Young People’s Health in an International Context The Health Behaviour in School-Aged Children...

Young People’s Health in an Young People’s Health in an International ContextInternational Context

The Health Behaviour in School-Aged Children (HBSC):WHO Collaborative Cross-National Study

Candace CurrieHBSC PI for Scotland& HBSC International Coordinator

Antony MorganHBSC PI for England& Head of HBSC InternationalPolicy Development Group

Gaining a perspective on young Gaining a perspective on young people’s health in the UK: evidence people’s health in the UK: evidence

from HBSCfrom HBSC

ComparativeComparative analysisanalysis : how does the health of young : how does the health of young people in the UK compare to those of other countries in people in the UK compare to those of other countries in the Europe and North Americathe Europe and North America

Trends over timeTrends over time: how has health of young people in the : how has health of young people in the UK changed over last two decadesUK changed over last two decades

Health inequalities: Health inequalities: how does health vary according to how does health vary according to gender and socioeconomic status gender and socioeconomic status

Implications for improving young people’s health in UK: Implications for improving young people’s health in UK: examples of good practice and policyexamples of good practice and policy

What is HBSC?What is HBSC?

An international study conducted in An international study conducted in member countries in WHO European member countries in WHO European Region, USA and CanadaRegion, USA and Canada

Initiated in 1983 in 3 countries in Initiated in 1983 in 3 countries in Northern Europe interested in Northern Europe interested in gathering comparative data on young gathering comparative data on young people’s health in social context people’s health in social context

HBSC study ‘short history’ HBSC study ‘short history’

shortly after its initiation designated as shortly after its initiation designated as WHO collaborative study; new members WHO collaborative study; new members began to joinbegan to join

First cross-national survey in five countries First cross-national survey in five countries in 1983/4 followed by second in 1985/6; in 1983/4 followed by second in 1985/6; thereafter survey every four yearsthereafter survey every four years

now 43 participating countriesnow 43 participating countries HBSC international network of >270 HBSC international network of >270

researchers researchers

Growth of HBSC study: countries by survey yearGrowth of HBSC study: countries by survey year1983/19841983/1984 1985/1981985/198

661989/19901989/1990 1993/19941993/1994 1997/19981997/1998 2001/20022001/2002 2005/62005/6

1. England1. England2. Finland2. Finland3. Norway3. Norway4. Austria4. Austria5. Denmark5. Denmark

1. Finland1. Finland 2. Norway2. Norway 3. Austria3. Austria 4. Denmark4. Denmark 5. Belgium5. Belgium 6. Hungary6. Hungary 7. Israel7. Israel 8. Scotland8. Scotland 9. Spain9. Spain10. Sweden10. Sweden11. 11.

SwitzerlSwitzerlandand

12. Wales12. Wales13. 13.

NetherlaNetherlandsnds

1. Finland1. Finland 2. Norway2. Norway 3. Austria3. Austria 4. Belgium 4. Belgium

(French)(French) 5. Hungary5. Hungary 6. Scotland6. Scotland 7. Spain7. Spain 8. Sweden8. Sweden 9. Switzerland9. Switzerland10. Wales10. Wales11.Denmark11.Denmark12. Netherlands12. Netherlands13. Canada13. Canada14. Latvia14. Latvia15. N. Ireland15. N. Ireland16. Poland16. Poland

1. Finland1. Finland 2. Norway2. Norway 3. Austria3. Austria 4. Belgium (French)4. Belgium (French) 5. Hungary5. Hungary 6. Israel6. Israel 7. Scotland7. Scotland 8. Spain8. Spain 9. Sweden9. Sweden10. Switzerland10. Switzerland11. Wales11. Wales12. Denmark12. Denmark13. Canada13. Canada14. Latvia14. Latvia15. Northern Ireland15. Northern Ireland16. Poland16. Poland17. Belgium 17. Belgium

(Flemish)(Flemish)18. Czech Republic18. Czech Republic19. Estonia19. Estonia20. France20. France21. Germany21. Germany22. Greenland22. Greenland23. Lithuania23. Lithuania24. Russia24. Russia25. Slovakia25. Slovakia


