ECH130 Final: Ech130 Exam Notes
29 May 2018
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Department
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]= Health and Wellbeing
Health (multifaceted concept) = ‘A state of complete physical, emotional and social wellbeing and not merely the absence of disease or infirmity’ – World Health
Organisation
• Quality of life = mental (happiness), physical (disease, activity, nutrition), social (family/friends) wellbeing
• Australian Institute of Health and Welfare states that a persons health and wellbeing results from a complex relationship between biological, lifestyle,
socioeconomic, societal and environmental factors, which can all be modified to some extent by health care and other interventions.
• Individual and community health, not being sick, good nutrition, physical activity, quality of life, limited and risk behaviours (smoking,
alcoholism, drugs) and health services
Wellbeing = Recent work on subjective wellbeing links the concept ‘wellbeing’ with happiness and quality of life
• OECD aims to measure society’s progress across 11 domains of wellbeing, ranging from income, jobs, health, skills and housing through to civic engagement
(community) and the environment
• The term 'wellbeing' is a ubiquitous one that is used widely in the full range of discourses in society, including in policy and legal arenas, in education and the
academy, in the workplace, in commercial settings and in media discourses such as television and magazines.
CHILD WELLBEING = ‘the realisation of children’s right and the fulfilment of the opportunity for every child to be all they can be in the light of a child’s abilities,
potential and skills’.
Context:
• Smoking in pregnancy, infant mortality (2007 – rates were twice as high among Indigenous infants and remote living areas), birth weight (2008 – 6% live-born
infants low birth weight), breastfeeding, obesity (23% aged 5-14yrs overweight in 2007-08) etc.
• 22% of children are developmentally vulnerable
• ATSI children more than twice as likely to be developmentally vulnerable
• Females less likely to be developmentally vulnerable compared to males
• The majority of children are doing well on each of the five AEDI developmental domains.
• Overall in Australia, 10.8 per cent of children are developmentally vulnerable on two or more domains.
• There are children in Australia who only speak English, but are reported as not proficient in English. These children are more likely to be developmentally
vulnerable on all the AEDI domains.
• Initiative that works on the development of social and emotional learning: Response Ability. It promotes the social and emotional wellbeing of children by
supporting the pre-service training of school teachers and early childhood educators regarding mental health issues.
• The population of the less-developed regions is relatively young, with children aged from birth to 14 years accounting for 28 per cent of the population (1.67
billion).
• In the least-developed countries, children constituted 40 per cent of the population - or 360 million children.
• In the more-developed regions, children accounted for an average of 1-6 per cent of the population (around 206 million people).
• Children currently aged from birth to 12 years are all members of Generation Z.
• It is a dynamic socio-cultural theoretical framework that employs a broad-brushstroke approach rather than an individual focus.
• Carers and educators need specialist preparation, as they are required to promote and teach health and wellbeing and to have the skills and knowledge to
understand and manage the plethora of issues related to young children.
• Around the world - including in Australia - early years’ education is undergoing significant reform as the potential to improve the quality of life is better
understood.
Current health crises:
• Asthma, allergies, obesity and inactivity, anxiety and depression, cardiovascular disease, type 2 diabetes (not contagious – stems from health choices/lifestyle and
behavioural factors)
• Poor educational outcomes (dropping out etc.), reduced economic success, increased deviance and contact with criminal justice system, poor employment
prospects and family dysfunction → all potential negative consequences from social, health and psychological problems when younger.
At-risk Populations for children:
• Indigenous children (genetics)
• Children with special needs e.g. down syndrome, low muscle tone (effects physical activity)
• Children of parents with drug dependency problems (neglection, abuse)
• Children of parents with mental illness (genetics, stress, influence)
• Children born prematurely (development of bodily parts)
• Children in poverty (malnutrition, physical health, disease, buying high in carbs food = low nutritional content)
Determinants of Health = make people healthy/unhealthy:
• All disease are linked to sociocultural factors and determinants of health
• General socio-economic, cultural and environmental conditions
• Social and community networks
• Living and working conditions
• Individual lifestyle factors
• Age, sex and constitutional factors
Main explanations for unhealthiness/poor health choices:
• Physical environment, less equitable access to healthy food, less income to purchase good food
• Stress created from poverty
• Stress, sense of powerlessness = higher likelihood to engage in poor health behaviours
How do we intervene in early childhood?
• Developmental prevention
o Early intervention
o Changing contexts
o Risk and protective factors
o Important transitions in life
Neoliberalism or Social Justice Approach:
• Australians use a mix of neoliberalist and social justice arguments regarding health.
