1. Potential new modules for future EHIS Module on health of children
Agenda point 4.3
Jakub Hrkal
ESTAT Unit F-4
13-14 October 2016
2nd meeting of EHIS Task Force

2. 2nd meeting of EHIS Task Force
Outline
Need for statistics on health of children
General issues and particularities of a sub-module on health of children
Preselected topics and variables
Remarks
13-14 October 2016
2nd meeting of EHIS Task Force

3. Why data on children in EHIS?
Envisaged in the current framework regulation 1338/2008 (Annex I, Scope)
Proposals as part of the modernisation of social statistics → DSS broad agreement to develop measures of disability prevalence, including children → EHIS identified as an appropriate source by GALI TF
Policy DGs consultation → various needs
Consultation of TG HIS → broad support to consider for future EHIS (+ proposals for topics & list of issues)
1338/2008, Annex I, Scope: Persons living in institutions as well as children aged 0-14 years shall be included, when appropriate and at the relevant ad hoc intervals, subject to successful prior pilot studies.
13-14 October 2016
2nd meeting of EHIS Task Force

4. 2nd meeting of EHIS Task Force
Criteria for selection of topics and construction of questions/variables
Policy relevance/importance
Appropriateness in survey:
Feasible to be collected via survey
Providing reliable estimates
Suitable for proxy respondents
Suitable for different data collection modes
Take into account existing sources (CSHCN, UNICEF/WG, HBSC, ESPAD, national surveys)
Alignment with EHIS adults and harmonization with SILC children variables, youth statistics
Reasonable size (→ short and long version)
13-14 October 2016
2nd meeting of EHIS Task Force

5. Statistical methodology aspects
Target population: 0 – 14 years
Sample size and sampling method
SILC: % of HHs with at least 1 child aged 0-15 is 24-43%
EHIS 2: % HHs with at least 1 child aged:
0-4: 10% (5-14), 5-13: 17% (13-23)
EHIS 2: Children (max. 2 children counted) to adults ratio:
0-4: 12% (6-17), 5-13: 23% (15-32)
Sample 1 or more children? Sampling method?
Use of proxy respondents
Only proxy respondents → exclude some topics
Define who can be proxy or at least collect info on the relation of proxy respondent to child
Modes of data collection → pre-testing
13-14 October 2016
2nd meeting of EHIS Task Force

6. Identified needs for data
EU needs/policies
National interest
Eurostat study
Disability of children
Health outcomes, incl. mental health
Weight and height
Eating behaviours: fruit, vegetables, sugar- sweetened beverages
Physical activity and sedentary activities
Tobacco use, Alcohol use, Cannabis use,
Sexual behaviour
Fighting, Being bullied and bullying others
MEHM, diseases, injuries
Phys. health: headache, stomach problems
Mental health
Disability
Lifestyles: physical activity, obesity, eating habits, breastfeeding
Violence (bullism) and psychological aspects
Behaviour (anger, hyperactivity, isolation)
Use of health services & medicines
General health
Oral health
Diseases and chronic conditions
Health potential and mental wellbeing
Special health care needs incl. funct. limit.
Physical activity/exercise
Consumption of fruits and vegetables
Curative services
Preventive services
13-14 October 2016
2nd meeting of EHIS Task Force

7. Overview of preselected topics and number of variables by version
Short
Long
Background information 3
Health status and functioning
MEHM for children
Perceived oral health
Physical and sensory functional limit.
Cognitive limitations
Mobility and participation
13 (15)
7 (9) 2 4
18 (20)
Health determinants and potential
Weight and height
Physical activity
Consumption of fruit and vegetables
Sweetened beverages
Breastfeeding 11 1
13-14 October 2016
2nd meeting of EHIS Task Force

8. 2nd meeting of EHIS Task Force
Age: 0-1y y years
Background variables
MEHM
Oral health
Functional limitations
Mobility and participation
Weight and height
Physical activity
Fruit and vegetables
Sweetened beverages
Breastfeeding
13-14 October 2016
2nd meeting of EHIS Task Force

9. Background information
General information
Presence of any children aged 0-14 in the HH
Names of the children
Proxy respondent’s characteristics
Respondent’s relationship with (each?) child
Demographic data on each child
Child’s sex
Child’s age
13-14 October 2016
2nd meeting of EHIS Task Force

