Best practice examples on prevention of polydrug use among young people in the CJS:

189 interviews with young people in 6 European countries were conducted to learn about drug use trajectories and factors of onset, persistence and desistance. This information was used to identify key points for intervention and to obtain perceptions and experiences of interventions to prevent or reduce drug use:

• Early drug consumption is rooted in a combination of social milieu, opportunity and sheer curiosity and inquisitiveness.
• Young people in the criminal justice system (CJS) show multiple problems, including needs in physical and mental health, criminal activity, broken family relationships, educational problems, and social deprivation. Prevention responses shall look beyond drug use or criminal activity and include personality traits, and social circumstances of clients.
• Specific challenges arise in interventions delivered in custody: Uncertainty of length of stay (remand prison); short sentences impinge on the effectiveness of interventions; reluctance to admit drug use in prison settings; motivation of young people to participate in trainings; transition from youth to adult services at age 18.
• Funding: Many interventions for drug prevention in Europe are funded on a short-term basis (1-4 years). Outside the prison system, projects often lack sustainability and face inadequate resource allocation.

Read more about the project and see the project page.

More findings

The findings of comparative analysis based on the results of the nine country reports (namely: Austria, Belgium, Croatia, Germany, Italy, Romania, Slovakia, Slovenia, and Spain) indicate that the temporary, mobile and transnational character of posting affects the health and safety of posted workers in multiple ways and involves several different aspects:

• economic vulnerability and dependence on the employers make workers comply to poorer working and living conditions;
• cases of injury reveal various irregularities to posted workers' health insurance and care;
• while each country has complex systems of OSH providing for both prevention and protection of workers, posted workers do not necessarily take advantage of the existing mechanisms.

This is partly due to their lack of knowledge on host countries OSH structures and mechanisms, and partly because of their hesitation to go to the authorities, but it is also partly because of the inadequate response of enforcement organizations. Furthermore, lack of or limited access to collective representation lowers workers' level of protection and language barriers limit their access to information which has a wide range of implications – from exercising their employment rights, including health and safety rights, to accessing healthcare and housing and managing their daily lives. Aware of the challenges, stakeholders demand more coordinated and cohesive action. More

Notes: Full dots indicate language barriers identified by informants as a problem for workers posted to the respective countries, while empty dots highlight specific aspects of language barriers. In the case of Romania, the information relates to language barriers for workers posted from Romania working in international road transport.

Posting is an important form of transnational temporary labour mobility for Austria. With a total of 108,627 of PDs A1 issued in 2015 for posted workers coming to Austria, the country ranked 4th in the EU after Germany, France and Belgium. The temporary migration and employment status affect the situation of EU and TCN workers posted to Austria in multiple way.

• Firstly, employers pay less attention in terms of OSH training towards them;
• secondly, their temporary status marks them as workers who are easier to exploit and pressure to accept unsatisfactory working/OSH conditions;
• thirdly, it also influences posted workers’ behavior in so far as due to their short-termed stay, they tend not to inform themselves sufficiently about their rights and the regulations in Austria.
• The last point is caused by a lack of integration and a feeling of not belonging of posted workers themselves into the Austrian system, which again are caused by the temporariness of their stay.

National competent authorities and agencies in Austria have made great attempts early on after the transposition of the Posting of Workers Directive (96/71/EC) to protect posted workers from increased OSH-related risks. Yet, data from our research suggest that vulnerabilities still persist. Read more

The results of the NORDCARE survey show manifold insights into the working situation of the long-term care workforce in Austria. Overall, long-term care workers, particularly in the residential care sector, have experienced a deterioration of working conditions over the last years. On the one hand this can be related to the increasing demands and needs of people in need of care, on the other hand time limitations and staff shortages add to such experiences. Long-term care workers are therefore confronted with numerous burdens and demands at the workplace. While the application of individual coping strategies partly helps to deal with such burdens, high levels of psychological and physical constraints nevertheless result in a subjectively perceived bad health status. Despite organizational characteristics it is thus the health status that significantly impacts on the future considerations of the workforce to continue working in the sector. In order to secure sustainable human resources for the long-term care sector, prevention and health promotion measures as well as developments in work organization such as autonomous and person-centered forms of work are key factors in improving working conditions. More...

