Dr Simon Denny Adolescent Health Research Group Auckland HPE Symposium December 2011

Youth2000: The National Youth Health Surveys  New Zealand has a poor record of adolescent health  Monitoring youth health is important to address and understand youth health issues  Health and education often have common goals and aims

Aims of today  Present findings from the national youth health surveys  Show some recent analyses of truanting behaviours among secondary schools students  What does taking part mean for schools?

Methodology  Two stage random sample 96/115 schools agreed to participate (84%) 9,107/12,549 students participated (75%)  Overall response rate 63%

Methodology

What do students enjoy about school?

Student engagement in school

Connectedness at School Source: 2007 National Youth Survey

Comparison of School Engagement Indicators 2001 to 2007

Comparison of School Safety 2001 to 2007

Cyber-bullying Source: 2007 National Youth Survey

Comparison of Family Relationships 2001 to 2007

Comparison of Activities 2001 to 2007

Comparison of Cigarette, Alcohol and Marijuana Use 2001 to 2007

Cigarette, Alcohol and Marijuana Use

Problems from Alcohol Use

Depression Symptoms, Suicidal thoughts and Suicide attempts 2001 and 2007

Proportion of students who have had sex 2001 and 2007

Violent behaviours during the last 12 months 2001 and 2007

Violence and harm in the last 12 months

Witnessing violence in students' homes in the last 12 months

Witnessing violence within the home and Sexual abuse 2001 and 2007

Youth Health in New Zealand Source: Youth’07

Social determinants of Youth Health

Dangerous/ Reckless Driving Binge Drinking Drinking and Driving Alcohol Consumption Risky Sexual Behaviour Age Prevalence of youth health risk behaviours by age

Current monthly use of alcohol, cigarettes, marijuana and other illicit drugs Chen and Kandel 1995

Co-occurrence of these behaviours is common

Potentially Risky Behaviours  Ever drunk alcohol  Ever smoked cigarette  Ever used marijuana  Ever had sex  Been in a fight in last 12 months  Thought of killing themselves in last 12 months  84.1% reported at least one of these 6 behaviours  11.8% reported either 5 or all 6 of these health risk behaviours.

Truanting  Young people who truant are a major problem for schools and our communities  Educational achievement is critical for young people’s wellbeing and for their community  Traditionally health has not paid much attention to this group of students

Measuring truanting  ‘This year have you wagged or skipped school for a full day or more without an excuse?’  ‘About how many days altogether have you wagged or skipped school this year’ (1 to 2 days’, ‘3 to 9 days’ 10 to 20 days’, ‘more than 20 days’, ‘not sure’)  Truanting = 3 or more full days of unexcused absence from school

Truanting by age

Truanting by ethnicity

Truanting by socio-economic deprivation

What about differences among students?  Students are not the same and vary by individual characteristics, family circumstances and emotional and behavioural issues  How do school environments impact of these students?  Are students with behavioural problems more likely to truant?  Do supportive school environments reduce the risk of truanting?

Strengths and Difficulties Questionnaire  Emotional symptoms:  Impulsive/aggressive behaviour problems:  Hyperactivity/inattention problems:  Peer problems

Group 1Group 2Group 3Group 4 Mainstream Problem behaviourAnxious/depressed Compound Proportion of all students:45%24%19%10% Truanting behaviours Rate of truanting:6%25%16%42% Strengths and Difficulties scales Emotional symptomslow very highhigh Impulsive/aggressivelowhigh very high Hyperactivity/inattentionlowhigh very high Peer problemslowhigh very high Gender balance:bothmainly malemainly femaleboth Socio-economic background % from high deprivation backgrounds:14%26%28%36%

Student Measures Student relationships ‘Students in this school have difficulty getting along with each other’ Student participation in extra-curricular activities ‘Do you belong to any school sports teams?’, ‘Do you belong to any clubs or teams other than sports teams at school? (e.g. musical or singing group, cultural club, library group)’, ‘Do you do any activities to help others at school? (e.g. peer support, tutoring, coaching, being a leader, helping others with work’ School engagement ‘Teachers go out of their way to help students’, ‘Students try to get the best grades that they can’, ‘How often do the teachers at your school treat students fairly?’, ‘How much do people at school care about you?’, ‘Do you feel like you are part of your school?’, ‘Do people at your school expect you to do well? School safety‘Do you feel safe in your school?’, ‘During this school year, how often have you been afraid that someone will hurt or bother you at school?’, ‘This year how often have you been bullied in school?’

Teacher Measures Innovation culture and vision Family involvement Teacher-student interactions Support for ethnic diversity Supports for disruptive students Health and welfare services

Mainstream Problem behaviour Anxious/ depressedCompound School climate factor Students get on wellyes - Student participate in sports etc yes--- Students feel part of the school and feel teachers care --yes- Students feel safe---- Teacher-student interactions ---- Family involvement---- Innovation---- Support for disruptive students -yes-- Support for ethnic diversity ---- Health and support services provided ----

 Students differ considerably in their propensity to truant – students with emotional and behavioural problems are much more likely to truant than students without such problems.  Most students – those with low to moderate emotional or behavioural problems – are less likely to truant from schools where students get on well together, join in activities beyond the classroom, and feel part of the school.  However, this is not the case with students with high levels of emotional and behavioural problems. They are very likely to truant from any type or condition of school, whether there is a climate encouraging engagement or not. For these students, targeted mental health services are needed to provide treatment for their emotional health concerns and behavioural problems.

Why is information from the Youth2000 surveys important?  Nationally representative  Largest surveys of young people in New Zealand  Comprehensive  Robust and accurate  Trends over time  Identifies areas of concern  Dispels myths  Gives young people a voice

Taking part in the National Survey in 2012  The success and validity of the national survey depends on high response rates  We randomly select 100 schools and 15% of students from each school to take part  We will do everything we can to accommodate each schools needs to minimise disruption  Each school gets a school report