(French)(French) 5. Hungary5. Hungary 6. Israel6. Israel 7. Scotland7. Scotland 8. Sweden8. Sweden 9. Switzerland9. Switzerland10. Wales10. Wales11. Denmark11. Denmark12. Canada12. Canada13. Latvia13. Latvia14. Northern 14. Northern

IrelandIreland15. Poland15. Poland16. Belgium 16. Belgium

(Flemish)(Flemish)17. Czech Republic17. Czech Republic18. Estonia18. Estonia19. France19. France20. Germany20. Germany21. Greenland21. Greenland22. Lithuania22. Lithuania23. Russia23. Russia24. Slovakia24. Slovakia25. England25. England26. Greece26. Greece27. Portugal27. Portugal28. Ireland28. Ireland29. USA29. USA


(French)(French) 5. Hungary5. Hungary 6. Israel6. Israel 7. Scotland7. Scotland 8. Spain8. Spain 9. Sweden9. Sweden10. Switzerland10. Switzerland11. Wales11. Wales12. Denmark12. Denmark13. Canada13. Canada14. Latvia14. Latvia15. Poland15. Poland16. Belgium 16. Belgium

(Flemish)(Flemish)17. Czech Republic17. Czech Republic18. Estonia18. Estonia19. France19. France20. Germany20. Germany21. Greenland21. Greenland22. Lithuania22. Lithuania23. Russia23. Russia24. England24. England25. Greece25. Greece26. Portugal26. Portugal27. Ireland27. Ireland28. USA28. USA29. tfyr Macedonia29. tfyr Macedonia30. Netherlands30. Netherlands31.31. ItalyItaly32. Croatia32. Croatia33. Malta33. Malta34. Slovenia34. Slovenia35. Ukraine35. Ukraine


(French)(French) 5. Hungary5. Hungary 6. Israel6. Israel 7. Scotland7. Scotland 8. Spain8. Spain 9. Sweden9. Sweden10. Switzerland10. Switzerland11. Wales11. Wales12. Denmark12. Denmark13. Canada13. Canada14. Latvia14. Latvia15. Poland15. Poland16. Belgium 16. Belgium

(Flemish)(Flemish)17. Czech Republic17. Czech Republic18. Estonia18. Estonia19. France19. France20. Germany20. Germany21. Greenland21. Greenland22. Lithuania22. Lithuania23. Russia23. Russia24. England24. England25. Greece25. Greece26. Portugal26. Portugal27. Ireland27. Ireland28. USA28. USA29. tfyr Macedonia29. tfyr Macedonia30. Netherlands30. Netherlands31. Italy31. Italy32. Croatia32. Croatia33. Malta33. Malta34. Slovenia34. Slovenia35. Ukraine35. Ukraine36.36. LuxemburgLuxemburg37. Turkey37. Turkey38. Slovakia38. Slovakia39. Romania39. Romania40. Iceland40. Iceland41. Bulgaria41. Bulgaria

HBSC countries 2005/06HBSC countries 2005/061.1. AustriaAustria2.2. Belgium (Flemish)Belgium (Flemish)3.3. Belgium (French)Belgium (French)4.4. BulgariaBulgaria5.5. CanadaCanada6.6. CroatiaCroatia7.7. Czech RepublicCzech Republic8.8. DenmarkDenmark9.9. EnglandEngland10.10. EstoniaEstonia11.11. FinlandFinland12.12. FranceFrance13.13. GermanyGermany14.14. GreeceGreece15.15. GreenlandGreenland16.16. HungaryHungary17.17. IcelandIceland18.18. Ireland, Republic ofIreland, Republic of19.19. IsraelIsrael20.20. ItalyItaly21.21. LatviaLatvia

