Health Behaviour in School-aged Children A World Health Organisation Collaborative Cross-national study

Promoting the health, wellbeing and development of young people: an asset model Antony Morgan

Health Behaviour in School-aged Children: WHO collaborative cross-national study HBSC Programme of Research: asset modelling T0 highlight the best ways of promoting caring and responsive environments that protect young people and which create opportunities for them to explore their worlds – growing up into productive and healthy people

Health Behaviour in School-aged Children: WHO collaborative cross-national study The Asset Model believes…..policy development has focused too much on the failure of individuals and local communities to avoid disease rather than their potential to create and sustain health and continued development Source: Morgan and Ziglio (2007)

Health Behaviour in School-aged Children: WHO collaborative cross-national study The inequalities context: Some policies have not been equity proofed meaning that some well intentioned policies and initiatives have increased inequalities Some policies have not been equity proofed meaning that some well intentioned policies and initiatives have increased inequalities Solutions are complex, long term and resource intensive (difficult to sustain in changing political environments) Solutions are complex, long term and resource intensive (difficult to sustain in changing political environments) Too much emphasis on disease and dying rather than health happiness and well being Too much emphasis on disease and dying rather than health happiness and well being From deficits to assets…………….. From deficits to assets……………..

Health Behaviour in School-aged Children: WHO collaborative cross-national study Inequalities in adolescent health strong and consistent association between family affluence and self-reported health. strong and consistent association between family affluence and self-reported health. in almost all countries and both genders those who report lower levels of family affluence are significantly more likely to report high levels of fair or poor health in almost all countries and both genders those who report lower levels of family affluence are significantly more likely to report high levels of fair or poor health Currie et al (2008)

Health Behaviour in School-aged Children: WHO collaborative cross-national study The misery of youth: Teenagers depressed and fearful as drink, drugs and crime take their toll July 2008, Daily MailThe misery of youth: Teenagers depressed and fearful as drink, drugs and crime take their toll July 2008, Daily Mail

Health Behaviour in School-aged Children: WHO collaborative cross-national study Happy not sad! Most children are satisfied with their lives, perceive their health to be good and do not regularly suffer from health complaints Most children are satisfied with their lives, perceive their health to be good and do not regularly suffer from health complaints

Health Behaviour in School-aged Children: WHO collaborative cross-national study Assets and deficits Deficit models focus on identifying problems and needs of populations requiring professional resources, resulting in high levels of dependence on hospital and welfare services (risk factors and disease). Deficit models focus on identifying problems and needs of populations requiring professional resources, resulting in high levels of dependence on hospital and welfare services (risk factors and disease). In contrast: Asset models tend to accentuate positive ability, capability and capacity to identify problems and activate solutions, which promote the self esteem of individuals and communities leading to less reliance on professional services In contrast: Asset models tend to accentuate positive ability, capability and capacity to identify problems and activate solutions, which promote the self esteem of individuals and communities leading to less reliance on professional services

Health Behaviour in School-aged Children: WHO collaborative cross-national study

Salutogenesis (Antonovsky 1979) Derivation of Greek and Latin Derivation of Greek and Latin Latin: salus = health Latin: salus = health Greek: genesis = source Greek: genesis = source In combination = Sources of health In combination = Sources of health Salutogenesis focuses attention on health generation as compared to a pathogenesis focus on disease generation Salutogenesis focuses attention on health generation as compared to a pathogenesis focus on disease generation What causes some to prosper, and others to fail or become ill in similar situations? What causes some to prosper, and others to fail or become ill in similar situations? Emphasis is upon the success and not the failure of the individual Emphasis is upon the success and not the failure of the individual

Health Behaviour in School-aged Children: WHO collaborative cross-national study Salutogenesis and health assets – how are they related? A health asset can be defined as any factor (or resource), which enhances the ability of individuals, communities and populations to maintain and sustain health and well-being. A health asset can be defined as any factor (or resource), which enhances the ability of individuals, communities and populations to maintain and sustain health and well-being. Examples might include: Examples might include: resilience as a protective factor for young peoples health development and wellbeing resilience as a protective factor for young peoples health development and wellbeing social capital may act as a protective factor for communities particularly those that are most disadvantaged social capital may act as a protective factor for communities particularly those that are most disadvantaged

