Convincing Government to invest in Prevention… it can be done!

Dr Brian BumbargerPrevention Research Center, Colorado State University, USA

26 March 2018Giselle Olive, Team Leader, Centre for Children’s Health & Wellbeing

Children’s Health Queensland Hospital and Health Service

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Our aim is to help children achieve a better life.

We focus on heading off problems before they arise.

Prevention Science Forum Overview

1. Welcome

2. ARACY Overview and Prevention in Australia

3. Dr Brian Bumbarger: Keynote

4. LCCH School Performance

5. Morning tea

6. Panel Discussion

7. Lunch and Networking

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Australian Research Alliance for Children & Youth

Members and

Subscribers

Researchers

Government

Families and community

Practitioners and

professions

Children and youth

To improve the wellbeing of children and young people by

collaboratively transforming evidence into policy and practice.

All young people are loved and safe, have material basics, are healthy, are learning and participating and

have a positive sense of identity and culture

Loved and safe Healthy Participating Learning Material

basicsCulture and

identity

A Prevention ApproachAustralian children aren’t doing as well as they should be in

a wealthy country. Researchers, service providers and policy makers need to work together if we are going to

change this.

ARACY National Report Card March 2018: www.aracy.org.au

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Millennial Morbidity • Changing nature of health

• 1900’s malnutrition, contagious disease, antibiotics, vaccine• 00’s ‘the new morbidity’ developmental disability, school dysfunction,

emotional, violence, injuries• Clear patterns and explanations • Millennial morbidity

• Dynamic interplay with the environment, economy, family, community & cultural norms• Inequity, poverty, societal health • Whole of child collaborating with communities to prevent disease and

promote health

• It’s not your genetic code, it’s your [post]code.Larry Cohen, Building a Thriving Nation

• ‘Millenial morbidity’ and ‘Wicked’ health issues (chronic disease, trauma, obesity, mental health etc) are complex, they require creative, multi strategy solutions. They require stepping outside of the health system and working across sectors to address the social determinants of health. They require working effectively in ‘partnership’.

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The hard hitting evidence that we can’t ignore…

The early years are a critical period for brain development

Significant cost savings down the track if we get it right in the early years

Prevention science and the implications for reducing health risks. SDOH account for as much as 50% of healthcare outcomes

Investing in the early years can build resilience and contributes to a productive and prosperous society

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What are the Social Determinants of Health (SDoH)?The lifestyles and conditions that people live, work, learn, grow / age and play in.

• The social gradient • Stress /stressful circumstances• Early life – (the health impact of early development and education lasts a lifetime,

circumstances which children are born determine their exposure to environments that promote or compromise healthy development, prenatal )

• Social exclusion • Work (environment, stability, safety, salary)• Unemployment • Social support• Addiction• Food (security, availability, cost, intake, access)• Transport• Housing

The Solid Facts, WHO, Wilkinson and Marmot, 2003,

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Growing up in low resource communities is associated with every negative child and youth outcome–independent of national resources

Those who start behind fall further behind

Those who fall behind early need more, but get less (Inverse Care Law)

The health impact of early development and education lasts a lifetime

Those who start behind, fall further behind

John Hopkins Medicine, 2012, Social Determinants of Health: Influence of Early Life

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Good health is a basic human right: Rights of the Child

• ‘an inclusive right, extending not only to timely and appropriate prevention, health promotion, curative, rehabilitative and palliative services, but also to a right to grow and develop to their full potential and live in conditions that enable them to attain the highest standard of health through the implementation of programmes that address the underlying determinants of health.’

Convention (Committee on the Rights of the Child, 2005, 2006, 2013). General Comment No. 7 (2005). General Comment 13 (2013)

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We need a service system that is…

• Flexible – focusing on child and family needs rather than program guidelines and internal restrictions• Locally responsive – understanding and working to the strengths, assets and needs of local communities• Evidence based – grounded in what we know works and building on that knowledge• Adaptive – continuously improving and responding to change (FACS, NSW) • Child centred – a holistic understanding of the child and family and their context (live, play, learn, grow), working

with the child and family to address their needs, asking and responding. Involved in all aspects of design / planning, implementation and measurement

• Interconnected and Integrated – that the service system is working towards the same core goal and all have a role and responsibility to contribute. That sectors work together in partnership sharing risks, benefits and outcomes.

• Outcomes focused – value outcomes rather than activities and outputs. Requires a longer term investment • Proportionate – that all children receive something and those that need more, get more.• Upstream – address upstream determinants with early detection of risks

“whole-person, whole-family, whole-community systems approach” Harvard Centre on the Developing Child

•

Susan Cary Partnerships and Innovation officer, South East Region

Department of Education

Perrin MossPrincipal Project Officer, Statewide Services

Children’s Health Queensland Hospital and Health Service

Giselle Olive Team Leader, Centre for Children’s Health and WellbeingChildren’s Health Queensland Hospital and Health Service

“A society that is good to children is one with the smallest possible inequalities for children, with the vast majority of them having the same opportunities from birth for health, education, inclusion and participation.”

(Stanley, Richardson & Prior, 2005)

ARACY Queensland Coordinators