22.22. LithuaniaLithuania23.23. LuxembourgLuxembourg24.24. Macedonia, TfyrMacedonia, Tfyr25.25. MaltaMalta26.26. NetherlandsNetherlands27.27. NorwayNorway28.28. PolandPoland29.29. PortugalPortugal30.30. RomaniaRomania31.31. Russian FederationRussian Federation32.32. ScotlandScotland33.33. Slovakia Slovakia 34.34. SloveniaSlovenia35.35. SpainSpain36.36. SwedenSweden37.37. SwitzerlandSwitzerland38.38. TurkeyTurkey39.39. UkraineUkraine40.40. USAUSA41.41. WalesWales

Broad aims of HBSCBroad aims of HBSC

increase understanding of young increase understanding of young people's health and well-being, health people's health and well-being, health behaviours and their social context behaviours and their social context

inform and influence policy and inform and influence policy and practice at national and international practice at national and international levelslevels

HBSC objectivesHBSC objectives

initiate and sustain national and initiate and sustain national and international research on young international research on young people’s healthpeople’s health

contribute to theoretical and contribute to theoretical and methodological development as well as methodological development as well as empirical evidenceempirical evidence

establish and strengthen a multi-establish and strengthen a multi-disciplinary international network of disciplinary international network of expertsexperts

disseminate findings to relevant disseminate findings to relevant audiencesaudiences

HBSC network HBSC network collaboration collaboration

National teams collaborate on all aspects National teams collaborate on all aspects of international study through their of international study through their membership of the HBSC networkmembership of the HBSC network

Design of survey instrument and Design of survey instrument and protocolprotocol

Development of survey methodologyDevelopment of survey methodology Data analysisData analysis Publication and disseminationPublication and dissemination

HBSC in UKHBSC in UK

Scotland and Wales joined the study in the Scotland and Wales joined the study in the mid 1980s and England in 1998; N Ireland mid 1980s and England in 1998; N Ireland participated in surveys 1990, 1994 and participated in surveys 1990, 1994 and 19981998

HBSC International Coordinating Centre HBSC International Coordinating Centre based at Child and Adolescent Health based at Child and Adolescent Health Research Unit (CAHRU), University of Research Unit (CAHRU), University of Edinburgh since 1995 Edinburgh since 1995

Survey methodSurvey method School –based, pupil self School –based, pupil self

complete, teacher or researcher complete, teacher or researcher administeredadministered

Three age groups with mean age Three age groups with mean age 11.5, 13.5 and 15.5 years 11.5, 13.5 and 15.5 years

National surveys conducted at National surveys conducted at time of year to obtain correct time of year to obtain correct mean ages mean ages

Sample size: 1,550 per age groupSample size: 1,550 per age group Every 4 yearsEvery 4 years

Health and behaviourHealth and behaviour

Perceived health, well-being and life Perceived health, well-being and life satisfactionsatisfaction

Smoking, drinking and cannabis useSmoking, drinking and cannabis use Physical activity and sedentary behaviourPhysical activity and sedentary behaviour Eating and dietingEating and dieting Body image Body image Height and weightHeight and weight Sexual behaviourSexual behaviour Bullying and fightingBullying and fighting InjuriesInjuries

Social and developmental Social and developmental contextcontext

Family structure and relationshipsFamily structure and relationships School environmentSchool environment Peer relations and social Peer relations and social

behaviourbehaviour NeighbourhoodNeighbourhood Socioeconomic circumstancesSocioeconomic circumstances

Highlighting key health Highlighting key health issues in the UKissues in the UK

look at comparative analysis, trends over look at comparative analysis, trends over time and health inequalitiestime and health inequalities

focus on various aspects of young people’s focus on various aspects of young people’s health of policy concern: substance use, health of policy concern: substance use, physical activity, BMI and body image, physical activity, BMI and body image, healthy eating, well-beinghealthy eating, well-being

present examples of dissemination to policy present examples of dissemination to policy and practiceand practice

Comparative analysisComparative analysis

Alcohol useAlcohol use

Percentage of boys aged 15 who are weekly Percentage of boys aged 15 who are weekly drinkers (HBSC 2001/2)drinkers (HBSC 2001/2)

