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Peter Goldblatt

Are social inequalities affecting the health of young people: taking a life course approach to health outcomes . Peter Goldblatt. The Commission on Social Determinants of Health (CSDH) – Closing the gap in a generation. Strategic Review of Health Inequalities in England:

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Peter Goldblatt

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  1. Are social inequalities affecting the health of young people: taking a life course approach to health outcomes Peter Goldblatt

  2. The Commission on Social Determinants of Health (CSDH) – Closing the gap in a generation Strategic Review of Health Inequalities in England: The Marmot Review – Fair Society Healthy Lives Review of Social Determinants of Health and the Health Divide in the WHO European Region

  3. Social justice Material, psychosocial, political empowerment Creating the conditions for people to have control of their lives Key principles www.who.int/social_determinants

  4. Fair Society: Healthy Lives: 6 Policy Objectives • Give every child the best start in life • Enable all children, young people and adults to maximise their capabilities and have control over their lives • Create fair employment and good work for all • Ensure healthy standard of living for all • Create and develop healthy and sustainable places and communities • Strengthen the role and impact of ill health prevention

  5. MACROLEVEL CONTEXT WIDER SOCIETY SYSTEMS LIFE COURSE STAGES Accumulation of positive and negative effects on health and wellbeing Prenatal Early Years Working Age Older Ages Family building Perpetuation of inequities

  6. MACROLEVEL CONTEXT WIDER SOCIETY SYSTEMS LIFE COURSE STAGES Accumulation of positive and negative effects on health and wellbeing Prenatal Early Years Working Age Older Ages Family building Perpetuation of inequities

  7. MACROLEVEL CONTEXT WIDER SOCIETY SYSTEMS LIFE COURSE STAGES Accumulation of positive and negative effects on health and wellbeing Prenatal Early Years Working Age Older Ages Family building Perpetuation of inequities

  8. Gaps in school readiness at 3 and 5 years by family income: UK Average percentile score Waldfogel & Washbrook 2008

  9. Child poverty rates <60% median before and after social transfers 2009 Source: EU SILC

  10. A) Give every child the best start in life. • Priority objectives • Reduce inequalities in the early development of physical and emotional health, and cognitive, linguistic, and social skills. • Ensure high quality maternity services, parenting programmes, childcare and early years education to meet need across the social gradient. • Build the resilience and well-being of young children across the social gradient.

  11. Early child care and education • Parenting and family support • Perinatal services • Care before and during pregnancy • Help for new mothers • Pre-school education and care • Primary, secondary and tertiary education and training

  12. Differences in PISA scores by attending preschool for more than one year before and after accounting for socioeconomic background OECD PISA 2009 database

  13. Children achieving a good level of development at age five, local authorities 2011: England Source: LHO (2012)

  14. Birmingham Brighter Futures • Aims to improve the lives of all the city's children and young people; • Focus on improving children’s physical health, literacy and numeracy, behaviour, emotional health, social literacy, and job skills. • Specific programmes relevant to early years include: Family Nurse Partnership (FNP), Incredible Years Parenting Programme, Promoting Alternative Thinking Strategies (PATHS), Triple P Parenting Programme.

  15. Per cent 5 year olds achieving ‘good development score’,* Birmingham LA, West Midlands & England % *in personal, social and emotional development and communication, language and literacy Source: Department for Education: preliminary data

  16. B) Enable all children, young people and adults to maximise their capabilities and have control over their lives. • Priority objectives • Reduce the social gradient in skills and qualifications. • Ensure that schools, families and communities work in partnership to reduce the gradient in health, well-being and resilience of children and young people. • Improve the access and use of quality lifelong learning across the social gradient.

  17. Life expectancy (at age 30) trends in Sweden 2000-2010, by education, women

  18. Trends in probability of survival in men by education: Russian Federation 45 p20 = probability of living to 65 yrs when aged 20 yrs University Less than secondary Source: Murphy et al 2006

  19. Absolute inequality in males death rates by level of education Mackenbach et al 2008

  20. MACROLEVEL CONTEXT WIDER SOCIETY SYSTEMS LIFE COURSE STAGES Accumulation of positive and negative effects on health and wellbeing Prenatal Early Years Working Age Older Ages Family building Perpetuation of inequities

  21. Per cent not in education employment or training by local authority: England

  22. Further information www.instituteofhealthequity.org

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