Building a child friendly community conference, Logan QLD How are Australian kids going?

1. Building a child friendly community conference, Logan QLD How are Australian kids going? Dr Lance Emerson, CEO The Australian Research Alliance for Children & Youth (ARACY)

2. ARACY: pioneering preventive action to progress the health and wellbeing of children and young people What we do: Advocacy to improve child wellbeing Support evidence based practice & policy Progress systems change initiatives Researchers collaborative hub of 1,800 members Community & business Policy • Our guiding principles: • focus on prevention & life-pathways • work across sectors and disciplines • provide a neutral space for organisational collaboration • value add to our members work • progress sustainable, evidence-based action Children & youth Practitioners & professions

3. .... recent achievements of ARACY COAG partnership on 4 site trial: Prevention of child abuse at the system level Australia’s first international comparative report on child wellbeing Instigating a middle years agenda for Australia children aged 9-14 (&social and emotional learning) Advocacy & research: Australia's Early Childhood Agenda

4. Today: • How are Australian kids going? • Key concepts in children's development • Measures of wellbeing (e.g ARACY report card) • What are some of the reasons for current wellbeing status? • The concept of equality and equity • Broader societal influencers on children's wellbeing • How can we improve children's wellbeing? • Address only the needs of the ‘vulnerable’? • Proportional universalism ?

5. Some key concepts in children's development • Sensitivity of the developing brain • What happens in the early years has a lasting impact • Early advantages accumulate, as do early disadvantages • The concepts of life course, pathways, risks & protective factors • An ‘ecological’ model of children's wellbeing • The best investments are early investments • Investing in early years pays off

6. Sensitivity of the developing brain: Stress Positive stress • necessary aspect of healthy development • occurs in the context of stable, supportive relationships. • brief increases in heart rate and mild changes in stress hormone levels .

7. Sensitivity of the developing brain: Stress Tolerable stress • Stress responses that could disrupt brain architecture, but are buffered by supportive relationships. • Allows the brain an opportunity to recover from potentially damaging effects. .

8. Sensitivity of the developing brain: Stress Toxic stress • Strong, prolonged activation of the body’s stress response systems in the absence of the buffering protection of adult support. • Can damage developing brain architecture & create a short fuse for the body’s stress response systems, leading to lifelong problems in learning, behavior, and both physical and mental health. .

9. Institutionalization and Neglect of Young Children Disrupts Their Body Chemistry 35% Percent of Childrenwith Abnormal Stress Hormone Levels (Cortisol) 30% 25% 20% 15% 10% 5% Middle Class US Toddlersin Birth Families Neglected/Maltreated ToddlersArriving from Orphanages Overseas Source: Gunnar & Fisher (2006)

10. Sensitivity of the developing brain

11. The concept of risks & protective factors (AIFS 2010)

12. Acute response to trauma What happens in the early years has a lasting impact

13. What happens in the early years has a lasting impact

14. What happens in the early years has a lasting impact 5 4 3 Odds Ratio 2 1 0 1 2 3 4 5+ ACEs Source: Chapman et al, 2004 Risk Factors for Adult Depression are Embedded in Adverse Childhood Experiences

15. What happens in the early years has a lasting impact 3.5 3 2.5 Odds Ratio 2 1.5 1 0.5 0 1 2 3 4 5,6 7,8 ACEs Source: Dong et al, 2004 Risk Factors for Adult Heart Disease are Embedded in Adverse Childhood Experiences

16. The concept of pathways Violence & Crime Suicidal behaviour Drug availability, norms Drug misuse Depression Developmental model(modifed from Silburn, 2002) Low self-esteem Increasing psychosocial difficulties Acute stress significant loss School & learning difficulties Peer problems Negative thinking patterns Adverse parenting Self-regulation of emotion, attention & social interaction Poor problem solving skills Genetic factors Early brain development Drug use in pregnancy Low SES Diet & nutrition Time

17. Ecological Systems Theory of child development (from Bronfenbrenner, 1979, Comer et al., 2004 and Nairn 2011) Source ACG 2008 - adapted from Brofenbrenner & Morris (1998)

18. Heckman: investment in the early years The best investments are early investments

19. Average public social spending per child by intervention as a proportion of median working-age household income (Adema 2008: OECD) The best investments are early investments

20. With these key concepts in mind – how do we measure children's wellbeing? • Across multiple domains • Mix of developmental and ‘symptom’ indicators • Need for a benchmark? • We should aim to be worlds best • Trend data?