Percentage of girls aged 15 who are Percentage of girls aged 15 who are weekly drinkers (HBSC 2001/2)weekly drinkers (HBSC 2001/2)

ObservationsObservations

England and Wales have among England and Wales have among highest rates of weekly drinking highest rates of weekly drinking internationally for both boys and internationally for both boys and girls girls

Differential between boys’ and girls’ Differential between boys’ and girls’ weekly drinking rates in UK smaller weekly drinking rates in UK smaller than in many other countries than in many other countries

Drinking trends 1990-2006 Drinking trends 1990-2006 ScotlandScotland

Trends in 15 year olds weekly drinking

3642 44 42 40

2933

46 44

37

0

20

40

60

1990 1994 1998 2002 2006% w

ho d

rink

alco

hol a

t lea

st o

nce

a w

eek Boys Girls

* **

*** ***

** **

ObservationObservation

Gender differences present in Gender differences present in early 1990s with lower rates of early 1990s with lower rates of weekly drinking among girls weekly drinking among girls

Steep increase in weekly drinking Steep increase in weekly drinking rates among girls between 1994 rates among girls between 1994 and 1998 close gender gap which and 1998 close gender gap which remains through to 2006remains through to 2006

HBSC 2001/02: HBSC 2001/02: Boys (15 years) drunk 4+ timesBoys (15 years) drunk 4+ times

HBSC 2001/02: HBSC 2001/02: Girls (15 years) drunk 4+ timesGirls (15 years) drunk 4+ times

ObservationsObservations Levels of drunkenness among boys in England Levels of drunkenness among boys in England

and Wales among highest across all countriesand Wales among highest across all countries

After Finland and Denmark, levels of After Finland and Denmark, levels of drunkenness among girls in UK highest across drunkenness among girls in UK highest across countriescountries

Smaller gender differences in UK than Smaller gender differences in UK than elsewhere (in Scotland almost no difference)elsewhere (in Scotland almost no difference)

Drinking trends 1990-2006: Drinking trends 1990-2006: ScotlandScotland

Trends in 15 year olds drunkenness: 4+ times

25

3533

3026

17

3034 33

29

0

10

20

30

40

1990 1994 1998 2002 2006

% w

ho h

ave b

een d

runk 4

or

more

tim

es Boys Girls

***

***

****

****


Large gender difference present in Large gender difference present in 1990 disappear as girls’ 1990 disappear as girls’ drunkenness rates rise more drunkenness rates rise more steeply than boyssteeply than boys

Gender gap closes by 1998 and Gender gap closes by 1998 and remains through to 2006remains through to 2006

Percentage of 15 year old boys who are Percentage of 15 year old boys who are weekly smokers (HBSC 2001/2)weekly smokers (HBSC 2001/2)

Percentage of 15 year old girls who are Percentage of 15 year old girls who are weekly smokers (HBSC 2001/2)weekly smokers (HBSC 2001/2)

ObservationsObservations Much lower rates of smoking are found in Much lower rates of smoking are found in

the US and Canadathe US and Canada

Scotland and Wales have lower rates of Scotland and Wales have lower rates of weekly smoking among boys than in weekly smoking among boys than in EnglandEngland

There is a pattern in western Europe of There is a pattern in western Europe of higher rates of weekly smoking among higher rates of weekly smoking among girls than boysgirls than boys

Smoking trends 1990-2006: Smoking trends 1990-2006: ScotlandScotland

****

Trends in 15 year olds weekly smoking

16

21 22

1614

17

2628

23 23

0

10

20

30

40

1990 1994 1998 2002 2006% r

epor

ting

that

they

sm

oke

at le

ast o

nce

a w

eek

Boys Girls

*** *

* **

*** ** ****** ** ***


Whereas in 1990 boys and girls had Whereas in 1990 boys and girls had equal rates of weekly smoking, equal rates of weekly smoking, increasing rates are accompanied by increasing rates are accompanied by a growing gender gap a growing gender gap

From 1994 to 2006 girls’ rates are From 1994 to 2006 girls’ rates are significantly higher than boyssignificantly higher than boys