• Neoliberalist arguments relate to individualism, privatisation and decentralisation.
• A basic idea is that individual should be allowed to make choice about their health care and health risk.
• Social justice approaches are community based and often government led.
• It is assumed that the role of government is the make sound policy to prevent and treat illness.
• Beliefs are closed aligned to other political beliefs and about personal vs. state responsibilities.
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Government, school/childcare, parent, child responsibilities
• There is constant conflict about who should take responsibility for health.
• Promotion of food product is an example:
- Health advocates generally argue for greater government regulation. For example, most would argue for no advertising during children’s TV viewing time (which
occurs primarily during adult shows in the early evening, not in children’s timeslots)
-Some argue that it is parental responsibility, not the role of the Government – we should not be a ‘Nanny State”
-Some argue that schools and childcare should be more proactive. In particular, associating junk food with fund raising (creating a positive association with the
product) and selling junk food in school canteens in a problem.
-Whatever the decisions, it is also important that children are educated about making good food choices- they are not passive recipients.
Prevention, intervention, treatment, cure
• Prevention- can be at an individual or population level. For example, I may be at low risk of contracting ‘whooping cough’, but may work with infants who are
at risk. By receiving the vaccination, I am preventing the spread of the illness
• Interventions- sometimes are for individuals, but can often be class-wide or school-wide. Many interventions are fun for everyone, not just those at risk (e.g.
some interventions for coping with stress involving play)
• Treatments- tend to be individually based and often monitored by a clinician.
• Cure- Some illnesses are cured, but for many illnesses, the severity of symptoms is lowered. By war of proposed of cures in areas such as autism.
World Health Organisation Approach
• Socioecological (Upstream) approach: Policies that shape the economic, social and physical (built and natural) environments.
• Policies that influence physical activity environments
• Policies that influence food environments
• Policies that influence underlying determinants of health in society
• Lifestyle (Midstream) approach: Policies that directly influence behaviour (reducing energy intake and increasing physical activity)
• Health services (Downstream) approach: Policies that support health services and clinical interventions.
• Approach which is put into place when the other approaches are unsuccessful
• Approach which is a lot more expensive.
Government guidelines
• Government guidelines are usually based and developed by expert panels.
• In the areas of child physical activity and nutrition, the Get Up and Grow guidelines are the best to access.
• Government guidelines change in response to changes in research.
• In recent years, there have been increases in the minimum amounts of physical activity recommend at all age levels.
• Recommendations relating to sedentary time are also emerging.
Government and industry health promotion
• If in doubt, use health promotion material from government sources, not the industries that make profits from the products (although not all of these provide bad
information)
• Current controversial areas include: tobacco and Drinkwise and Toddler formula.
Public Health Experts vs Industry
• Public health experts will generally lobby for government based interventions such as taxes, restrictions and prohibition.
• Industries involved in manufacture or distribution of health damaging products will often push for self-regulation and education to support individual choice.
Health at home vs health in child care and schools
• Family germs are different to community gems
• Our hygiene practices at home do not need to be as stringent as they are in community settings
• In general, the younger the age-group you are working with, the more vigilant you need to be about hygiene.
• Infectious diseases spread easily in setting with large numbers of infants and children
• It is important to teach children about the difference between what we do at day care and what we do at home.
Ethical issues
• Not allowing children to attend childcare when unwell.
• Not allowing enrolment of children who are not immunised
• Fund raising through sale of chocolate or canteen junk food
• Banning certain foods due to allergies of individual children (e.g., nut allergies)
Summary
• The years from birth to 12 years are increasingly recognised as a crucial time for laying the foundations for life, with significant consequences for ongoing
educational success and future participation in society.
• Carers and educators need specialist preparation, as they are required to promote and teach health and wellbeing, and to have the skills and knowledge to
understand and manage a plethora of issues related to young children.
• Health is a state of complete physical, mental and social wellbeing, and not merely the absence of disease or infirmity.
• Measuring wellbeing is a challenging undertaking, as there is no consensus on how to operationalise and measure the concept - although there have been many
attempts to construct indexes over recent years.
• There is a global imperative to improve the health and wellbeing of children, and there are many initiatives in place to support this goal
Chapter 3: Promoting healthy development and wellbeing (CONCEPTS OF HEALTH)
Life-course perspective
• Evidence from empirical studies indicates that children who display early signs of disruptive behaviour, who are unprepared for school or who
live in a disadvantaged home environment are at greater risk of developing social, health and psychology problems later in life.
