Health Behaviour in School-aged Children A World Health Organisation Collaborative Cross-national study

Health Behaviour in School-aged ChildrenA World Health Organisation Collaborative Cross-national study

Promoting the health, Promoting the health, wellbeing and development wellbeing and development

of young people: of young people: an asset model an asset model

Antony MorganAntony Morgan

Health Behaviour in School-aged Children: WHO collaborative cross-national study Health Behaviour in School-aged Children: WHO collaborative cross-national study www.hbsc.orgwww.hbsc.org

HBSC Programme of HBSC Programme of Research: asset modellingResearch: asset modelling

‘‘T0 highlight the best ways of promoting T0 highlight the best ways of promoting caring and responsive environments caring and responsive environments that protect young people and which that protect young people and which

create opportunities for them to create opportunities for them to explore their worlds – growing up into explore their worlds – growing up into

productive and healthy people’ productive and healthy people’


The Asset Model The Asset Model believes…believes…

‘‘....policy development has focused too policy development has focused too much on the failure of individuals and much on the failure of individuals and

local communities to avoid disease local communities to avoid disease rather than their potential to create rather than their potential to create and sustain health and continued and sustain health and continued

development’development’

Source: Morgan and Ziglio (2007) Source: Morgan and Ziglio (2007)


The inequalities context:The inequalities context: Some policies have not been ‘equity proofed’ Some policies have not been ‘equity proofed’

meaning that some well intentioned policies and meaning that some well intentioned policies and initiatives have increased inequalitiesinitiatives have increased inequalities

Solutions are complex, long term and resource Solutions are complex, long term and resource intensive (difficult to sustain in changing political intensive (difficult to sustain in changing political environments)environments)

Too much emphasis on disease and dying rather Too much emphasis on disease and dying rather than health happiness and well beingthan health happiness and well being

From deficits to assets……………..From deficits to assets……………..


Inequalities in adolescent healthInequalities in adolescent health

strong and consistent association strong and consistent association between family affluence and self-between family affluence and self-reported healthreported health. .

in almost all countries and both genders in almost all countries and both genders those who report lower levels of family those who report lower levels of family affluence are significantly more likely to affluence are significantly more likely to report high levels of fair or poor healthreport high levels of fair or poor health

Currie et al (2008)Currie et al (2008)


‘‘The misery of youth: Teenagers depressed The misery of youth: Teenagers depressed and fearful as drink, drugs and crime take and fearful as drink, drugs and crime take their toll’their toll’

July 2008, Daily Mail July 2008, Daily Mail


Happy not sad!Happy not sad!

Most children are Most children are satisfied with their satisfied with their lives, perceive their lives, perceive their health to be good health to be good and do not and do not regularly suffer regularly suffer from health from health complaintscomplaints


Assets and deficitsAssets and deficits

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 services of dependence on hospital and welfare services (risk factors and disease).(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



AEvidence Base

B

ACTION

C

EVALUATION

An Asset Model for public health

Figure 1


Salutogenesis (Antonovsky Salutogenesis (Antonovsky 1979)1979)

Derivation of Greek and LatinDerivation of Greek and Latin Latin: salus = healthLatin: salus = health Greek: genesis = sourceGreek: genesis = source In combination = Sources of healthIn combination = Sources of health

Salutogenesis focuses attention on health generation as Salutogenesis focuses attention on health generation as compared to a pathogenesis focus on disease generationcompared to a pathogenesis focus on disease generation

What causes some to prosper, and others to fail or become ill in What causes some to prosper, and others to fail or become ill in similar situations? similar situations?

Emphasis is upon the success and not the failure of the Emphasis is upon the success and not the failure of the individualindividual


Salutogenesis and health assets – Salutogenesis and health assets – how are they related?how are they related?

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.

Examples might include:Examples might include:

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

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


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?

Risk factors:Risk factors:

FitnessFitness

Body FatBody Fat

CholesterolCholesterol

Smoking Smoking

Excess alcohol and Excess alcohol and other drugsother drugs


Supporting Macro Environment

Key developmentassets

Young People’sMental Well Being

Positive Health Promoting Behaviour

Good Education

Decent Housing

High Standards of Living

Access to health promoting physical environments

Low levels of

substance misuse

Increased healthy eating and physical

activity

Safer

sexual health

Low incidence of

bullying

Increasing personal socio- economic circumstances – chances for increasing well being

Increasing age – less

opportunity for mental well being

to effect +ve health promoting behaviour


Assets versus deficitsAssets versus deficits

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 (health assets), the protective factors (health assets), the more likely they are to achieve and more likely they are to achieve and sustain mental well being in later lifesustain mental well being in later life


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


Social Cohesion(feelings of safety and trust, sense

of belong

Emotional Well Being

Social Well Being

Psychological Well Being

MentalWell Being

Mechanisms and pathways for building young people’s health e.g.

social cohesion and wellbeing POSITIVE

HEALTH

BEHAVIOURS


Modelling assets using HBSC. Modelling assets using HBSC.

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’


Summarising………Summarising……… Focuses on Focuses on positive health promoting and protecting positive health promoting and protecting

factorsfactors for the creation of health. for the creation of health.

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

Passionate about the need to Passionate about the need to involve young people in all involve young people in all aspects of health development processaspects of health development process

Recognises that many of the key assets for creating health Recognises that many of the key assets for creating health lie within the lie within the social context of young people’s social context of young people’s health health inequalitiesinequalities

Helps to reconstruct existing knowledge in such a way as to Helps to reconstruct existing knowledge in such a way as to help policy and practice to promote positive approaches to help policy and practice to promote positive approaches to healthhealth


For more informationFor more information

[email protected]

Morgan A and Ziglio E (2007) Revitalising the evidence base Morgan A and Ziglio E (2007) Revitalising the evidence base for public health: an assets model, Promotion and Education for public health: an assets model, Promotion and Education Supplement 2 pp17-22Supplement 2 pp17-22

Morgan A, Davies M and Ziglio E (2010) Health Assets in a Morgan A, Davies M and Ziglio E (2010) Health Assets in a Global Context: Theory Methods Action. Springer: new York: In Global Context: Theory Methods Action. Springer: new York: In PressPress

Health Assets in a Global Context: the case for young people; Health Assets in a Global Context: the case for young people; Symposium, Seville, Spain , 28-30 April 2010Symposium, Seville, Spain , 28-30 April 2010


Positive Lives, Positive Positive Lives, Positive FuturesFutures

Documents

Health Behaviour in School-aged Children A World Health Organisation Collaborative Cross-national study