Halifax 2004Canada’s 2004

National Parks and RecreationConference and Trade Show

“Proving Recreation Keeps KidsOff Streets, and Social Costs Down”

Gina Browne, PhD, RegN

When the Bough Breaks

Proactive and ComprehensiveVersus

Self-Directed Servicesfor

Sole-Support Parents on Social Assistanceis More Effective

and Less Expensive

Gina Browne, Ph.D., Reg.N.Carolyn Byrne, Ph.D.(C), Reg.N.

Jacqueline Roberts, M.Sc., Reg.N.Amiram Gafni, Ph.D. (Econ.)Susan Watt, D.S.W., C.S.W.

in Collaboration with

Bonnie Ewart, Commissioner, Social ServicesMichael Schuster, Commissioner, Social Services

Jane Underwood, Director, Public HealthSheila Flynn-Kingston, Director, Public Health

Kathy Rennick, Family BenefitsScott Haldane, CEO, YMCA

Ida Thomas, General Manager, YMCA

21 other youth serving organizations

Collaborative Project“Together for Kids”

University

Community

Centre for Health Economics& Policy Analysis

School ofNursingClinical

Epidemiology

Commissionersof Social ServicesHamilton/Halton

School of Social WorkSystem-LinkedResearch Unit

YMCA Hamilton/Burlington

Funded by:1994 - 1999•Health Canada-Children’s Mental Health Div.•Hamilton Community Foundation•National Health Research and Development Program

WHEN THE BOUGH BREAKS

SERVICESProactive and Comprehensive Versus Self Directed

Services for

• SOLE-SUPPORT PARENTS ON SOCIAL ASSISTANCE

IS MORE EFFECTIVE AND LESS EXPENSIVE

PROBLEMS:

Many ProgramsWork with the CHILDREN and by pass the MOTHER

-School Lunch Programs

-Early Child Development Program

Or Work with the MOTHER and by pass the CHILDREN-Ontario works

Assume one approach will meet the varied needs of CHILDREN and MOTHERS

EFFECTIVE TREATMENT

Employment retraining (MCSS)

In-home visits by Public Health Nurses (Olds)

Quality Child Care/Recreation (Doherty; Reid, Trembley)

Supplemental Income

Pharmacotherapy and Counselling (Reizer)

765 sole-support parents and 1330 children (45% of those eligible)

R

Comprehensive•Public Health

•Employment Retraining

•Subsidized Child Care/Recreation

Self-Directed Care

Public Health

Employment Retraining

Subsidized Child

Care/Recreation

Primary OutcomesEffects Parental MOOD

Parental ADJUSTMENT

Childhood BEHAVIOR

UtilizationExpense

50% Of Welfare clients are sole support parents

45% Of sole support parents are depressed

60.4% Of your clients have 2 or more mental health problems

33.3% Of client’s children have behavior disorders

29.3% Live with pain which limits activities

38.8% Have 2 or 3 health problems

61.0% Have children over 7 years

78.8%

0%

20%

40%

60%

80%

100%

35.1%

0%

20%

40%

60%

80%

100%66.2%

0%

20%

40%

60%

80%

100%

Time 1

Engagement Rates by Group Group I N = 151

% o

f Gro

up (h

ouse

hold

s)

Public Health*Employment Retraining

% o

f Gro

up (h

ouse

hold

s)

Children’s Services***

% o

f Gro

up

(Hou

seho

lds)

**

* Engaged = at least one (1) home or office visit or telephone > 10 min ** Engaged = at least one (1) home or office visit or telephone > 10 min***Engaged = at least one (1) child in at least one (1) program (recreation, daycare,

etc.) / per family

73.8%

0%

20%

40%

60%

80%

100%

38.4%

0%

20%

40%

60%

80%

100%

79.7%

0%

20%

40%

60%

80%

100%

Engagement Rates by Group

Group II Group III N = 155N = 153

% o

f Gro

up (h

ouse

hold

s)

Public Health*

Employment Retraining**

Children’s Services***

Group IVN = 153

% o

f Gro

up (h

ouse

hold

s)

