Young People:

Health and Wellbeing

Eustace de SousaNational Lead – Children, Young People and FamiliesNovember 2014 – CHYPS Convention

Presentation

• State of young people’s health and wellbeing

• Vulnerable groups

• Variation

• The case for investing in young people’s health

• Next steps for PHE

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3

Population projections - 1,000s, England, ONS

2,600

2,800

3,000

3,200

3,400

3,600

3,800

2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023

10-14

15-19

20-24

Some Key Health and

Wellbeing Outcomes

- Excluding mental health and wellbeing to

be covered by next speakers

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Obesity Prevalence 11-15 years

Sexual health

• Since 2001, the median age for first

heterosexual intercourse remains at 16 years

• Those aged under 25 experienced the highest

STI rates, contributing 64 per cent of all new

chlamydia diagnoses in 2012

• Teenage conception rates continue to fall

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Under 18 conception rate | 1998-2012

0

5

10

15

20

25

30

35

40

45

50

1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Rate per 1,000 females

aged 15-17

Year

Conception rate

Maternity rate

Abortion rate

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Lowest rate since 1969 when conception data collection began

41% reduction in under 18 conception rate – from 46.6/1000 15-17s in 1998 to 27.7/1000 in 2012

Both maternity and abortion rates now declining but steeper overall reduction in births of 46%

Evidence that concerted effort can make a difference

England progress: 1998-2012

9 HSCIC 2014 - http://www.hscic.gov.uk/catalogue/PUB14579/smok-drin-drug-youn-peop-eng-2013-rep.pdf

England secondary school pupils – 11-15 years

10 HSCIC 2014 - http://www.hscic.gov.uk/catalogue/PUB14579/smok-drin-drug-youn-peop-eng-2013-rep.pdf

England secondary school pupils – 11-15 years

11 HSCIC 2014 - http://www.hscic.gov.uk/catalogue/PUB14579/smok-drin-drug-youn-peop-eng-2013-rep.pdf

England secondary school pupils – 11-15 years

Vulnerable Groups

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Preventable, external causes of death

Young people aged 11-15 years with a long-term condition or

disability

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Young people aged 11-15 years with a long-term medical illness or disability including

asthma, diabetes, allergies, epilepsy, cancer and physical and mental impairment.

5 GCSEs A*-C, England

15 AYPH: http://www.ayph.org.uk/publications/480_KeyData2013_WebVersion.pdf

Variation

Non-elective admissions as a result of injury, poisoning and

external events | 2010/11 | Rate by IMD quintile | Boys

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Source: Hospital Episode Statistics, The Information Centre for health and social care, Office for National Statistics mid-year population estimates and

Department of communities and local government

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LA variation in health outcomes

18 http://www.chimat.org.uk/resource/view.aspx?QN=PROFILES_STATIC_RES&SEARCH=B*

Source: Child and Maternal Health Intelligence Network, PHE, May 2014

England Best Average Worse

u18 Teenage

Conception Rate

(per 1000)

9.4 30.7 58.1

Alcohol

admissions

(per 100,000)

14.6 42.7 113.5

Self harm

admissions (10-24)

(per 100,000)

82.4 346.3 1,152.4

The case for investing in

Young People

the research and evidence

the social context

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• There are more than 9.9 million aged 10-24 in England

• The rate of developmental change during adolescence is

second only to infancy

• Good health allows young people to make the most of

their teenage years

• Many poor health outcomes for adults originate when we

are young, for example smoking, mental health, obesity

and violence

Why focus on young people?

Adolescence – periods of change

Adolescence and early adulthood

represent a transition period marked by

many pressures and challenges . . .

Physical and emotional changes . . .

Changing social relationships and growing

academic and professional expectations

EuroHealthNet, Making the Link: Youth and Health Equity

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Behaviour across Adolescence

Source: Hawkins & Monahan 2009

Research from the CMO’s report• All cause mortality for 10-19 year olds is now higher than

for other periods of childhood except for new borns –

main cause is Injury

• Five of the ten riskiest factors for the total burden of

disease in adults are initiated or shaped in adolescence

• Adolescents have higher use of health services than

other child categories above the age of 3

• There appears to be a window of vulnerability to risky

behaviours between 14-17 years

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Summary

• Positive trends for some key

outcomes

• Inequalities a significant factor

• Variation across authorities

• England often poor compared

with international comparators

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Public Health England’s Mission

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“To protect and improve the

nation’s health and to address

inequalities, working with national

and local government, the NHS,

industry, academia, the public and

the voluntary and community

sector.”

A new approach that brings together• appreciation of wider health determinants

• promoting wellbeing, prevention and early intervention

A new vision and transformed approach1

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2 A new approach that relies on• evidence-base for what works

• collaboration and cross-sector leadership

• adapting to local needs

A renewed focus on driving healthy behaviour• promoting healthy behaviour (campaigns)

• informing personal choice

• providing local data for improving health

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PHE cannot succeed by itself

Our partnerships with local authorities, the NHS

and the third sector are what will allow us to

achieve the outcomes we all seek

PHE as a link between local and national

We will have dedicated expertise at the heart of

PHE and in each centre to offer practical know-

how and advice to local government and the NHS

We will work across Government

Working together

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The evidence base

Part of our support role to local government and

providers is to collect, collate and share best

evidence and practice of what works, so local

areas can get the best possible outcomes for

individuals and local communities

Guidance

We are also producing guidance in the areas

where we have expertise, working with NICE and

partners such as the LGA, ADCS and ADPH

Supporting Improvement

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Young people’s health and wellbeing

framework

A high level document to inform local strategies

that will draw on what works and what matters

Working in collaboration with schools, FE

and Local Authorities

Central to our work to support local improvements

– identifying what works from the evidence base,

supporting evidence into practice

Strengthening the public health

workforce

Wider than just ‘public health’ trained workforce –

youth services, children’s centres, VCS etc

Next Steps

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• The evidence base

• Case for investment

• Holistic approach – seeing the whole young person, not

individual issues or conditions

• Integrated solutions – no wrong door approach locally

• A local health offer for young people

• Key questions for local leaders

PHE and AYPH Young People’s

Health and Wellbeing Framework

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A Trusted Service

Advocacy Role

Continuity of contact - building relationships

Non judgemental – positive guidance

Role modelling – life skills – testing boundaries -

exploration

Youth Services – A Platform for

Helping Build Health and Wellbeing

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Further Information

• eustace.desousa@phe.gov.uk

• www.gov.uk/phe

• www.chimat.org.uk

• Twitter @PHE_children @EustacedeSousa

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