Halifax 2004
Canada’s 2004
National Parks and Recreation
Conference and Trade Show
“Proving Recreation Keeps Kids
Off Streets, and Social Costs Down”
Gina Browne, PhD, RegN
When the Bough Breaks
Proactive and Comprehensive
Versus
Self-Directed Services
for
Sole-Support Parents on Social Assistance
is 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 Services
Michael Schuster, Commissioner, Social Services
Jane Underwood, Director, Public Health
Sheila Flynn-Kingston, Director, Public Health
Kathy Rennick, Family Benefits
Scott Haldane, CEO, YMCA
Ida Thomas, General Manager, YMCA
Collaborative Project
“Together for Kids”
University
Clinical
Epidemiology
School of
Nursing
Centre for Health Economics
& Policy Analysis
System-Linked
Research Unit School of Social Work
Community
YMCA Hamilton/Burlington
Commissioners
of Social Services
Hamilton/Halton
Funded by:
1994 - 1999
21 other youth
•Health Canada-Children’s Mental Health Div. serving organizations
•Hamilton Community Foundation
•National Health Research and Development Program
WHEN THE BOUGH BREAKS
SERVICES
Proactive and Comprehensive Versus Self Directed
Services for
• SOLE-SUPPORT PARENTS ON SOCIAL
ASSISTANCE
IS MORE EFFECTIVE AND LESS EXPENSIVE
PROBLEMS:
Many Programs
Work 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
Public
Health
Employment
Retraining
Subsidized
Child
Care/Recreation
Self-Directed
Care
Primary Outcomes
Effects
Parental MOOD
Parental ADJUSTMENT
Childhood BEHAVIOR
Expense
Utilization
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
Engagement Rates by Group
Group I
Time 1
N = 151
Employment Retraining
100%
80%
100%
% of Group (households)
% of Group (households)
Public Health*
66.2%
60%
40%
**
20%
0%
80%
60%
40%
35.1%
20%
0%
Children’s Services***
% of Group
(Households)
100%
80%
78.8%
60%
40%
20%
0%
* 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
Engagement Rates by Group
Group II
N = 153
Group V
Group III
Group IV
N = 155
N = 153
N = 153
Public Health*
% of Group (households)
100%
80%
79.7%
60%
40%
20%
**
Employment Retraining**
0%
% of Group (households)
100%
80%
60%
40%
38.4%
20%
Children’s Services***
100%
0%
% of Group
(Households)
80%
73.8%
60%
40%
20%
0%
* 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
c:\data\gwamain\benfg3&4.ppt
The Reduction in Proportion of Parents
With a Mood (Depressive) Disorder
Receiving Five Approaches to Service
60%
50%
52.00%
48.90%
49.40%
43.30%
42.00%
40%
30%
20%
18.20%
21.00%
20.30%
17.60%
18.30%
10%
0%
Full
Intervention
PHN
Employment Recreation
Retraining
Services
Time 1
Time 3
Self
Directed
Per Person Annual Expenditures for
Health and Social Services Utilization
$3,000.00
$2,473.71
$2,275.37
$1,904.80
$1,771.09
$1,140.05
$1,270.95
$1,256.31
$2,049.13
$1,247.33
$914.35
$0.00
Full
Intervention
PHN
Time 1
Employ- Recreation
Self
Retraining Services Directed
Time 3
Percent of Single Parents Exit from
Social Assistance Within One Year
30
25 %
22 %
20%
20 %
%
10 %
0
Full
Intervention
PHN
EmployRetraining
Recreation Self-Directed
Services
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)
COST
LESS:
3900
3809
3800
3700
SAVES
MORE:
400
400
300
3600
3500
Reduction in Social Assistance Costs Per
100 Families: Subsidized Recreation vs.
Non-Subsidized
200
200
3389
3400
100
3300
3200
0
3100
1
2
Total Includes Health, Correctional
Recreational and Special
Educational Services
1
1=Subsidy
2
2=No Subsidy
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: Public
Private
Voluntary
Foci
.. Health
Savings
.. Social
Savings
.. Education
.. Recreation
.. Corrections
Re-Investments
Savings
Seniors
Adults
Children
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