Health Behaviour in School-aged Children: WHO collaborative cross-national study Assets and Deficits What makes us strong? What makes us strong? What factors make us more resilient (more able to cope in times of stress)? What factors make us more resilient (more able to cope in times of stress)? What opens us to more fully experience life? What opens us to more fully experience life? Risk factors: Fitness Fitness Body Fat Body Fat Cholesterol Cholesterol Smoking Smoking Excess alcohol and other drugs Excess alcohol and other drugs

Health Behaviour in School-aged Children: WHO collaborative cross-national study Supporting Macro Environment Key development assets Young Peoples Mental Well Being Positive Health Promoting Behaviour Good Education Decent Housing High Standards of Living Access to health promoting physical environments Low levels of substance misuse Increased healthy eating and physical activity Safer sexual health Low incidence of bullying Increasingpersonalsocio-economiccircumstances – chances forincreasing wellbeing Increasing age – less opportunity for mental well being to effect +ve health promoting behaviour

Health Behaviour in School-aged Children: WHO collaborative cross-national study Assets versus deficits The more we provide young people with opportunities to experience and accumulate the positive effects of protective factors (health assets), the more likely they are to achieve and sustain mental well being in later life The more we provide young people with opportunities to experience and accumulate the positive effects of protective factors (health assets), the more likely they are to achieve and sustain mental well being in later life

Health Behaviour in School-aged Children: WHO collaborative cross-national study 40 Development Assets (Scales, 2001) Support (family relationships, caring school and neighbourhood) Support (family relationships, caring school and neighbourhood) Empowerment (community values youth, young people seen as resources) Empowerment (community values youth, young people seen as resources) Constructive use of time (participation in clubs and associations) Constructive use of time (participation in clubs and associations) Commitment to learning (achievement motivation) Commitment to learning (achievement motivation) Positive values (caring and responsible to others) Positive values (caring and responsible to others) Social competencies (cultural competence, peaceful conflict resolution Social competencies (cultural competence, peaceful conflict resolution Positive identity (self esteem Positive identity (self esteem

Health Behaviour in School-aged Children: WHO collaborative cross-national study Social Cohesion (feelings of safety and trust, sense of belong Emotional Well Being Social Well Being Psychological Well Being Mental Well Being Mechanisms and pathways for building young peoples health e.g. social cohesion and wellbeing POSITIVEHEALTHBEHAVIOURSPOSITIVEHEALTHBEHAVIOURS

Health Behaviour in School-aged Children: WHO collaborative cross-national study Modelling assets using HBSC. Are some assets (protective factors) more important than others? Are some assets (protective factors) more important than others? What are the cumulative effects of multiple assets on young people's mental well being? What are the cumulative effects of multiple assets on young people's mental well being? How do different social and cultural impact on the benefits of these assets? How do different social and cultural impact on the benefits of these assets? Redressing the balance between asset and deficit models for research

Health Behaviour in School-aged Children: WHO collaborative cross-national study Summarising……… Focuses on positive health promoting and protecting factors for the creation of health. Focuses on positive health promoting and protecting factors for the creation of health. Emphasis on a life course approach to understanding the most important key assets at each life stage. Emphasis on a life course approach to understanding the most important key assets at each life stage. Passionate about the need to involve young people in all aspects of health development process Passionate about the need to involve young people in all aspects of health development process Recognises that many of the key assets for creating health lie within the social context of young peoples health inequalities Recognises that many of the key assets for creating health lie within the social context of young peoples health inequalities Helps to reconstruct existing knowledge in such a way as to help policy and practice to promote positive approaches to health Helps to reconstruct existing knowledge in such a way as to help policy and practice to promote positive approaches to health

Health Behaviour in School-aged Children: WHO collaborative cross-national study For more information Morgan A and Ziglio E (2007) Revitalising the evidence base for public health: an assets model, Promotion and Education Supplement 2 pp17-22 Morgan A and Ziglio E (2007) Revitalising the evidence base for public health: an assets model, Promotion and Education Supplement 2 pp17-22 Morgan A, Davies M and Ziglio E (2010) Health Assets in a Global Context: Theory Methods Action. Springer: new York: In Press Morgan A, Davies M and Ziglio E (2010) Health Assets in a Global Context: Theory Methods Action. Springer: new York: In Press Health Assets in a Global Context: the case for young people; Symposium, Seville, Spain, April 2010 Health Assets in a Global Context: the case for young people; Symposium, Seville, Spain, April 2010

Health Behaviour in School-aged Children: WHO collaborative cross-national study Positive Lives, Positive Futures