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Health services must tackle ‘shocking’ child health ‘postcode lottery’

The National Children’s Bureau (NCB) is urging ministers and local health services to narrow the gap in public child health and renew strategies to tackle the issue after revealing a “shocking postcode lottery” in early development.

Its research has found “startling variations” in child health nationwide, with “huge gaps” in terms of obesity, tooth decay, injury and early childhood development across the country – including across areas with similar levels of deprivation.

It showed, for example, that a five-year-old in Leicester is five times more likely to have tooth decay than one in West Sussex.

The report claimed that if young children in the north west had the same health as those in the south east, over 15,000 cases of child ill-health could be prevented.

Anna Feuchtwang, chief executive of NCB, 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 schools. Government must make it a national mission over the next five years to ensure that the health and development of the first five years of a child’s life is improved.”

The report emphasised that the link between poverty and health is not innate as there were a number of deprived local authorities where young children are doing “as well as, or better than, the national average”.

However children growing up in more deprived areas are more likely, in early childhood, to be obese, suffer from tooth decay or suffer injury.

But there was also variation amongst the most deprived areas themselves: in 2013-14 there were 100 cases (per 10,000) of a child under five being admitted to hospital due to an injury in Haringey, compared to 241 in Middlesbrough – despite both having “the same level of deprivation”.

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 of 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 comes ahead of a shift in responsibilities for young children’s public health services to local authorities from October.


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