Source: WHO/Europe (2018) The health and well-being of men in the WHO European Region: better health through a gender approach, based on data from SHARE (wave 6)

Caregiving has traditionally been associated with feminine values, but recent data point to a gender role inversion in later life. It is well established that men are less likely to engage in unpaid work and provide filial care or care to older family members during adulthood, when a large proportion of men are engaged in remunerated work activities. Even once they reach older age, a lower proportion of men, with respect to women engage in care provision in virtually all European countries. However, while the proportion of men carers decreases with age in later life, it does so slower than is the case for women, leading to a situation where a greater share of men in the oldest age groups act as informal carers than women. Informal care provided by older men is generally concentrated on care for their spouses and takes place within the household. The higher prevalence of carers among older men is closely linked with differences in living arrangements, which are in turn closely related and sensitive to changes in, the health, marital and socioeconomic status of the older population. More...

Source: Own illustration based on the latest Census data (2011) and interviews with municipal staff conducted in 2017

A specific budget line for social services from the Ministry to the municipal government does not exist yet, which has led to inadequate staffing, facilities and service provision. Other sources of income from private or nongovernmental donors have been fluctuating. The formerly centrally governed Centres of Social Work have not been fully incorporated into the municipal structures.

Inadequate funding is further aggravated by its uneven distribution across municipalities. As shown in the graph, the ratio between social services staff and the population is markedly different among municipalities of similar size. While larger municipalities tend to employ fewer social services staff per population, some larger municipalities such as Ferizaj/Uroševac not only manage a better ratio, but also cooperate with NGOs in providing social services.

For 2019, a specific budget line for social services is planned. Detailed account of decentralizing social services delivery in Kosovo can be found in the original Situation analysis prepared by the European Centre and Save the Children Kosovo and a policy brief by Rahel Kahlert and Sonila Danaj. More...

Source: Own illustration based on data from European Central Bank Statistics, OECD National Accounts Statistics and Eurostat Database, EU-SILC.

Housing affordability has become a central issue in recent years as some population groups find themselves priced out of the housing market in some European countries or cities. Although the financial crisis depressed housing prices, these have in the meantime recovered in most countries. Disposable income however, particularly among lower income households, has yet to increase significantly, with housing costs representing nowadays a significant financial burden on low income families. The share of households "overburdened" by housing costs (i.e. the latter represent more than 40% of disposable income) ranges from between 33%-34% in Hungary and Italy, to 42-43% in the UK and the Netherlands. Countries have implemented housing allowances to alleviate this problem, and although these allowances overwhelming target the poor, their poverty reducing impact is somewhat limited. Detailed account of why this is the case, further results and policy implications can be found in the original research note and in a policy brief by Eszter Zólyomi and Katarina Hollan.

The use of both formal (home-based care services) and informal care across Europe is unequally distributed among income groups, with poorer individuals using significantly more long-term care. In the case of home-based care, differences in utilization basically reflect differences in needs: less affluent older people have, on average, poorer health. Only in Denmark and Estonia (both pro-poor) and Italy and Spain (both pro-rich) is the distribution of home care use inequitably distributed across income groups. For informal care, however, there is strong evidence (9 out of the 15 countries considered) that poorer older people disproportionately use this type of care even after accounting for different needs. This may suggest financial barriers in accessing home care services. Detailed results and a discussion of policy implications can be found in the original research articles by Ricardo Rodrigues and Stefania Ilinca (and Andrea E. Schmidt) in EuroHealth, the International Journal of Environmental Research and Public Health and Health Economics.

The framework outlines what the fulfilment of universal human rights necessitates when applied to the case of older people with care and support needs and is organised according to three key domains:

1. Desired outcomes: fulfilment of rights;
2. Enabling processes: monitoring and enforcement; and
3. Structural conditions: legal recognition.

These correspond with three areas across which the implementation of fundamental rights can be measured: results (outcome indicators); effort (process indicators); and commitment (structural indicators). The framework was developed as part of the ongoing project, 'From disability rights towards a rights-based approach to long-term care in Europe: Building an index of rights-based policies for older people'. More...

Our framework attempts to capture the complexities and interdependencies inherent to the organization of community-based dementia care along the disease trajectory, recognizing the roles played by the various actors involved. Furthermore, we include the socio-cultural, economic, and legal and governance context of community care for people with dementia in our framework.

While we do not develop each of these dimensions in depth, we emphasize instead how each interacts with and affects the organization and quality of community-based care by linking them with 5 core tensions, or ‘Tension Points’ within the system. More...