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 [email protected]
And visit our website at:http://www.fhs.mcmaster.ca/slru
Or call us at: (905)-525-9140 ext. 22293