Postcode Poverty and Brexit Concerns 'Threaten Child Health'

Peter Russell

January 23, 2019

Child poverty, cuts to public health services, and uncertainties about Brexit, threaten to undermine a "hugely welcome shift" towards UK-wide improvements in children's health, experts said.

A progress report by The Royal College of Paediatrics and Child Health (RCPCH) commended the Government's long-term NHS plan for prioritising children's health.

However, in a detailed analysis across the four nations, the ongoing political deadlock in Northern Ireland was impacting on child health, and England was shown to lag behind other western countries on a range of outcomes.

Scotland and Wales were commended for progress in a number of areas.

Overall Improvements in Child Health

The State of Child health: Two Years On scorecard charted progress against a series of recommendations made in the RCPCH's 2017 State of Child Health report.

Key overall findings were that children's health in the UK as a whole continued to show improvements but that progress had fallen behind comparable wealthy countries. Also, children from deprived backgrounds had much worse health and wellbeing than those from the wealthiest backgrounds, with some of the outcomes in deprived groups amongst the worst in the developed world.

England

The scorecard identified a number of areas in need of improvement in England, including:

  • Reducing child poverty and inequality

  • Addressing stalling infant mortality reductions

  • Extending smoking bans, and the introduction of a minimum unit price for alcohol in line with Wales and Scotland

  • Improving breastfeeding rates

However, the progress report applauded England for establishing a mental health prevalence study for young people, rolling out mental health education in schools, and proposals to tackle irresponsible advertising and promotions of unhealthy food and drink.

Northern Ireland

Despite some progress in Northern Ireland in road safety, breastfeeding, and home safety, the situation remained "stark" for children, the RCPCH said.

Obesity problems and mental health were "slipping into deeper levels of crisis", according to the report, which called for all political parties to "put children's health before politics and put child health at the top of the agenda before it is too late".
 

Scotland

The report commended Scotland for making good progress towards improvements in child health.

It said good work undertaken during last year's 'Year of the Young Person' had addressed three of the major barriers to good child health identified as cause for concern in 2017: child poverty, obesity, and mental health.

However, it cautioned that policies needed to be translated into actual improvements.
 

Wales

A "promising obesity strategy" for Wales was welcomed by the RCPCH, which also approved of recent bans on smoking in public places being extended to school grounds, playgrounds and NHS grounds.

There was also approval for a decision by the Welsh Government to accept recommendations to increase breastfeeding rates.

There was approval, too, for minimum unit pricing of alcohol expected in the spring.

"It is clear that child health is high on Welsh Government’s agenda", the RCPCH said.

Poverty and Inequality

Commenting on the report, Prof Russell Viner, RCPCH president, said: "Child poverty and inequality could undo much of the progress we are seeing.

"Deprivation is a major contributing factor to poor child health outcomes, and can lead to higher rates of poor mental health, increased alcohol or substance misuse, obesity, and death.  Babies from the most deprived families are also more likely to be born premature or a low weight which makes them more susceptible to illness.
 
"The gap between rich and poor continues to widen so without inequalities being addressed, England has little chance of catching up with its European neighbours.

"Cuts to public health budgets are a substantial threat to the good progress the government is making. Without health visitors for example, many families miss out on vital stop smoking and mental health support as well as advice around child development and feeding. 

"Increased investment in public health is essential to ensure a healthier future for all children in England."
 

Reaction to the Report

Responding to the launch of the scorecard, Dr Peter English, public health medicine chair at the British Medical Association (BMA), said: "While some welcome commitments aimed at improving healthcare services for children and young people have been made recently, the BMA remains concerned by the startling lack of progress on child poverty and inequality.

"It is unacceptable that most studies show that the future health and wellbeing of children born in England still remains dependent on their social position.

"We are also disappointed that the recent NHS long-term plan failed to allocate substantial additional funding specifically to public health services at a time when we need more resources focused on this vital part of the NHS."

Scotland's Public Health Minister, Joe FitzPatrick, commented: "We welcome the recognition from the Royal College of Paediatrics and Child Health that we are making good progress across a wide range of measures. 
 
"The Year of Young People 2018 was about giving young people a stronger voice and we’ve seen real progress in tackling the different inequalities that can put up barriers for too many young people. 

"We are looking seriously at how we address obesity, not just among children, but are also absolutely clear that to improve people’s health, we also need to care for mental health and look at the impact of poverty."

A spokesperson for the Department of Health and Social Care said: "As this report makes clear, the mental and physical health of our children and young people is a key priority for this government.

"That’s why the NHS long-term plan has committed to prioritising prevention so children can live well in their communities, increasing funding to give 345,000 more children and young people access to NHS-funded mental health services, as well as earlier detection and cutting-edge treatments for major illnesses, including genomic tests for every child with cancer."
 

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