Bump to bairn

The Tranent health and Well Being Group worked with the East Lothian Young people and Food Group to run an event for local parents at the Loch Centre in Tranent. Parents could find out about health topics such as weaning and oral health or other aspects of life such as financial issues or childcare from a range of local and East Lothian services.  We estimate that at least 30 parents came along and the event had a positive and lively atmosphere.  We will be asking stall holders for their views so we can judge if this is something we should do again.

Parents were asked to give us their views on how it feels being a parent or carer in Tranent.  I thought others might be interested to see what they said – see below:

What’s not so good about being a parent or carer in Tranent? 

 

  • Stigma if a young parent.
  • Early Daze- 2nd baby mums not always able to attend
  • You can’t get buggies on most of the buses.
  • ‘Policeman’s Close’ – need to go on the road with buggies.
  • Lack of support from Council-funding not being allocated to our worker to keep our young parents group going.
  • Some shops not accessible to parents with buggies.
  • Lack of funding for groups

 

 

What’s good about being a parent or carer in Tranent?

 

  • Able to go to local parent and toddler groups
  • Early Daze 0-6months group with Health Visitors- really good for mums mixing and to access advice.
  • Local support groups.
  • Good health visitors
  • Good mums
  • Good midwives.
  • Social life with other mums.
  • Information given from midwives and health visitors.
  • Everything on the ‘door- step’ for a parent i.e. shops, banks etc.
  • Early Daze – provides advice, and a social aspect allowing friendships to be forged.
  • Good groups and support networks.
  • Having the support of local workers

 

How easy is it to be a parent or carer in Tranent?

(Individuals were asked to indicate on a scale between 1 and 10)

 

  • 2 parents indicated 5
  • 1 parent indicated 7

 

What needs to change?

 

  • More childcare.
  • More jobs for mums
  • Better parks and cafes.
  • Less stigma
  • Fill the gap with a local playgroup.
  • More private nurseries.
  • Better parks
  • More jobs for mums.
  • Better facilities for all ages 0-15yrs
  • More jobs aimed at single parents
  • Funding continuum for groups.

 

 

What’s not so good about Tranent?

 

  • The high street pavements aren’t buggy friendly.
  • Dated facilitied
  • Doctors’ surgery too small for size of population in Tranent.
  • Lack of cafes and meeting places.
  • No cafes or restaurants for families.

 

 

What’s good about Tranent?

 

Friendly mums.

Good choice of school for the size of Tranent.

Anti-natal classes and follow-up visits.

Plenty of groups for parents and children to meet.

Good support for breast feeding.

Quite child friendly.

Can access most shops with pram.

If improvements to Polson Park go ahead will make a big difference.

Helpful information from

 

How child friendly is Tranent?

(Individuals were asked to indicate on a scale between 1 and 10)

 

  • 1 parent  indicated 6

 

 

 

What needs to change?

 

  • More child friendly shops.
  • Better transport from surrounding villages.
  • Too many ‘bookies’ and off licences.

 

 

Logic Modelling

In preparing for battle I have always found that plans are useless, but planning is indispensable.
–  Dwight D. Eisenhower

Having spent a good bit of time in the last few weeks working on logic modelsrelated to health outcomes I can agree with this sentiment. I have never been good at absorbing information that is presented in boxes.  For people like me at least the product of the logic modelling process is not very useful as a communication tool about the plan that it describes, particularly if I haven’t been involved in developing it.  However, the process of developing the logic model really does help with thinking through the linkages between Outcomes ( the impacts we want), the Outputs (the tasks we perform) and Inputs (what we invest) in a complex and dynamic environments such as health and well being.

Logic Modelling is never going to be a favourite task for me, but at least I can understand why it is necessary.

I am still an edubuzz novice and havent mastered the art of inserting images but hopefully clicking below will reveal a draft logic model for  Support from the Start

 equally-well-logic-model

Rationale For Support for the Start

brain-pic 

This picture was part of a presentation given by the Chief Medical officer Harry Burns at a conference on Equally Well. The pictures shows what happens to brain development in cases of extreme neglect. Neglect so extreme to cause such marked under development of a child’s brain is thankfully very rare but the picture does demonstrate that brain development is closely related to the environment a child finds itself in.
 