10. Health status and functioning (1)
Minimum European Health Module (MEHM) for children
CHS1: Perceived general health of child
CHS2: Child long-standing health problem
CHS3: Child general activity limitation
Perceived oral health of child (COH)
COH1: Perceived condition of child's teeth: how the respondent perceives the child's oral health in general
COH2: Child occurrence of toothache, decayed teeth, and/ or unfilled cavities in the past 12 months
13-14 October 2016
2nd meeting of EHIS Task Force

11. Health status and functioning (2)
Physical and sensory functional limitations of children (CPL)
CPL1: Child wearing glasses or contact lenses
CPL2: Child have difficulty seeing even when wearing glasses
CPL3: Child using hearing aid
CPL4: Child have difficulty hearing even when using hearing aid
CPL5: Child using equipment or receiving assistance for walking
CPL6: Child have difficulty walking even when using equipment or receiving assistance
CPL7: Child have difficulty walking without any aid or support
CPL8: Child have difficulty walking 500 meters even when using equipment or receiving assistance
CPL9: Child have difficulty walking 500 meters without any aid or support
13-14 October 2016
2nd meeting of EHIS Task Force

12. Health status and functioning (3)
Cognitive limitations of children (CCL)
CCL1: Child have difficulty in learning new things
CCL2: Child have difficulty in remembering things
Mobility and participation of children in major life domains
CMR1: Difficulty of child in [aspect of mobility] because of a longstanding health problem (Aspects: Leaving home, Accessing buildings, Moving about in buildings)
CMR2: Lack of [type of support] contributing to the level of difficulty experienced by child in [aspect of mobility] (Type of support: Special aids or equipment, Personal help or assistance)
CPR1: Difficulty of child participating in [major life domain] because of a longstanding health problem (Domains: Attending primary or secondary school at the moment, Pursuing hobbies or interests, or playing with other children, Attending cultural events)
CPR2: Lack of [type of support] contributing to the level of difficulty experienced by child in [major life domain]
13-14 October 2016
2nd meeting of EHIS Task Force

13. Health determinants and potential (1)
Weight and height of children (CBM)
CBM1: Height of child without shoes
CBM2: Weight of child without shoes or clothes
Physical activity/ exercise of children (CPE)
CPE1: Number of days in a typical week carrying out sports, fitness, or recreational (leisure) physical activities that cause child to get out of breath or sweat
CPE2: Time spent on doing sports, fitness, or recreational (leisure) physical activities that cause child to get out of breath or sweat
13-14 October 2016
2nd meeting of EHIS Task Force

14. Health determinants and potential (2)
Child consumption of fruit and vegetables (CFV)
CFV1: Frequency of child eating fruit, excluding non-fresh juice
CFV2: Number of portions of fruit a day consumed by child, excluding non-fresh juice
CFV3: Frequency of child eating vegetables or salad, excluding potatoes and non-fresh juice
CFV4: Number of portions of vegetables or salad a day consumed by child, excluding potatoes and non-fresh juice
Sugar and artificial sweetener intake of children (CSI)
CSI1: Frequency of child drinking sugar-sweetened and artificially-sweetened beverages
CSI2: Amount of sugar-sweetened and artificially-sweetened beverages consumed by child, each time
Breastfeeding (CBF)
CBF1: Infant breastfed, at least partially, at three and six months of age
13-14 October 2016
2nd meeting of EHIS Task Force

15. 2nd meeting of EHIS Task Force
Remarks
Possible new topics:
Mental health, Psychological aspects, Behaviour (anger, hyperactivity, isolation)
Simplification/aggregation:
Aspects of mobility, Lack of support,
Sugar and artificial sweetener intake
Reconsider priorities:
+ MEHM
- Oral health
- Using equipment or receiving assistance for walking
- Difficulty walking even when using equipment or receiving assistance
- Number of portions of fruit/vegetables a day consumed
Further discuss and harmonise minimum age:
MEHM: age 0 for all vars or only for CHS1 and CHS2 and age 2 for CHS3?
dietary habits (6 months or 2 years?)
13-14 October 2016
2nd meeting of EHIS Task Force

16. TF EHIS are kindly invited to:
Comment on the content (selected and missing topics; priorities)
Comment on the proposed questions (sources, modifications)
Discuss methodological elements which need to be tackled and how they could be tackled
Discuss next steps of development of the sub-module:
Format of the development (continue with short/long version?)
Need and maturity of the current proposal for pre-testing
13-14 October 2016
2nd meeting of EHIS Task Force