Professor Jonathan Bradshaw. Child Well-being. CHIMAT Annual Conference: Informed Decisions and Intelligent Investment: The Future of Child and Maternal Health Services, Royal York Hotel, York, 18 March 2010.

1. CHIMAT ANNUAL CONFERENCE
Informed Decisions and Intelligent Investment: The Future
of Child and Maternal Health services
CHILD WELL-BEING
Jonathan Bradshaw
The Royal York Hotel
18 March 2010

2. Objectives





Introduce two sources of data now available through CHIMAT
Comparative data on child well-being and health
 Bradshaw, J. and Richardson, D. (2009) An index of child
well-being in Europe, J. Child Indicators Research, 2, 3,
319.
http://www.springerlink.com/content/r5kq13v750q53782/?p
=76a9631290a7476b9802650b9750b54d&pi=0
Area level data on child health and well-being at small area level
in England
 Bradshaw J, Noble M, Bloor K, Huby M, McLennan D,
Rhodes D, Sinclair I, Wilkinson K. (2009) A Child WellBeing Index at Small Area Level in England, J. Child
Indicators Research 2, 2, 201-219
http://www.communities.gov.uk/publications/communities/ch
ildwellbeing2009
Show them on CHIMAT
Introduce some analyses that are possible

3. Conceptualisation of child well-being


Multi-dimensional approach
Based on children’s rights as outlined in the
UN CRC

“the primary consideration in all actions concerning children must be in their best
interest and their views must be taken into account”


What children think and feel is important
Aspirations




Child the unit of analysis
Well-being more important than well-becoming
Focus on outcomes not inputs
Use direct measures

4. Data Sources for EU index 2009

Surveys


Programme for International Student Assessment (PISA)
at 2006


Health Behaviour of School Aged Children (HBSC) at
2005
Survey of Income and Living Conditions (EU) at 2006
Series

WHO mortality data base

World Bank World Development Indicators

OECD Health Indicators

EU Health for All Data base

OECD Education at a Glance,

5. DOMAINS OF WELL-BEING



43 indicators
20 components
7 domains

6. DOMAINS OF WELL-BEING
Health
Subjective
Personal
Material
well-being
relationships
resources
Education
Behaviour
Housing
and risks
and the environment

7. Child well-being: Summary
Rank
Country
Child well-being
in the EU 29
Health
Subjective
Relationships
Material
Risk
Education
Housing
1
Netherlands
117.3
2
1
1
7
4
4
9
2
Sweden
114.8
1
7
3
10
1
9
3
3
Norway
114.8
6
8
6
2
2
10
1
4
Iceland
112.7
4
9
4
1
3
14
8
5
Finland
111.0
12
6
9
4
7
7
4
6
Denmark
109.6
3
5
10
9
15
12
5
7
Slovenia
107.1
15
16
2
5
13
11
19
8
Germany
106.1
17
12
8
12
5
6
16
9
Ireland
105.3
14
10
14
20
12
5
2
10
Luxembourg
104.8
5
17
19
3
11
16
7
11
Austria
104.2
26
2
7
8
19
19
6
12
Cyprus
103.7
10
13
Spain
103.6
13
4
17
18
6
20
13
14
Belgium
103.0
18
13
18
15
21
1
12
15
France
100.9
20
14
28
11
10
13
10
16
Czech Republic
98.9
9
22
27
6
20
3
22
17
Slovakia
98.7
7
11
22
16
23
17
15
18
Estonia
96.9
11
20
12
14
25
2
25
19
Italy
96.1
19
18
20
17
8
23
20
20
Poland
94.6
8
26
16
26
17
8
23
21
Portugal
94.5
21
23
13
21
9
25
18
22
Hungary
94.3
23
25
11
23
16
15
21
23
Greece
94.0
29
3
23
19
22
21
14
24
United Kingdom
92.9
24
21
15
24
18
22
17
25
Romania
87.0
27
19
5
24
27
26
Bulgaria
84.9
25
15
24
26
26
27
Latvia
84.1
16
24
26
22
27
18
26
28
Lithuania
82.3
22
27
25
25
28
24
24
29
Malta
81.9
28
28
21
13
11
14

8. Health
Health
Child health
from
birth
World Development Indicators
circa 2006
OECD Health and EU Health
for All Databases
Immunization, measles (% aged 12-23 months)
2006
World Development Indicators
Child immunization rate, DPT3 (% aged 12-23 months)
2006
World Development Indicators
Child immunization rate, Pol3 (% aged 12-23 months)
Children’s
health
behaviou
r
2006
Low birth weight newborns (lower than 2.5kg, [%])
Immunisation
Mortality rate, infant (per 1,000 live births)
2006
HNP stats
Children who brush their teeth more than once a day
2005/06
HBSC (Currie et al, 2008)
Children who eat fruit daily
2005/06
HBSC (Currie et al, 2008)
Children who eat breakfast every school day
2005/06
HBSC (Currie et al, 2008)
Children's physical activity
2005/06
HBSC (Currie et al, 2008)
Children who are overweight (BMI)
2005/06
HBSC (Currie et al, 2008)