Dr Burns presentation described the determinants of early brain development with the following bullet points:- 
  • At birth, development shifts from genetic to environmental influences
  • There are 100 billion neurons but they are not part of functional networks
  • First few years are spent forming permanent neural networks -‘Neurons that fire together wire together’
  • Social interaction determines brain development

He went on to discuss attachment theory giving the following quote:

  “Infants develop the attachment behaviours that optimally enhance their survival in their own characteristic environments.”

Crittenden, 2000

 He described the development of attachment as ‘Serve & return’ meaning that the infant will respond to positive rewarding stimuli by developing an attachment which strengthens with each return. However, if the return is absent, negative or chaotic this will set up responses in the child that help it to cope with this environment but which will probably prove maladaptive in the longer term. He illustrated this with reference to a study called the Dunedin cohort which was 1000 children recruited in late 1972/3.  At age 3, “at risk” children were identified on the basis of chaotic circumstances, emotional behaviour, negativity and poor attentiveness

As adults, those “at risk” were more likely to : –

  • be unemployed
  • have criminal convictions (especially for violence)
  • been pregnant as a teenager
  • have a substance abuse problem
  • exhibit signs of insulin resistance and metabolic syndrome

The above means that the template for health can be set at a very young age, and though it is possible to change problems created by difficulties in the early years of life, a poor start can make it hard to catch up. This is the rationale for focusing on preventing health inequalities by focusing on the early years of life and support for parents. 

You can view the full presentation on the social circumstances of health at this link

Support from the Start

Scotland’s public health minister Shona Robinson chaired a ministerial taskforce to look at how Scotland can challenge the kind of inequality that leads to significantly different health outcomes for different parts of our community. The taskforce published a report called ‘Equally Well’ which amongst a number of recommendations called for the setting up of ‘test sites’ to lead on the learning that is needed to address the issue of health inequality. East Lothian has been selected as one of eight test sites in Scotland with a focus on early years and parenting. We have called the test site in East Lothian ‘Support from the Start’ to reflect the aim of ensuring that communities and services are doing all that is possible to address the health needs of the youngest members of our community in the areas where we know that health outcomes are poorest.

Support from the Start is not a short term project but rather a focus within all mainstream services on health inequality in the early years of life. Governance for the programme will be provided by a steering Board consisting of Councillor Roger Knox (Depute Provost & Health Spokesman); Councillor Ruth Currie (Cabinet Member for Joint Future & Community Care & Youth Champion); Sue Ross (Director of Community Services & Chair of Joint Health Improvement Project Board); Don Ledingham (Acting Director of Education & Children’s Services & Chair of Children’s Services Chief Officers Group); Gerry Power (General Manager East Lothian Community Health Partnership)  This group will provide strategic leadership and ensure that all relevant planning groups are involved in developing Support from the Start.

Four broad outcome areas for mainstream services in relation to health inequality have been identified:-

  • Community Engagement with key health issues in the early years,
  • Improving Support for Parents & Carers,
  • Improving Support for Families,
  • Creating Child Friendly Environments

We know that there is already lots of good practise in these areas but ‘Support from the Start’ will be asking service providers to review what they are are already doing with the following questions in mind : –

  • How do we get our communities, parents and children involved in key health improvement challenges for the early years of life? e.g. increasing the number of breastfeeding mothers, reducing passive smoking in the home environment, increasing physical activity levels of children in the early years, improving diet and dental hygiene
  • Do East Lothian services make it easy for parents to be ‘good enough’, and can parents access the right support, early enough when they are finding it hard to cope?
  • How do we target support for children and families that are at risk of poor health, and is it effective?
  • Does the physical space of our communities contribute to creating good health in the early years and support parents in raising healthy children safely

 Key to ensuring success in this endeavour will be engagement, leadership and learning. A process has started to identify individuals from across a range of services who can act as ‘champions’ for ‘Support from the Start’. These champions will be tasked with creating a learning environment in their service areas on the issues of health and social justice related to tackling health inequality in the early years. The champions will be contributors to this blog.

My hope for this web log is that it will be a space in which discussion and reflection on the complex task of reducing health inequalities in East Lothian can be supported and encouraged.

All views and opinions welcome.

Steven Wray

Health Improvement Development Officer