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Cephir June 27, 2012 Local strategies against inequalities in childhood health Dr. Onno de Zwart, MPH.

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Presentation on theme: "Cephir June 27, 2012 Local strategies against inequalities in childhood health Dr. Onno de Zwart, MPH."— Presentation transcript:

1 Cephir June 27, 2012 Local strategies against inequalities in childhood health Dr. Onno de Zwart, MPH

2 Rotterdam youth demography 23% of today’s Rotterdam population is 0- 20 yrs old 175 different nationalities 12% of non-western origin (mainly Turkish, Moroccan, Surinam, Dutch Antills) 53% of non-western origin in the age group 0-20 years

3 Disadvantaged areas (children at risk) and (% non- western youth 0-20 years 36 23 28 26% 7% 56 28% 37% 10% 20% 12% 4% 7 6% 36 5% 75 66 11% 16%12% 62 7763 52 12% 29%

4 Risk inventarisation Municipal Health Office Rotterdam

5 Families About one third lives in a single-parent family Families with children have a lower income than families without: 20% minimum, 14% structural minimal About 25% lives in a house that is too small

6 Youth in G4 and the Netherlands: Potential unfavorable family situations Number% Children in families living on well-fare 2009 Rotterdam 20.450 17,5% Amsterdam 20.320 14,6% Den Haag 10.480 10,5% Utrecht 4.290 7,5% The Netherlands183.5005,2% One-parent family with children (0-25 yr) 2010 Rotterdam 42.842 23,8% Amsterdam 53.020 24,2% Den Haag 29.161 20,0% Utrecht 10.928 10,6% The Netherlands 135.951 14,0% Teenage mothers 20112010 Rotterdam 319 − Amsterdam 185 − Den Haag 141 −

7 Preventive health care Rotterdam 2000-2007* Landelijk 2000-2007 First visit to preventive health care after 14 weeks of pregnancy 36,1%20,7% Bron: Rapportage Perinatale gezondheid in Rotterdam, nulmeting periode 2000-2007 *Begin 2013 gegevens beschikbaar over 2008-2011

8 Solutions. Youth Policy (incl. regional en local program Every Child Gains). Educational policy. Healthy School. Ready for a Child

9 Youth policy Rotterdam. Youth policy including Youth Health Care (Youth and Family Centres): responsibility of the city of Rotterdam. Youth care and child protection: responsibility of the region of Rotterdam. 2015: youth healthcare, care and child protection: decentralisation to municipalities 9

10 Every child gains!. Regional program (2007-2010). Regional and local program (2011 -2014). Result:. Youth and Family Centres: provides advice on raising children and, when needed, guides parents and children into other areas of the youth care system.. More than 90% of children is seen. More focus on children at risk

11 Every child gains and decentralisation youth care Common goal More children in Rotterdam will grow up in a safe home with possibility to develop their talents. Three objectives:. Strengthen the basic services and the educational environment. Strengthen the professional workers. Strengthen the strategy on care (improving steering conditions)

12 Rotterdam: educational facts and figures. 90.000 pupils in compulsory education: 174 nationalities. 250 primary schools, 75 secondary schools, 2 schools for upper secondary vocational training (50 locations), 4 schools for higher vocational education, 1 university. Private school boards govern the schools. Majority of parents is low educated. Language at home is often not Dutch

13 The Rotterdam school population: Ethnicity in compulsory Education

14 Schoolboards Rotterdam Education Forum Schoolboards Schools R Schoolboards CPM... City Districts: welfare, health, safety, childcare, sports, recreation Educational Advisory services authorities City Council, Mayor & Aldermen

15 Educational Policy Rotterdam 2011-2014 Two action programmes:.Beter Presteren: raising education results.Aanval op Uitval: tackling Early (or Unqualified) School Leaving

16 Educational Policy Rotterdam 2011-2014 raising education results more time for learning professi onal schools parents involve ment 2 school arrangements: ISO and Topclasses

17 Tackling Early school leaving main factors, interventions - growing focus on truancy; early and complete reporting by schools; more personnel to find and pick up truant youngsters - growing awareness in vocational education that Gripping & Binding is important to keep pupils in school - more diversity in vocational trajectories, more different ways of learning/training - possibilities for streaming into school at several moments during the year, following the process of tracking and leading back And a non-planned, positive development: bad perspectives on the labourmarket keeps the youngsters longer in education/training

18 Tackling Early school leaving monitoring ESL since the Lisbon Agreements:

19 GGD Rotterdam-Rijnmond

20 Youth health care: Healthy City, Healthy Schools. Gezonde School officially started in 2008. In Rotterdam en region now more than 80 schools Healthy Primary School Primary School secondary School Healthy secondary school Special education

21 Starting point. ‘Maximize their potential’. Using this message gets politicians at our side. health, education and development are closely linked

22 Basic principles Question/need of the school is central No ad hoc activities, but a structural approach Integrated approach on four levels Team with other partners: local & regional organizations

23 Programma Klaar voor een Kind Ernie van der Weg Program Ready for a Child

24 B C D E A TOP 5 ongunstige wijken A Waalhaven / rand Charlois37 B Schieveen34 C Pernis24 D Delfshaven23 E Nieuw Crooswijk22 Gemiddelde Nederland: 10,3 A13 A20 A16 A15 Babysterfte (foetale sterfte: vanaf 22 weken zwangerschapsduur + vroegneonatale sterfte: tot 7 dagen na de bevalling) in aantal per 1000 geboorten, naar wijk

25 Preconceptional care- PregnancyGiving birth safelyAfter birth care CJF (CJG) Programstructure, education, information, research, monitoring & evaluation

26 Conclusions. Rotterdam does have inequalities in youth health. As in health among adults. Health infrastructure is suited to all. Youth health care more focus on groups at risk. ‘Every child gains’ offers a chance for a new system. Important to stimulate better educational results. We need a more integrated postitively based youth policy. With the restructuring of the city organisation there’s a chance to reach that goal.

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