Child Poverty Needs Assessment for Cornwall Indirect influence upon families’ ability to enter & sustain well paid employment & escape poverty now & in the future: Teenage Pregnancy Research has found a very close association between teenage pregnancy and social and economic disadvantage 1 . Teenage parents & their children are more likely to experience poor economic wellbeing as young mothers face significant hurdles to achieving positive outcomes in education & subsequently employment. Research suggests 2 the implications of low educational attainment coupled with low participation in education, employment & training post 16 means that by age 30 teenage mothers are: 22% more likely to be living in poverty than mothers giving birth aged 24 or over; 20% more likely to have no qualifications than mothers giving birth aged 24 or over; Much less likely to be employed or living with a partner; Where they do live with a partner, that partner is more likely to be unemployed and have poor qualifications. ¾ ¾ ¾ ¾ As a consequence, children born to teenage mothers have a 63% higher risk of living in poverty, compared to babies born to mothers in their twenties. They have lower academic attainment and are at higher risk of economic inactivity in later life. The below chart shows the latest teenage conception rates per thousand females aged 15 – 17 from the ONS (2008) for Cornwall & the Isles of Scilly, its statistical neighbour group, the regional & national averages. Cornwall & IoS has the 4th highest rate amongst a group of 11 statistical neighbours. Whilst Cornwall’s rate is below the national average it is slightly above the regional average. Teenage Conception Rate per Thousand Females Aged 15 - 17 (2008) South West England Rate per 1000 females aged 15 - 17 45.0 40.0 40.4 35.0 34.7 30.0 25.0 20.0 30.6 30.4 28.1 34.3 33.4 33.4 31.2 35.7 37.0 41.1 39.8 15.0 10.0 5.0 Table 2.11: Closest Statistical Neighbour Teenage Conception Rates LA & Closest Under-18 % SN conception rate difference 1998 2008 1998-2008 Cornwall & IoS Norfolk Devon Somerset Herefordshire 39.8 37.0 32.9 38.8 37.2 35.7 34.3 33.4 33.4 31.2 -10.2% -7.4% 1.4% -14.0% -16.2% br ia Cu m sh ire U A W ig ht of Table 2.11 above, compares the percentage Is le Li nc ol n Io S k al l & N or fo l Co rn w er se t D So m ev on re U A re H er ef or ds hi lk op sh i Su ff o Sh r D or se t 0.0 reduction in teenage conception rates for Cornwall & IoS & the closest statistical neighbours from 1998 to 2008. The current reduction in 2008 is 10.2% with a target of 50% by 2010. Under 18 Conception Rates 50.0 CIoS SW England 45.0 rate per thousand females 15 - 17 40.0 35.0 30.0 25.0 20.0 15.0 10.0 5.0 0.0 1997 2 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 The chart left shows the trend for Cornwall with the broken line showing the trajectory to 2010. Following a dip in rates in 2006 (33.0) the rate in 2008 has increased to 35.7. The chart shows the significant decline in conception rates required to meet the 2010 target. Teenage Parents Next Steps: Guidance for Local Authorities & Primary Care Trusts (DCSF, 2007) Cornwall Children’s Trust Needs Assessment 2010 1 Child Poverty Needs Assessment for Cornwall Local Data on Teenage Conceptions Local under 18 conception data for Cornwall is collated and reported by NHS Cornwall & Isles of Scilly. An element of omission is to be expected from the nationally released figures by the ONS. However, local data provides more timely figures for smaller geographic areas which can be used to inform local service planning / delivery. The local data is based upon the 2009 calendar year and on the basis of a total of 271 conceptions. 36.8 22.1 East 24.0 Mid West Table 2.12: Teenage Conception rates 2009 by Network Area Conception Rate Community Network 2009 Camborne & Redruth 53.4 Penzance, Marazion & St Just 39.4 St Austell 38.0 Bodmin 37.9 Bude 36.3 Hayle and St Ives 33.3 Falmouth and Penryn 29.8 Truro and Roseland 28.2 Camelford 28.2 St Blazey, Fowey and 25.6 Lostwithiel Liskeard and Looe 23.9 Callington 22.0 China Clay 21.9 Wadebridge & Padstow 14.6 Helston & Lizard 13.9 St Agnes and Perranporth 12.8 Saltash and Torpoint 12.6 Launceston 11.2 Newquay 8.8 Cornwall Average 28.0 The bar chart above shows teenage conception rates for each service delivery area based on the 2009 local data, the Cornwall average is 28.0. As would be anticipated when looking at smaller areas (Table 2.12) there is a strong link between higher teenage conception rates and areas of higher deprivation. The Camborne & Redruth network area has a rate (53.4) between 1.5 times & twice the county average. Network areas with above average rates include Penzance, Marazion, St Just, St Austell, Bodmin, Bude, Hayle & St Ives. Cornwall Children’s Trust Needs Assessment 2010 2 Child Poverty Needs Assessment for Cornwall What children and young people think about sexual health? The TellUs survey TellUs4: How helpful is the information & advice you get in school on Sex & Relationships Education TellUs4: Which of these things do you often worry about? 60% 30% Cornwall England SN 57% 53% Cornwall 55% England SN 26% 25% 25% 25% 50% 40% 15% 15% 14% 15% % % 20% 30% 10% 20% 5% 10% 19% 19% 20% 13% 14% 14% 13% 10% 11% 0% 0% Relationships/girlfriends/boyfriends Helpful Sex Not helpful Don't know Haven't received any Children & young people in Years 6, 8 & 10 responded to the question: which of these things do you often worry about with regards to relationships / girlfriends & boyfriends & sex. The survey shows that 25% of young people in Cornwall often worry about relationships, this is in line with the national average, as represented in the chart above left. 14% of children & young people often worry about sex this is marginally lower than the national & statistical neighbour average. The chart above right shows what young people in years 8 & 10 think about the information, advice & guidance they receive in school on sex & relationships education (SRE). A greater proportion of young people in Cornwall (57%) than nationally & compared with statistical neighbours thought SRE in schools was helpful. 