child-healthLack of strategic national focus and persistence of a wide gap between rich and poor in the UK is damaging the health of the nation’s infants, children and young people, according to a ground-breaking report from the Royal College of Paediatrics and Child Health (RCPCH).

Launching today, The State of Child Health brings together data for the first time on a comprehensive list of 25 measures of the health of UK children, ranging from specific conditions such as asthma, diabetes and epilepsy, risk factors for poor health such as obesity and a low rate of breastfeeding, to child deaths. The data provide an “across the board” snapshot of child health and wellbeing in the UK.

Nearly one in five children in the UK is living in poverty and inequality is blighting their lives, with those from the most deprived backgrounds experiencing much worse health compared with the most affluent. Despite some improvements in the health of UK children over the last decades, there is clear disparity with Europe, and major cause for concern.

Child deaths
  • The UK ranks 15 out of 19 Western European countries on infant (under one year of age) mortality and has one of the highest rates for children and young people in Western Europe.
  • There is a strong association between deprivation and mortality, for example infant mortality is more than twice as high in the lowest compared with the highest socio-economic groups.
Smoking in pregnancy
  • The prevalence of smoking during pregnancy in the UK is higher than in many European countries (for example 5% in Lithuania and Sweden, compared with 19% in Scotland, 16% in Wales and 15% in Northern Ireland).
  • Smoking in pregnancy increases the likelihood of death, disability, and disease (for example stillbirth, cot death and the risk of respiratory disease across the life-course).
  • There is marked variation in smoking in pregnancy across the UK with a strong association with deprivation; for example in Scotland over a quarter (25.9%) of women in the most deprived areas acknowledged smoking following the birth of their baby, compared with 3.3% in the least deprived areas.
  • Breastfeeding in England and Scotland has shown minimal improvement since data recording commenced in 1975, with no improvement over the last five years, and remains lower than many other comparable high-income countries.
  • At 6 months, only 34% of babies in the UK are wholly or partially breastfed, compared to 71% in Norway
  • Breastfeeding has substantial health benefits for mothers and babies.
  • Across the UK, 46% of mothers in the most deprived areas breastfed compared with 65% in the most affluent areas.
  • Across England, Scotland and Wales more than one in five children in the first year of primary school are overweight or obese.
  • There has been minimal improvement in the prevalence of child overweight and obesity over the past decade.
  • Obesity leads to substantially increased risk of serious life-long health problems, including type 2 diabetes, heart disease, and cancer.
  • In 2015/2016, 40% of children in England’s most deprived areas were overweight or obese, compared to 27% in the most affluent areas.
  • The percentage of 15-year-old children smoking regularly is 6% in England and 8% in Wales and Scotland.
  • Smoking continues to be the greatest single cause of avoidable mortality in the UK.
  • Starting to smoke during adolescence increases the likelihood of being a life-long smoker.
  • The prevalence of child smoking is much higher amongst children from the most deprived areas; for example in Scotland’s most deprived areas, at least 1 in 10 young people are regular smokers.
  • In 2013/2014, 13% of 15-year-olds surveyed in Wales, 11% in England and 13.5% in Scotland reported drinking alcohol at least once a week.
  • Alcohol abuse continues to be a problem across the social spectrum.

Professor Neena Modi, President of the RCPCH said: “The health of infants, children and young people in the UK has improved considerably over the last 30 years. Many will lead happy and healthy lives. But seven years after the Marmot Review, “Fair Society, Healthy Lives”, it is tragic that the future health and happiness of a significant and growing number is in jeopardy because of an alarming gap between rich and poor.

“Children living in the most deprived areas are much more likely to be in poor health, be overweight or obese, suffer from asthma, have poorly managed diabetes, experience mental health problems, and die early. Poor health in infancy, childhood, and young adult life will ultimately mean poor adult health, and this in turn will mean a blighted life and poor economic productivity. The UK is one of the richest countries in the world; we can and must do better, for the sake for each individual, and that of the nation as a whole.”

Compiled by child health experts, with input from children and young people themselves, the report provides clear recommendations to improve child health. These include calling for:

  • Each UK Government to develop a child health and wellbeing strategy, coordinated, implemented and evaluated across the nation
  • Each UK Government to adopt a ‘child health in all policies’ approach
  • UK Government to introduce a ban on the advertising of foods high in saturated fat, sugar and salt in all broadcast media before 9pm
  • Each UK Government to develop cross-departmental support for breastfeeding; this should include a national public health campaign and a sector wide approach that includes employers, to support women to breastfeed
  • An expansion of national programmes to measure the height and weight of infants and children after birth, before school and during adolescence
  • A reversal of public health cuts in England, which are disproportionately affecting children’s services
  • The introduction of minimum unit alcohol pricing in England, Wales, and Northern Ireland, in keeping with actions by the Scottish Government
  • UK Government to extend the ban on smoking in public places to schools, playgrounds and hospitals
  • UK Government to prohibit the marketing of electronic cigarettes to children and young people
  • National public health campaigns that promote good nutrition and exercise before, during and after pregnancy

Professor Russell Viner, RCPCH Officer for Health Promotion said:

“We are calling on each Government across the UK to adopt a ‘child health in all policies approach’. That means that whatever policies are made, from whatever Government department, they must consider the impact on child health.

“If politicians are serious about improving our nation’s health, then they have to think long term. And that means investing in children. It has to be our ambition for the health of the UK’s children to be amongst the best in the world; anything less and we are failing current and future generations.”

The State of Child Health also highlights the importance of national oversight and responsibility for recording high quality data to inform metrics of child health and wellbeing, noting significant variation across the UK in the availability of information on the prevalence of many conditions such as mental health, obesity and disability. Without a clear measure of the scale of the problems, services cannot be targeted effectively. The report makes clear that more investment in child health research is needed to redress chronic under-resourcing.

The report will be a springboard for RCPCH campaigning activity to ensure child health is a key political priority.