE STAGES
MACROLEVEL CONTEXT
WIDER SOCIETY SYSTEMS
Perpetuation of inequities
Gaps in school readiness at 3 and 5 years by family income: UK
Ave
rage
per
cent
ile s
core
Waldfogel & Washbrook 2008
0 10 20 30 40 50 60
Romania Latvia
Bulgaria Lithuania
Italy Greece
Spain Poland
Portugal Luxembourg
Hungary United Kingdom
Malta Estonia
Switzerland Ireland
Slovakia France
Belgium Netherlands
Germany Austria
Czech Republic Sweden Finland Cyprus
Slovenia Denmark
Norway Iceland
Poverty rate
Before social transfers After social transfers
Child poverty rates <60% median before and after social transfers 2009
Source: EU SILC
A) Give every child the best start in life.
Priority objectives
1. Reduce inequalities in the early development of physical and emotional health, and cognitive, linguistic, and social skills.
2. Ensure high quality maternity services, parenting programmes, childcare and early years education to meet need across the social gradient.
3. Build the resilience and well-being of young children across the social gradient.
Early child care and education
• Parenting and family support– Perinatal services– Care before and during pregnancy– Help for new mothers
• Pre-school education and care• Primary, secondary and tertiary education and
training
Differences in PISA scores by attending preschool for more than one year before and after accounting for socioeconomic background
OECD PISA 2009 database
IsraelBelgium
FranceItaly
SwitzerlandDenmark
United Kingdom
TurkeyLithuania
SerbiaTFYR Montenegro
NetherlandsIreland
Slovenia
0 20 40 60 80 100 120 140
Before accounting for socioeconomic backgroundAfter accounting for socioeconomic background
Children achieving a good level of development at age five, local authorities 2011: England
0 30 60 90 120 15040
45
50
55
60
65
70
75
80
Local authority rank - based on Index of Multiple Deprivation
Good level of development
at age 5%
Source: LHO (2012)
Birmingham Brighter Futures• Aims to improve the lives of all the city's children
and young people;• Focus on improving children’s physical health,
literacy and numeracy, behaviour, emotional health, social literacy, and job skills.
• Specific programmes relevant to early years include: Family Nurse Partnership (FNP), Incredible Years Parenting Programme, Promoting Alternative Thinking Strategies (PATHS), Triple P Parenting Programme.
Per cent 5 year olds achieving ‘good development score’,* Birmingham LA, West Midlands & England
*in personal, social and emotional development and communication, language and literacy
Source: Department for Education: preliminary data
%
B) Enable all children, young people and adults to maximise their capabilities and have control over
their lives.
Priority objectives
1. Reduce the social gradient in skills and qualifications.
2. Ensure that schools, families and communities work in partnership to reduce the gradient in health, well-being and resilience of children and young people.
3. Improve the access and use of quality lifelong learning across the social gradient.
Life expectancy (at age 30) trends in Sweden 2000-2010, by education, women
Trends in probability of survival in men by education: Russian Federation
0.4
0.45
0.5
0.55
0.6
0.65
0.7
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
Calendar year
45 p
20
45 p20 = probability of living to 65 yrs when aged 20 yrs
University
Less than secondary
Source: Murphy et al 2006
Absolute inequality in males death rates by level of education
Mackenbach et al 2008
Prenatal Early Years Working Age Older Ages
Family building
Accumulation of positive and negative effects on health and wellbeing
LIFE COURSE STAGES
MACROLEVEL CONTEXT
WIDER SOCIETY SYSTEMS
Perpetuation of inequities
Per cent not in education employment or training by local authority: England
0
5
10
15
20
Not in Education Employment or Training
Local authorities
Per cent NEET
Further information
www.instituteofhealthequity.org