19% of young people thought that the SRE they received was not helpful in line with the national average & marginally below the average of statistical neighbours. SRE has been highlighted in the Young People’s Manifesto 2010 as an area of importance by young people across Cornwall. Comments on how SRE could be improved from a focus group of 10 pregnant young women / young mum’s (aged 16 – 19) as part of the consultation process for the manifesto included: “We need more sex education” “My mum taught me about it not school” “Embarrassing , need more info” “We get sexual health advice from SHARE” “Need to be mature about it” The same group were asked about wider health services & feedback included: ¾ ¾ health professionals should be less intimidating, more understanding & less judgemental of young people more home visits for young babies would be helpful Young people’s views help to shape services and provide quality assurance by undertaking mystery shopper visits as part of the EEFO / You’re Welcome accreditation and are formally engaged through participation strategies. The young people’s mobile IAG / sexual health service is in the process of being evaluated and the report for this will be due in September 2010. Findings from the evaluation will be used to inform future commissioning of any mobile service. Cornwall Children’s Trust Needs Assessment 2010 3 Child Poverty Needs Assessment for Cornwall Recommended Focus Areas Sharon Hindley: Teenage Pregnancy Coordinator Integration & more for less Prevention & Early Intervention Transition from child to adult services Geographical Variations In year cuts of £36,000 to the Teenage Pregnancy budget as a result of the reduction of the ABG have meant a scaling back of services and projects. There is a significant risk that without funding from 1st April 2011 onwards that rates will begin to increase again. Provisional Q1 2009 data (Source: ONS May 2010) showed a significant reduction in under 18 conception rates for the first time in three years, falling from 35.7 / 1000 to 31.2 / 1000. The Reducing Teenage Pregnancy Strategy has a focus on sustained intervention and prevention programmes targeted at those young people most at risk. Priorities also include: • increasing access to young people’s contraceptive services which includes expansion and availability of the C Card Scheme, • continuation of the mobile IAG / sexual health service in wards with high and increasing rates of U18 conceptions and in rurally isolated areas, • working with teenage parents and their children to improve outcomes for both and ultimately reducing the number of second and subsequent pregnancies. • Developing the competences of the workforce by ensuring that frontline practitioners working with young people attend Foundation in Sexual Health training. • Developing a sound evidence base for targeted work / interventions – focus on local data collection and reporting. • Supporting schools to deliver high quality SRE. All of the above will have contributed to the fairly significant reduction in rates reported for Q1 2009 and without continued funding from 2011/12 there is a risk that these services will be reduced/cut which could ultimately lead to rates increasing again. It is essential that young people identified as being at increased risk of early sexual activity or teenage pregnancy have access to additional support and interventions so they can make informed choices and manage their own behaviours. A risk assessment approach needs to be developed to enable identification of vulnerable young people at risk of becoming teenage parents. Investment in School Nursing will mean that each secondary and short stay school will have a school nurse led weekly drop in offering contraception and sexual health information. Professionals working with young people around alcohol or substance misuse problems are aware of the associated contraception sexual health risks and are pro-active in supporting young people to access contraception and sexual health services including the C Card Scheme, Chlamydia Screening and referral to GU. It is well documented that young people do prefer to access designated young people clinics, e.g. Share & Brook which both offer services for young people aged 13-25. Young people can often mistrust all age services so it is important that they are supported to access these services. In Cornwall, all age health services are encouraged to show they are Young People friendly by working towards the EEFO level 3 / You’re Welcome Quality Standard. Currently there are 10 services within Cornwall that have achieved You’re Welcome accreditation, the total number for the SW is 11. Although overall the rate of Under 18 conceptions in Cornwall is lower than the national average, there are geographic variations where rates are twice the local and national averages, these areas are called hotspots. Local / timely under 18 conception data is vital to ensure that targeted prevention work in hotspots is implemented at the appropriate level and time. Areas within the county that have been identified as hotspots (rates of under 18 conceptions in excess of 60 per 1000) are prioritised within the Reducing Teenage Pregnancy Strategy to ensure that local areas have clear intelligence and resources are targeted to meet need. Cornwall Children’s Trust Needs Assessment 2010 4