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Local Strategies to Combat Childhood Health Inequalities in Rotterdam

This presentation by Dr. Onno de Zwart highlights the challenges faced by the youth in Rotterdam, where 23% of the population is aged 0-20, with significant ethnic diversity and high rates of single-parent families. It discusses local strategies, including youth health care and educational policies designed to improve outcomes for children at risk. The program "Every Child Gains" aims to enhance basic services, strengthen the educational environment, and focus on vulnerable populations to ensure that more children can grow up in safe and supportive environments.

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Local Strategies to Combat Childhood Health Inequalities in Rotterdam

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  1. Cephir June 27, 2012 Local strategies against inequalities in childhood health Dr. Onno de Zwart, MPH

  2. Rotterdam youth demography • 23% of today’s Rotterdam population is 0-20 yrs old • 175 different nationalities • 12% of non-western origin (mainly Turkish, Moroccan, Surinam, Dutch Antills) • 53% of non-western origin in the age group 0-20 years

  3. Disadvantaged areas (children at risk) and (% non-western youth 0-20 years 7 10% 23 28 36 26% 62 29% 37% 56 28% 7% 77 63 12% 5% 6% 75 52 66 36 11% 12% 16% 12% 20% 4%

  4. Risk inventarisation Municipal Health Office Rotterdam

  5. Families • About one third lives in a single-parent family • Families with children have a lower income than families without: 20% minimum, 14% structural minimal • About 25% lives in a house that is too small

  6. Preventive health care

  7. Solutions • Youth Policy (incl. regional en local program Every Child Gains) • Educational policy • Healthy School • Ready for a Child

  8. Youth policy Rotterdam • Youth policy including Youth Health Care (Youth and Family Centres): responsibility of the city of Rotterdam • Youth care and child protection: responsibility of the region of Rotterdam • 2015: youth healthcare, care and child protection: decentralisation to municipalities 9

  9. Every child gains! • Regional program (2007-2010) • Regional and local program (2011 -2014) • Result: • Youth and Family Centres: provides advice on raising children and, when needed, guides parents and children into other areas of the youth care system. • More than 90% of children is seen • More focus on children at risk

  10. Every child gains and decentralisation youth care Common goal More children in Rotterdam will grow up in a safe home with possibility to develop their talents. Three objectives: • Strengthen the basic services and the educational environment • Strengthen the professional workers • Strengthen the strategy on care (improving steering conditions)

  11. Rotterdam: educational facts and figures • 90.000 pupils in compulsory education: 174 nationalities • 250 primary schools, 75 secondary schools, 2 schools for upper secondary vocational training (50 locations), 4 schools for higher vocational education, 1 university • Private school boards govern the schools • Majority of parents is low educated • Language at home is often not Dutch

  12. The Rotterdam school population:Ethnicity in compulsory Education

  13. Educational Policy Rotterdam 2011-2014 Two action programmes: • Beter Presteren: raising education results • Aanval op Uitval: tackling Early (or Unqualified) School Leaving

  14. Educational Policy Rotterdam 2011-2014 raising education results more time for learning parents involvement professional schools 2 school arrangements: ISO and Topclasses

  15. Tackling Early school leaving main factors, interventions - growing focus on truancy; early and complete reporting by schools; more personnel to find and pick up truant youngsters - growing awareness in vocational education that Gripping & Binding is important to keep pupils in school - more diversity in vocational trajectories, more different ways of learning/training - possibilities for streaming into school at several moments during the year, following the process of tracking and leading back And a non-planned, positive development: bad perspectives on the labourmarket keeps the youngsters longer in education/training

  16. Tackling Early school leaving monitoring ESL since the Lisbon Agreements:

  17. GGD Rotterdam-Rijnmond

  18. Youth health care: Healthy City, Healthy Schools • Gezonde School officially started in 2008 • In Rotterdam en region now more than 80 schools Healthy Primary School Primary School secondary School Healthy secondary school Special education

  19. Starting point • ‘Maximize their potential’ • Using this message gets politicians at our side • health, education and development are closely linked

  20. Basic principles • Question/need of the school is central • No ad hoc activities, but a structural approach • Integrated approach on four levels • Team with other partners: local & regional organizations

  21. Program Ready for a Child Programma Klaar voor een KindErnie van der Weg

  22. Babysterfte (foetale sterfte: vanaf 22 weken zwangerschapsduur + vroegneonatale sterfte: tot 7 dagen na de bevalling) in aantal per 1000 geboorten, naar wijk TOP 5 ongunstige wijken A Waalhaven / rand Charlois 37 B Schieveen 34 C Pernis 24 D Delfshaven 23 E Nieuw Crooswijk 22 A13 A20 A16 B E D A C A15 Gemiddelde Nederland: 10,3

  23. Preconceptional care- Pregnancy Giving birth safely After birth care CJF (CJG) Programstructure, education, information, research, monitoring & evaluation

  24. Conclusions • Rotterdam does have inequalities in youth health • As in health among adults • Health infrastructure is suited to all • Youth health care more focus on groups at risk • ‘Every child gains’ offers a chance for a new system • Important to stimulate better educational results • We need a more integrated postitively based youth policy. With the restructuring of the city organisation there’s a chance to reach that goal.

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