9. HEALTH

10. CHIMAT: Health Map

11. Risk and safety
Risk and Safety
Violence and
violent
behaviou
r
Children involved in physical fighting at least once in the
past year
2005/06
HBSC (Currie et al, 2008)
Children who have been bullied at school at least twice in
the past 2 months
2005/06
HBSC (Currie et al, 2008)
Child deaths
All child deaths: All under 19 deaths per 100,000 children
circa 2005
WHO Mortality Database
Risk
Adolescent fertility rate (births per 1,000 women ages 1519)
2006
World Development Indicators
15-year-olds who have had sexual intercourse
2005/06
HBSC (Currie et al, 2008)
15-year-olds who used a condom at last sexual intercourse
2005/06
HBSC (Currie et al, 2008)
Children who smoke at least once a week
2005/06
HBSC (Currie et al, 2008)
13 and 15 year olds who have been drunk at least twice
2005/06
HBSC (Currie et al, 2008)
15-year-olds who have ever used cannabis in their lifetime
2005/06
HBSC (Currie et al, 2008)
behaviou
r

12. Components of risk and safety

13. Child well-being by GDP Euros per capita
120.00
net
nor
swe
fin
den
110.00
sln
ire
ger
lux
domain
cyp
cze
slk
100.00
bel
spa
fra
est
ita
por
pol
gre
hun
uk
90.00
rom
bul
lat
lit mal
R Sq Linear = 0.477
80.00
0
20000
40000
60000
gdp
80000
100000

14. WELL-BEING BY CHILD POVERTY RATE

15. Overall child well-being by spending on
families with children 2005 as %GDP

16. Child well-being at small area level: Background

Index of deprivation 2004




Contains IDAC and education data
But need for age specific indices
CLG commission one on children to coincide
with ID 2007
Thrust of policy increasingly local




Children’s Trusts
Every Child Matters
Comprehensive Spending Review
Child Poverty Unit
16

17. Methods





Child well-being rather than child deprivation
Multi-dimensional
Lower level super output areas and LAs
Mainly administrative data but census for housing and
CiN survey
Domains: material well-being, health, education, crime,
housing, environment and children in need





2005
Denominators pop estimates
Children 0-16 or 18 in FTE
Some indicators weighted. No weights applied to
domains
Shrinkage estimation, factor analysis and exponential
ranking
17

18. Material well-being





Children aged 0-15 in households claiming Income Support
(Source: DWP, 2005).
Children aged 0-15 in households claiming Income Based
Jobseeker’s Allowance (Source: DWP, 2005).
Children aged 0-15 in households claiming Pension Credit
(Guarantee) (Source: DWP, 2005).
Children aged 0-15 in households claiming Working Tax Credit
in receipt of Child Tax Credit whose equivalised income
(excluding housing benefits) is below 60 per cent of the median
before housing costs (Source: HMRC, 2005).
Children aged 0-15 in households claiming Child Tax Credit
(who are not eligible for Income Support, Income Based
Jobseeker’s Allowance, Pension Credit or Working Tax Credit)
whose equivalised income (excluding housing benefits) is below
60 per cent of the median before housing costs (Source: HMRC,
2005).
18

19. Health



All emergency admissions to hospital for
children aged 0-18 as a proportion of all
children aged 0-18 in each LSOA (Source:
Hospital Episode Statistics for England
2005/6).
All outpatient hospital attendances for children
aged 0-18 as a proportion of all children aged
0-18 in each LSOA (Source: Hospital Episode
Statistics for England 2005/6).
The proportion of children aged 0-16 receiving
Disability Living Allowance (Source: DWP
2005).
19

20. Education






Two year rolling average points score at Key Stage 2 (aged 11)
derived from test score. Source: Pupil Level Annual Schools
Census (PLASC) (2004-2005), National Pupil Database (NPD)
(2004-2005).
Two year rolling average points score at Key Stage 3 (aged 14)
derived from test score. Source: PLASC (2004-2005), NPD
(2004-2005).
Two year rolling average capped (best of 8 GCSE and/or
equivalent vocational qualifications) points score at Key Stage 4
(ages 16). Source: PLASC (2004-2005), NPD (2004-2005)
Secondary school absence rate – based on two year average of
school level absence rates allocated to local area using PLASC.
Source: PLASC and DfES absence rate data (2004-2005).
Proportion of children not staying on in school or non-advanced
further education or training beyond the age of 16 (2005).
Source: Child Benefit (2004-2006)
Proportion of those aged under 21 not entering higher education
(4 year average, 2002-2005). Source: Universities and Colleges
Admission Service, Higher Education Statistics Agency.
20

