1. Rationale for building resilience Health inequalities are caused by ‘differences in poverty, power and resources needed for health’ (Due North, 2014). ‘Those who face the most adversity are least likely to have the resources necessary to build resilience. This ‘double burden’ means that inequalities in resilience are likely to contribute to health inequalities’ (IHE, 2014). Develop resilience to address inequalities and improve outcomes for young people and adults.

2. What is resilience? capacity to ‘bounce back’ from stresses, adversity, or risk factors capability to make positive, or less harmful, decisions about one’s health it is contextual, not a constant state influenced by the world we live in at individual, familial, and community levels; resilient environments It is less about dealing with risks in silos but addressing the whole person

3. Risk Factors Resilience is associated with a range of health topics/risk factors: Substance Misuse Reproductive and sexual health, Teenage pregnancy Mental Health Diet and obesity Physical activity Youth Justice Presentation title - edit in Header and Footer

4. The rate of developmental change during adolescence is second only to infancy Good health allows young people to make the most of their teenage years Many poor health outcomes for adults originate when we are young, for example smoking, mental health, obesity and violence Why focus on young people?

5. Research from the CMO’s report All cause mortality for 10-19 year olds is now higher than for other periods of childhood except for newborns – main cause is injury Five of the ten riskiest factors for the total burden of disease in adults are initiated or shaped in adolescence There appears to be a window of vulnerability to risky behaviours between 14-17 years Adolescents have higher use of health services than other child categories above the age of 3

6. Behaviour across Adolescence Source: Hawkins & Monahan 2009

7. Poor health outcomes death or injury in childhood premature death in adulthood increased risk of disease (including cancer, lung disease, liver disease, heart disease, diabetes, hypertension and stroke) poor mental health Health-harming behaviours: Binge drinking 12% Poor diet 14% Smoking 23% Violence perpetration 52% Heroin and crack use 59% Unintended teenage pregnancy 38% Adverse Childhood Experiences Children and young people exposed to ACEs have an increased risk of poor health outcomes and health-harming behaviours across the life course :

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9. Perinatal and infant mental health One of the strongest predictors of wellbeing in the early years is the mental health and wellbeing of the mother or caregiver Up to 20% of women experiencing a mental health problem during pregnancy or within a year of giving birth; this can have significant and long term consequences for mother and baby The cost of failing to deal adequately with perinatal mental health and child maltreatment has been estimated at £23billion each year Children of mothers experiencing perinatal mental illness are at increased risk of: prematurity low birth weight irritability sleep problems behavioural problems emotional problems conduct disorders language development delays Impaired parent child interaction all of which can have a negative impact on school readiness In the most extreme cases perinatal mental illness increases the risk that children will be abused or neglected.