21. The ARACY Report Card on the Wellbeing of Young Australians • “ What is to be gained by measuring and comparing child well-being in different countries? The answer lies in the maxim ‘to improve something, first measure it” UNICEF 2007, p.3 • First internationally comparable child wellbeing report • Allows evidence based dialogue on need • Allows prioritisation of effort

22. Main objective • To use available data to present a picture of how Australia’s children and young people (0-24 years) are faring in comparison with the ‘best’ international comparator • Australian general population • Australian Indigenous population • Best international

23. How?

24. Report Card Framework

25. Eight Domains • Material wellbeing • Health and safety • Educational wellbeing • Family and peer relationships • Behaviour and risks • Subjective wellbeing • Participation • Environment

26. Sample surveys ABS (adult literacy and life skills, GSS, NATSISS,NHS) AIHW (National drug strategy household survey) Australian Early Development Index International Assoc for the Evaluation of Educational Achievement (CIVED) European school survey project (ESPAD) OECD (PISA, Income and Distribution survey) WHO (health survey, HBSC) Admin datasets/reports ABS (births) ABS/AIHW (Health and Welfare of Australia’s Aboriginal and Torres Strait Islander Peoples AIHW (Juvenile justice minimum dataset, mothers and babies) OECD (Education at a glance, Environmental indicatos, Health database) WHO (SURF, mortality database) World Bank (HNP statistics, Development indicators) 23 data sources used for Report Card measures

27. Challenges • Numerous gaps in data • Indigenous data missing or unavailable for a significant number of measures • Limited measures for several indicators (especially in the peer and family relationships and subjective wellbeing domains) • Lack of consistency in frequency of data collection (numerous ‘one-off’ collections and out of date data) • Undeveloped indicators/measures (child abuse, breastfeeding, child care) • Inconsistency in definitions • Inconsistency in age groupings • Different data collection standards • Inconsistency in data collected around similar topics

28. Reported deprivation: % of children having fewer than 11 books in their home (Australia 10/30, Indigenous 29/31)

29. Family relationships: % of children who report eating the main meal of the day with parents several times per week (Aust 21/27, Indigenous 24/28) Family relationships: % of children (15 y.o) who report that parents spend time ‘just talking to them’ more than once per week (Aust 18/27, Indigenous 17/28)

30. Teenage fertility: age specific fertility rates for females 15-19 years (Australia 21/30, Indigenous 31/31)

31. Low Birthweight rate: rate per 1,000 live birthsAustralia: 7/18 Indigenous Australia: 19/19

32. Intentional self-injury death rate for young people aged 15-24 years (rate per 100,000 children)Australia: 13/23 Indigenous Australia: 23/24

34. Findings of the ARACY Report Card • Overall - Australian children doing well but consistently not as well as the ‘best’ international • Australia was not ‘best’ for any chosen indicator (exception AEDI - only two countries: Aus and Canada) • Indigenous children do not fare as well as non-Indigenous children in Australia • Indigenous children fare substantially less well than the ‘best’ international

35. Summary of how Australian kids are going • Increase in complex conditions: • Health of Aboriginal kids • Obesity, Asthma, Diabetes • Psychological problems (depression, anxiety..) • Behavioural problems (ADHD, hyperactivity..) • Violent & anti-social behaviour • Some Risk behaviours (earlier drinking..) • Young people not in employment / education increasing • Child abuse and neglect? • Parental stress? Good news in some areas • Greater immunisation rates • Lower Infant mortality • Less accidental injuries • Lower child smoking / illicit drug use • Improved school achievement • Lower teenage births • Education scores • Lower alcohol use during pregnancy • Parent joblessness improving x

36. www.aracy.org.au

37. What are the reasons for poor child wellbeing? Inequality plays a big factor ‘ Ability gaps between advantaged and other children open up early before schooling begins. Conventional school based policies start too late to completely remedy early deficits, although they can do some good. Children who start ahead keep accelerating past their peers, widening the gap…Early advantages accumulate, so do early disadvantages - Heckman J. & Masterov DV, 2005

38. Inequality & inequity? • Health inequalities- differences in health status or in the distribution of health determinants between different population groups. … Some health inequalities are attributable to biological variations or free choice and others are attributable to the external environment and conditions mainly outside the control of the individuals concerned.. ..the uneven distribution may be unnecessary and avoidable as well as unjust and unfair, so that the resulting health inequalities also lead to inequity in health WORLD HEALTH ORGANISATION

44. The ‘inequality cycle’ and its impact on child wellbeing Antenatal Youth / young adulthood Birth / pre-school Middle years Kindergarten