21. Crime




Burglary (four recorded crime offence types, police
force data for April 2004-March 2005, constrained to
Crime and Disorder Reduction Partnership (CDRP)
level).
Theft (five recorded crime offence types, police force
data for April 2004-March 2005, constrained to CDRP
level).
Criminal damage (ten recorded crime offence types,
police force data for April 2004-March 2005,
constrained to CDRP level).
Violence (14 recorded crime offence types, police
force data for April 2004-March 2005, constrained to
CDRP level).
21

22. Housing

Access




Overcrowding - occupancy rating: the counts of households
comprising couples, lone parents, and other types of household
containing dependent children living in accommodation with at
least one room too few is summed across the tenures and
expressed as a proportion of all households to give a rate of
‘overcrowded’ households containing dependent children. Source:
Census table CAS053.
Shared accommodation: people living in shared dwellings, aged 0
to 15 as a proportion of all children 0-15 in each LSOA. Source:
Census table CAS054.
Homelessness: concealed (not the householder) families
containing dependent children as a proportion of all families with
dependent children. Source: Census table CAS011.
Quality

Lack of central heating: children aged 0 to 15 years old living in
accommodation without central heating as a proportion of all
children aged 0 to 15. Source: Census table CAS054.
22

23. Environment

Environmental quality




Air quality: combined air quality indicator. Source: Geography
Department at Staffordshire University.
The natural environment: percentage of green space and
woodland; number of bird species. Source: European Environment
Agency’s CORINE Land Cover (CLC) database; British Trust for
Ornithology bird breeding atlas.
Road safety: severity-weighted accidents per 1000 children aged
under 16. Source: Department of Transport.
Environmental access



Availability of opportunities for sports and leisure: average number
of different types of sports and leisure facility within walking
distance for children aged 11 to 16. Source: Ordnance Survey
Points of Interest.
Distance to school: average road distances to primary for children
aged 4 to10 years and
secondary schools for children aged 11 to 16 years. Source:
PLASC (2005) and Edubase (2005).
23

24. Children in need

Children in need under 19 as a proportion of
all children under 19.

Actually modelled
24

25. Relationshsips between domains:
Spearman’s r
Material Education Health Environment Crime Housing Children
in need*
Material
Education
Health
Environment
Crime
Housing
Children in
need*
Overall wellbeing
Overall less
CiN
1.00
0.80
1.00
0.56
0.57
1.00
0.07
0.03
0.05
1.00
0.55
0.53
0.36
-0.02
1.00
0.63
0.48
0.31
0.16
0.35
1.00
0.96*
0.86*
0.59
0.07
0.54
0.59
1.00
Overall
Overall Overall
excluding
less
individual
CiN
domains**
0.85
0.90
0.86
0.76
0.83
0.81
0.55
0.68
0.68
0.08
0.30
0.33
0.51
0.63
0.63
0.58
0.69
0.69
0.87
0.87
0.91
0.996
1.00
1.00
25

26. Discussion


First attempt ?in the world
Administrative data strengths




Administrative data weaknesses





Population data
Geographically coded
Up to date
Indirect indicators
Nothing on subjective well-being, relationships,
behaviour
Some events too rare IMR
Lack of data on eg health outcomes
Will it be useful?
26

27. Overall child well-being: York LSOAs

30. Poverty and health: NE local authority ranks

31. Poverty and Health in NE: %LSOAs in the lowest quintile

32. ar
li
H
ng
to
n
ar
U
A
tle
M
po
R
id
ed
dl
ol
es
ca
U
br
A
ra
ou
nd
gh
C
St
U
le
oc
A
ve
kt
la
on
nd
-o
U
nA
Te
C
he
es
st
U
er
A
-l e
-S
tre
D
er
et
w
en
ts
id
e
D
ur
ha
m
Ea
si
ng
to
Se
n
dg
ef
ie
ld
Te
es
da
W
le
ea
rV
al
Be
le
rw
y
Al
ic
knw
up
ic
on
k
-T
w
ee
Bl
d
yt
h
Va
C
as
ll e
tle
y
M
or
pe
th
Ty
ne
da
le
W
an
sb
N
ec
ew
G
k
at
ca
es
st
he
le
ad
up
on
N
Ty
or
ne
th
Ty
So
ne
ut
sid
h
e
Ty
ne
si
de
Su
nd
er
la
nd
D
Quintile distribution of material well-being for SOAs in each LA in the
NE.
60
50
40
30
20
10
0
Qunitile 1
Quintile 2
Quintile 3
Quintile 4
Qunintile 5

33. Sources of data

EU29 – email me

jrb1@york.ac.uk
Child well-being index available at
http://www.communities.gov.uk/publications/com
munities/childwellbeing2009







Download
Local Index of Child Wellbeing 2009 PDF, 267 kb , 20 pages
Local Index of Child Wellbeing 2009 MS Word, 166 kb , 20 pages
Child Wellbeing Index 2009 ZIP, 8781 kb
Child Wellbeing 2009 - County MS Excel, 78 kb
Child Wellbeing 2009 - District MS Excel, 153 kb