Observations: gender Observations: gender trends in substance usetrends in substance use

Over the sixteen years studied there is Over the sixteen years studied there is rather little change in the substance rather little change in the substance use habits of boys with similar levels use habits of boys with similar levels at the beginning and end of this 16 at the beginning and end of this 16 year periodyear period

This is in contrast to very substantial This is in contrast to very substantial changes in girls’ substance use changes in girls’ substance use behaviour which has increased behaviour which has increased considerably over this time periodconsiderably over this time period

Health improvement Health improvement implicationsimplications

Are there different risk and protective factors Are there different risk and protective factors operating in relation to substance use among operating in relation to substance use among boys and girls – how have these changed across boys and girls – how have these changed across the last two decades? the last two decades?

What social and developmental factors need to What social and developmental factors need to be addressed in any prevention/ intervention be addressed in any prevention/ intervention programmesprogrammes

What lessons can we learn from other What lessons can we learn from other countries? E.g. Norway (smoking), France countries? E.g. Norway (smoking), France (drinking) (drinking)

‘‘Global’ gender Global’ gender patternspatterns

Global gender patternsGlobal gender patterns

Suggest powerful biological and cultural Suggest powerful biological and cultural determinants of behaviour and well-beingdeterminants of behaviour and well-being

These may be more difficult to intervene These may be more difficult to intervene on?on?

Should we expect equality in health Should we expect equality in health outcomes? Have any countries achieved outcomes? Have any countries achieved it?it?

HBSC 2001/02:HBSC 2001/02:

Boys (15 years) meeting physical activity guidelines Boys (15 years) meeting physical activity guidelines

HBSC 2001/02:HBSC 2001/02:

Girls (15 years) meeting physical activity guidelinesGirls (15 years) meeting physical activity guidelines


Netherlands only country where Netherlands only country where boys and girls levels of PA are equal boys and girls levels of PA are equal

Boys in England and Wales have Boys in England and Wales have among highest levels of PAamong highest levels of PA

% overweight boys% overweight boys

% overweight girls% overweight girls

Observation Observation

Universal finding that boys are more Universal finding that boys are more likely to be overweight than girlslikely to be overweight than girls

But next slides show that in all But next slides show that in all countries girls more likely than boys countries girls more likely than boys think they are too fatthink they are too fat

Interventions need to take into Interventions need to take into account these differences in actual account these differences in actual and perceived levels of overweight and perceived levels of overweight

Boys (15 years) Boys (15 years) report ‘too fat’report ‘too fat’

Girls (15 years) Girls (15 years) report ‘too fat’report ‘too fat’

Socioeconomic Socioeconomic inequalitiesinequalities

Family affluence and adolescent Family affluence and adolescent healthhealth

Ukraine

Russian Federation

Latvia

Greenland

Lithuania

Croatia

Malta

Poland

TFYR Macedonia

Czech Republic

Estonia

Hungary

Portugal

Greece

Israel

Italy

Belgium (French)

Spain

Ireland

Slovenia

Scotland

Finland

Belgium (Flemish)

Austria

Germany

France

England

Wales

Denmark

Switzerland

USA

Canada

Sweden

Netherlands

Norway

80706050403020100

% Low FAS

% low family affluence (FAS) by country

Ukraine

NorwayHBSC2001/2

Scotland

* EnglandWales

FAS and daily fruit: Scotland FAS and daily fruit: Scotland 20022002

24%

31%

35%

29%

34%43%

0

10

20

30

40

50

60

Boys† Girls†

% e

at

fru

it d

ail

y

FAS 1 (low) FAS 2 FAS 3 (high)

†Significant differences between FAS groups (p<0.01)

Daily fruit and FASDaily fruit and FAS

FAS gradients in around half countries FAS gradients in around half countries especially in Eastern Europeespecially in Eastern Europe

higher percent of daily fruit consumption higher percent of daily fruit consumption among young people with higher FASamong young people with higher FAS

FAS and perceived health: FAS and perceived health: Scotland 2002Scotland 2002

†Significant differences between FAS groups (p<0.01)