% o

f Gro

up(H

ouse

hold

s)

**

* Engaged = at least one (1) home or office visit or telephone > 10 min ** Engaged = at least one (1) home or office visit or telephone > 10 min***Engaged = at least one (1) child in at least one (1) program (recreation, daycare,

etc.) / per family

Group VN = 153

c:\data\gwamain\benfg3&4.ppt

The Reduction in Proportion of Parents With a Mood (Depressive) Disorder

Receiving Five Approaches to Service

48.90%

42.00%

52.00% 49.40%43.30%

18.30%17.60%20.30%21.00%18.20%

0%

10%

20%

30%

40%

50%

60%

FullIntervention

PHN EmploymentRetraining

RecreationServices

SelfDirected

Time 1 Time 3

Per Person Annual Expenditures for Health and Social Services

Utilization

$1,771.09

$2,275.37$2,473.71

$1,904.80$2,049.13

$1,140.05$1,270.95 $1,256.31

$914.35

$1,247.33

$0.00

$3,000.00

Full Intervention

PHN Employ-Retraining

Recreation Services

Self Directed

Time 1 Time 3

Percent of Single Parents Exit from Social Assistance Within One Year

2522

20 20

10

0

30

%

Full Intervention

PHN Employ-Retraining

Recreation Services

Self-Directed Care

%% % %

%

Comparison of Total Cost Per Family on Social Services: Those Receiving Proactive Subsidized Recreation (1) vs. Those in Self Directed and Self Financed Programs (2)

310032003300340035003600370038003900COST

LESS:

Total Includes Health, Correctional Recreational and Special

Educational Services

Reduction in Social Assistance Costs Per 100 Families: Subsidized Recreation vs. Non-Subsidized

0

100

200

300

400SAVES MORE:

1=Subsidy 2=No Subsidy

1 2 1 2

3389

3809 400

200

RECREATION/CHILD CARE PAYS FOR IT SELF BY REDUCTIONS:

•½ THE USE OF SPECIALISTS

•½ USE OF C.A.S SERVICES

•¼ USE OF OCCUPATIONAL THERAPIST

•1/3 USE OF PHYSIOTHERAPISTS

•½ USE OF PSYCHOLOGIST

•1/10 USE OF SOCIAL WORKERS

•1/10 USE OF PROBATION OFFICERS

•½ USE OF CHIROPRACTORS

•½ USE OF 911 SERVICES

BENEFITS FOR RECREATION FOR CHILDREN

INCREASE IN ACADEMIC, SOCIAL AND INTERPERSONAL COMPETENCE FOR CHILDREN

WITH A DISORDER

BENEFITS OF RECREATION FOR PARENTS DECREASE IN NERVOUSNESS, ANXIETY, SLEEP

PROBLEMS AND USE OF FOOD BANKS

LESSONS:

Raising Children is a Community Responsibility

Reaching out is better than waiting to be asked

Support Services work best when they:

- comprehensive (health and social)

- work together

-tailored/customized

Poor is Poor, Welfare and Working Poor

FINDINGS REFUTE THE NOTION THAT

•Helping Perpetuates Dependence

•That Single Parents are “Unemployable”

•Cutting Public Health/Recreation Saves the System Money

•That Employment Retraining is All That is Needed

INVESTMENTS IN COMPREHENSIVE

PROGRAMMING FOR FAMILIES WITH CHILDREN

ON WELFARE: SERVICES FOR SINGLE PARENT

MOTHERS AND CHILDREN ON WELFARE PAYS

FOR ITSELF WITHIN ONE YEAR

Intersectoral Services

Financing:

Foci

Children

Adults

Seniors

Savings

Public Private Voluntary

Savings

SavingsRe-Investments

.. Health

.. Social

.. Education

.. Recreation

.. Corrections

on Health and Social Service

Utilization

For further information, contact:Dr. Gina Browne at browneg@mcmaster.ca

And visit our website at:http://www.fhs.mcmaster.ca/slru

Or call us at: (905)-525-9140 ext. 22293