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首页> 外文期刊>International Journal of Integrated Care >Can social and educational markers predict risk for future health vulnerabilities? A population health approach for vulnerable young people on the Central Coast of NSW Australia
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Can social and educational markers predict risk for future health vulnerabilities? A population health approach for vulnerable young people on the Central Coast of NSW Australia

机译：社会和教育指标可以预测未来健康漏洞的风险吗？在澳大利亚新南威尔士州中部海岸为弱势年轻人提供的人口健康方法

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Introduction : Lifestyle choices, social and environmental factors impact 60% of health outcomes, while health system impacts 10%. Why then, do we continue to focus on health as the place for early intervention with young people? Young people become vulnerable through a combination of their circumstances, stages of development and barriers to participation. Vulnerabilities can be a combination of health (physical, mental health, substance use), educational (disengagement from school) and social factors (homelessness, unemployment, financial hardship). Description : This case study, describes the process of partnership for health, education` and social care partners on the Central Coast of NSW, Australia delivering an integrated school based model of early intervention to impact vulnerabilities within a population of 10,000 school students (5-18years) and their families. Working with schools we can identify youth vulnerabilities before they become clinically significant, and intervene by strengthening family links with their health care neighborhood. Change : An early intervention approach, using risk factors identified in schools as markers for vulnerability and providing an upstream preventative health and social care response. Targeted : Socioeconomically deprived school communities, a combined student population of 10,000+. Timeline : A six month process of co-design has built social capital and trust amongst partners. Implementation has been phased over three school terms in 2016/17, with each program running for minimum of 12 months in each school. Highlights : Partners have designed local solutions, built around existing resources, and leveraged partnerships to address service gaps across health and social care agencies. Collaborative approaches have supported levels of clinical, professional and organisational integration across health and social care agencies. Sustainability : This program has been seed funded by Government agencies with additional funding from participating schools. If effective, the program would continue to be funded through the partnerships in the schools Education wellbeing budgets. Transferability : The educational infrastructure, combined with the co-design approach, provide potential for the model to be transferable across NSW and Australia. Conclusions : Impacting health outcomes for vulnerable young people requires a collective response with shared investment and accountability, and cannot be achieved with a traditional disease focused health service delivery model. Effective early intervention health responses for young people require a shift from identification of health risk factors to early signs of vulnerability as they impact on the young person’s primary role as a learner. Discussions : Integration of health, education and social care agencies around the needs of a school population provides common purpose and can make a meaningful difference to vulnerable populations Lessons : Wrapping health and social care services around a school community requires flexibility and challenges health agencies to reconsider their importance in the world of children and families. Placing leadership within the school ensures that service models remain focused on the needs of the young person and the family rather than the health system. Opportunities are emerging for joining health and education data to better understand the trajectory of service use and vulnerability for families. Challenges remain to measure medium and long term benefits from this model and to measure cost impact over time.
机译：简介：生活方式的选择，社会和环境因素影响60％的健康结果，而卫生系统影响10％。那么，为什么我们继续将健康作为早期干预年轻人的场所呢？年轻人由于处境，发展阶段和参与障碍而变得脆弱。漏洞可能是健康（身体，心理健康，物质使用），教育（脱离学校）和社会因素（无家可归，失业，经济困难）的组合。说明：此案例研究描述了澳大利亚新南威尔士州中部海岸卫生，教育和社会护理合作伙伴的伙伴关系过程，提供了一种基于学校的早期干预综合模型，以影响10,000名在校学生的脆弱性（5- 18岁）及其家人。通过与学校合作，我们可以在青年脆弱性变得具有临床意义之前就确定其脆弱性，并通过加强与其保健社区之间的家庭联系进行干预。变更：一种早期干预方法，使用在学校中确定的风险因素作为脆弱性的标记，并提供上游预防性健康和社会护理对策。定位：社会经济匮乏的学校社区，总学生人数超过10,000。时间表：六个月的协同设计过程已经建立了社会资本和合作伙伴之间的信任。在2016/17年度，实施已分三个学期进行，每个计划在每个学校的运行时间至少为12个月。要点：合作伙伴已设计了本地解决方案，并以现有资源为基础，并利用合作伙伴关系解决了卫生和社会护理机构之间的服务差距。协作方法已支持卫生和社会护理机构之间临床，专业和组织整合的水平。可持续性：该计划由政府机构提供种子资金，参与学校提供额外资金。如果有效，该计划将继续通过学校教育福利预算中的伙伴关系提供资金。可转移性：教育基础架构与协同设计方法相结合，为该模型在新南威尔士州和澳大利亚之间的转移提供了潜力。结论：影响弱势年轻人的健康结果需要有共同的投资和责任感的集体反应，而传统的以疾病为中心的卫生服务提供模式是无法实现的。有效的针对年轻人的早期干预健康应对措施，需要从健康风险因素的识别转变为脆弱性的早期迹象，因为它们会影响年轻人作为学习者的主要作用。讨论：围绕学校人口的需求整合卫生，教育和社会护理机构提供了共同的目标，并且可以对弱势群体产生有意义的变化。在儿童和家庭世界中的重要性。在学校内部设置领导层可确保服务模式始终侧重于年轻人和家庭的需求，而不是卫生系统。加入健康和教育数据以更好地了解服务使用和家庭脆弱性的轨迹正在出现。衡量此模型的中长期收益以及衡量随时间推移的成本影响仍然存在挑战。

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