66%

66%

66%

66%

66%

66%

20%

25%

27%

10%

14%

18%

0

10

20

30

40

Boys Girls†

% p

erc

eiv

e h

ea

lth

as

ex

ce

lle

nt

FAS 1 (low) FAS 2 FAS 3 (high)

FAS and perceived healthFAS and perceived health

FAS gradients found in almost every FAS gradients found in almost every country with better health among country with better health among young people with higher FAS young people with higher FAS

DisseminationDissemination ScientificScientific PolicyPolicy PracticePractice

Data analysis and scientific Data analysis and scientific publicationspublications

Complete list of all HBSC papers on: Complete list of all HBSC papers on: www.hbsc.org/publications/journal-artiwww.hbsc.org/publications/journal-articles.htmlcles.html

Every scientific article logged on Every scientific article logged on international publications database and international publications database and tracked on-line through progress from tracked on-line through progress from planned to acceptedplanned to accepted

165 published papers; 127 currently in 165 published papers; 127 currently in prep/ submittedprep/ submitted

Dissemination to policy and Dissemination to policy and practicepractice

National Reports, Briefing Papers and National Reports, Briefing Papers and Fact Sheets published by UK teamsFact Sheets published by UK teams

International Reports (published by International Reports (published by WHO) ‘Young People’s Health in WHO) ‘Young People’s Health in Context’ (2004); ‘Inequalities in Young Context’ (2004); ‘Inequalities in Young People’s Health’ (2008)People’s Health’ (2008)

WHO/ HBSC Forum initiated in 2006WHO/ HBSC Forum initiated in 2006

WHO/HBSC ForumWHO/HBSC Forum Collaboration between HBSC study Collaboration between HBSC study

and its partner the WHO Regional and its partner the WHO Regional Office for EuropeOffice for Europe

Purpose is to support Member States Purpose is to support Member States in integrating measures to address in integrating measures to address socieconomic determinants of health socieconomic determinants of health into policies and interventions to into policies and interventions to promote young people’s health promote young people’s health

WHO/HBSC ForumWHO/HBSC Forum

2006 Forum: socioeconomic 2006 Forum: socioeconomic determinants of healthy eating habits determinants of healthy eating habits and physical activity levels among and physical activity levels among adolescentsadolescents

2007 Forum: social cohesion and mental 2007 Forum: social cohesion and mental health among young people in Europehealth among young people in Europe

Risk versus protective Risk versus protective factorsfactors

The more we provide young people The more we provide young people with opportunities to experience and with opportunities to experience and accumulate the positive effects of accumulate the positive effects of protective factors, the more likely protective factors, the more likely they are to achieve and sustain they are to achieve and sustain mental well being in later lifemental well being in later life

AEvidence Base

B

ACTION

C

EVALUATION

An Asset Model for public health

Figure 1

Assets and deficitsAssets and deficits Much of the evidence base available to Much of the evidence base available to

address inequalities is based on a deficit address inequalities is based on a deficit (pathogenic) model of health.(pathogenic) model of health.

Deficit modelsDeficit models focus on focus on identifying identifying problems and needsproblems and needs of populations requiring of populations requiring professional resources, resulting in high levels professional resources, resulting in high levels of dependence on hospital and welfare of dependence on hospital and welfare services (risk factors and disease).services (risk factors and disease).

In contrast: In contrast: Asset modelsAsset models tend to accentuate tend to accentuate positive ability, capability and capacitypositive ability, capability and capacity to to identify problems and activate solutions , identify problems and activate solutions , which promote the self esteem of individuals which promote the self esteem of individuals and communities leading to less reliance on and communities leading to less reliance on professional servicesprofessional services

So what are health assets?So what are health assets? A health asset can be defined as any factor (or A health asset can be defined as any factor (or

resource), which enhances the ability of resource), which enhances the ability of individuals, communities and populations to individuals, communities and populations to maintain and sustain health and well-being. maintain and sustain health and well-being.

