Postcode lottery of child health and development

A new report reveals that a child's health and development can be determined by where he/she is born.
A new report reveals that a child's health and development can be determined by where he/she is born.

A child living in the North East is far more likely to suffer from obesity, accidental injury and poor educational development than those in other regions, according to a report published today.

The analysis by the National Children’s Bureau looks at important indicators of health and development in early childhood and reveals startling variations, with a five-year-old in Middlesbrough more than twice as likely to have tooth decay and nearly 25 per cent more likely to have been hospitalised due to injury as one in Hartlepool, just 16 miles down the road.

At a regional level, if under fives in the North East enjoyed the same health and development as those in the South East, almost 2,500 more Reception-class children would be reaching a good level of development.

While the North East has average levels of tooth decay among five-year olds (25 per cent), on the other measures of children’s health and development studied, it has the worst outcomes of any region for admissions to hospital due to injury (199 per 10,000 under fives) and fewer young children reaching a good level of development (55 per cent).

It also has high levels of obesity in young children (10.4 per cent). In the North East, one in every ten children starting schools is obese – amounting to over 3,000 children.

The report confirms that the health and development of children under five is closely linked to the affluence of the area they grow up in, with those living in deprived areas far more likely to suffer poor health.

Comparing the 30 most deprived local authorities in England with the 30 best-off, the report finds that children under five in poor areas are significantly more prone to obesity, tooth decay, accidental injuries and lower educational development. While only 18.4 per cent of children living in the 30 richest areas suffer from tooth decay, this rises substantially to 31.6 per cent of four to five-year-olds in the 30 most deprived areas.

However, the data shows that poor early health is not inevitable for children growing up in deprived areas. Several areas with high levels of deprivation buck the trend and achieve better than expected results, suggesting that more work is needed to understand how local strategies and programmes can make a difference.

Poor Beginnings is published as responsibility for public health services aimed at under fives, including health visitors and family nurse partnerships, is transferred from central government to local authorities in October.

Anna Feuchtwang, chief executive of the National Children’s Bureau, said: “It is shocking that two children growing up in neighbouring areas can expect such a wildly different quality of health. As these variations are closely linked to poverty, with those in areas with the highest levels of deprivation more likely to suffer from a range of health issues, we have to ask whether England is becoming a nation of two halves?

“The link between poverty and poor health is not inevitable. Work is urgently needed to understand how local health services can lessen the impact of living in a deprived area. We need local and national government to make the same efforts to narrow the gap in health outcomes across the country for under fives as has been made to narrow the gap in achievement between poor and rich pupils in school. Government must make it a national mission over the next five years to ensure that the heath and development of the first five years of a child’s life is improved.”

Cheryll Adams, chief executive of the Institute of Health Visitors, said: “Trends in inequalities in health can be complex as this report suggests, with poverty not always being associated with poor health outcomes. Local health professionals, such as health visitors, understand the social determinants off health in communities, and how these may most effectively be addressed upstream with the right local policies and interventions.

“Although the greatest need is often concentrated in many poor communities, the majority of need, whilst less concentrated, is in fact in the rest of the population which is so much larger in number. Health services must continue to be commissioned to recognise risk and intervene early in the life cycle, in pregnancy and the very early years, as this can have the greatest impact on improving health and development.”

The report calls on the Government to set out a renewed strategy to improve the health and development of children and families in the early years and further investigate the variations uncovered in the report and how they relate to local health initiatives.

Poor Beginnings: health inequalities among young children across England is available from