• Examples of potential negative consequences include poor educational outcomes, reduced economic success, increased deviance and contact
with the criminal justice system, poor employment prospects and family dysfunction.
• The life-course perspective acknowledges the influence of factors – individual, cultural, social, environmental and economic- that potentially
affect vulnerability.
• Example: some children are particularly vulnerable when moving from home to a formal school environment, such as kindergarten, prep or
primary school. The transition into a new institution can be frightening and overwhelming if strategies are not in place to both protect the child
and equip them with the necessary skills and resources to cope with the transition.
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• These strategies can occur before the transition – for example, preparing to learn in the kindergarten years – or at the time of the transition-
such as strategies aimed at reducing stress and uncertainty. This could be as simple as having an older ‘buddy’ assisting the child in negotiating
a new and unfamiliar environment.
Early Intervention
• Early intervention begins by identifying individuals early in the lifecourse.
• For example- pre-schoolers- who are seen as members of vulnerable groups, and providing resources to assist them to mediate vulnerability
through risk minimisation and protective factor-enhancement strategies.
• Enabling protective factors, with the gaol of enriching the available pathways for an individual, typically involves the provisions of access to
experiences and services that compensate for adverse life circumstances, disadvantage and vulnerability.
Risk and protective factors
• Risk and protective factors underpin the life-course perspective.
• Risk factors are measureable characteristics that precede an outcome, and are used to divide the population of interest into a range of risk
groups.
• Risk factors can be classified as fixed or variable. Protective factors are variables- such as the presence of a stable emotional bond with a
caregiver – that reduce the probability of negative outcomes.
• Risk and protective factors may function simultaneously – for example – the divorce of a child’s parents might have a negative impact on some
children and may constitute risk factors. On the other hand, a stressful family environment due to marital discord and even domestic violence is
likely to have a negative impact on the child’s social and emotional wellbeing, so divorce may actually act as a protective device from children
being subjected to further stress.
Functional capabilities
• Development science highlights that not all children are born healthy, provided with adequate health care, have access to good nutrition, or live
in acceptable housing conditions; not all children are born free of disabilities, or are raised by parents who can comfort, nurture and provide
adequate language, literacy, social problem-solving and behaviour-management skills.
• The early years are important, as this period is a starting point from which individuals can minimise the effect of adverse life circumstances,
disadvantage and vulnerability, and provide opportunities for developing new pathways that promote improved quality of life.
• Quality of life may be defined as subjective wellbeing, reflecting the difference between the expectations and hopes of a person and their
present experiences.
Why we begin interventions early
• The consensus among developmental scientists is that we begin as early as we can
• Some describe the temporal boundaries of prevention as ‘womb to tomb’.
• In other words, we begin providing resources to expectant mothers and continue to provide resources and opportunities over the entire life-
course.
• Early children should be considered the first point in a series of important life phases, each of which contains aspects of vulnerability and
opportunity.
• Many cognitive and motor skills are gained quickly during childhood, but after childhood such skills are not mastered as easily.
Does development prevention work?
• Early childhood invention programs that employ a risk-focused approach can have positive impacts on outcomes of children who are
considered at risk at an early age.
• Successful experiments have demonstrated or vulnerable families has resulted in large reductions in crime involvement amongst targeted
groups.
• Studies have also confirmed improved outcomes for those target across multiple domains, including improved educational outcomes, decreases
in child maltreatment, reductions in child and youth anti-social behaviour, lower levels of substance abuse, and increase in income and
workforce participation.
Addressing the complexity of human development in the future
• The inequalities in wellbeing between mainstream and marginalised communities, exacerbated by the growing concentration of multiple
disadvantage families living in low socio-economic status areas, pose significant challenges to policy development and cannot be overcome
without a major paradigm shift.
• The interventions that have occurred have tended to lack important collaborative relationships with key institutions within communities; this is
especially the case in socially and economically disadvantaged areas.
Changes over time (health in the 1900’s compared to now)
Birthrate: 1901: 3.5 children per female → Now: less than 2
Maternal mortality at birth: 1901: 7.2% → Now: Less than 1 per thousand
Infant mortality in the first year: 1901: 11% → Now: Less than 0.5%
Common and killer problems for children
➔ 1901
• Common: gastroenteritis, malnourishment
• Killers: pneumonia, tuberculosis
➔ Now
• Common: asthma, obesity, diabetes, anxiety
• Killers: accidents
Changes due to changes in practices
• Vaccination
• Anti-smoking campaigns
find more resources at oneclass.com
find more resources at oneclass.com