These assets can operate at the level of the These assets can operate at the level of the individual, family or community as protective individual, family or community as protective (and /or promoting) factors to buffer againsts life’s (and /or promoting) factors to buffer againsts life’s stresses’.stresses’.

Examples might include:Examples might include:

resilienceresilience as a protective factor for young peoples health as a protective factor for young peoples health development and wellbeingdevelopment and wellbeing

social capitalsocial capital may act as a protective factor for may act as a protective factor for communities particularly those that are most communities particularly those that are most disadvantageddisadvantaged

Assets and DeficitsAssets and Deficits

What makes us strong?What makes us strong?

What factors make us What factors make us more resilient (more more resilient (more able to cope in times of able to cope in times of stress)?stress)?

What opens us to more What opens us to more fully experience life?fully experience life?

What in organisations What in organisations make us grow?make us grow?

Risk factors:Risk factors:

FitnessFitness

Body FatBody Fat

CholesterolCholesterol

Smoking Smoking

Excess alcohol and Excess alcohol and other drugsother drugs

40 Development Assets (Scales, 2001)40 Development Assets (Scales, 2001)

SupportSupport (family (family relationships, caring relationships, caring school and school and neighbourhood)neighbourhood)

EmpowermentEmpowerment (community values (community values youth, young people youth, young people seen as resources)seen as resources)

Constructive use of Constructive use of timetime (participation in (participation in clubs and clubs and associations)associations)

Commitment to Commitment to learninglearning (achievement (achievement motivation)motivation)

Positive valuesPositive values (caring and responsible (caring and responsible to others)to others)

Social competenciesSocial competencies (cultural competence, (cultural competence, peaceful conflict peaceful conflict resolutionresolution

Positive identityPositive identity (self (self esteemesteem

Other examples of health assets: Other examples of health assets: resilience resilience

Resilient young people possess Resilient young people possess problem solving skills, social problem solving skills, social competence and a sense of purpose.competence and a sense of purpose.

Resilience can support young people Resilience can support young people to rise above poor circumstances and to rise above poor circumstances and succeed.succeed.

Other examples of health Other examples of health assets: social cohesion assets: social cohesion

Social cohesion a Social cohesion a key health assetkey health asset operating at the community level.operating at the community level.

Young people living in cohesive Young people living in cohesive communities have an increased communities have an increased sense of sense of belongingbelonging and have an and have an active roleactive role in in decision making with their communities.decision making with their communities.

Young people living in cohesive Young people living in cohesive communities where they feel safe are communities where they feel safe are more likely to report more likely to report higher levels of higher levels of health and mental well being. health and mental well being.

Building an evidence base Building an evidence base for young people’s mental for young people’s mental

well being: an asset model. well being: an asset model. Are some assets (protective factors) more Are some assets (protective factors) more

important than others?important than others?

What are the cumulative effects of multiple What are the cumulative effects of multiple assets on young people's mental well assets on young people's mental well being? being?

How do different social and cultural impact How do different social and cultural impact on the benefits of these assets?on the benefits of these assets?

‘‘Redressing the balance between asset and Redressing the balance between asset and deficit models for research’ deficit models for research’

An asset model for research, policy An asset model for research, policy

and practiceand practice Focus on Focus on positive health promoting and positive health promoting and

protecting factorsprotecting factors for the creation of health. for the creation of health.

Emphasis on a Emphasis on a life course approachlife course approach to to understanding the most important key assets at each understanding the most important key assets at each life stage.life stage.

Passionate about the need to Passionate about the need to involve individuals, involve individuals, communities and populationscommunities and populations in all aspects of in all aspects of health development processhealth development process

Many of the key assets for creating health lie within Many of the key assets for creating health lie within the the social context of people’s life'ssocial context of people’s life's and therefore and therefore has the potential to contribute to reducing health has the potential to contribute to reducing health inequalitiesinequalities

AcknowledgementsAcknowledgements

Scottish HBSC team: University of Edinburgh

HBSC International Coordinating Centre: University of Edinburgh

HBSC International Databank: University of Bergen

HBSC International Research Network

www.hbsc.org

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