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UK lagging behind peers on child health

UK stalling after many years’ progress on several key indicators including mortality and immunisation

Louise Prime

Thursday, 15 March 2018

The UK is, after many years’ progress, now stalling on several key indicators of child health including infant mortality and immunisation levels, according to the first ever international analysis1 investigating child health measures over time. It also revealed that the UK is lagging behind most other high-income countries in terms of mortality, breastfeeding and obesity rates.

The analysis, published jointly this morning by the Nuffield Trust and the Royal College of Paediatrics and Child Health (RCPCH), used 16 child health measures2 to assess the UK against 14 other comparable countries3 in the Organisation for Economic Co-operation and Development (OECD). They said their findings show that governments in the UK must do more to improve maternal and antenatal health promotion, address health and socioeconomic inequalities, and protect public health budgets.

The report, by paediatrician and Nuffield Trust visiting fellow Dr Ronny Cheung, found that:

  • Child health outcomes have improved across nine of the 16 areas examined over the past decade, including reductions in the rate of infant deaths, increases in cancer survival, and a rise in the rate of immunisation (for example the proportion of children in the UK receiving two doses of the measles vaccine has grown by almost a fifth over ten years and the infant mortality rate has reduced by nearly a quarter).
  • However, the rates of deaths for babies under a year old and for babies under 28 days have plateaued since 2013 – and in 2014, the UK had the fourth highest infant mortality rate among all comparable countries. Improvements in life expectancy have stalled since 2011.
  • The UK still lags behind countries including Sweden, Spain, Germany and the Netherlands on the uptake of measles vaccinations. Uptake of vaccines for illnesses such as whooping cough and meningitis have all dropped in the past year.
  • UK rates of breastfeeding are among the lowest in the world, with just 34% of babies in the UK receiving any breast milk at six months in 2010, compared with 62.5% in Sweden.
  • The UK has considerably more overweight or obese children than the average amongst high-income countries, and in 2013 it had one of the highest proportions of overweight girls aged 2-19, at 29% – second only to the US.
  • The UK has the second highest prevalence of babies born with neural tube defects.
Dr Cheung commented: “While international comparisons of health outcomes should be handled with care, this research has an unequivocal message: we must do much better for our children and young people. The recent changes to the UK’s trajectory on life expectancy, premature deaths and immunisation should set alarm bells ringing for policymakers about the effects of cuts to public health and early years services.”

The report also found that although the UK has a comparatively low rate of child income poverty using an OECD definition, the proportion of children in relative income poverty is now back to levels last seen in 2009/10; and the UK also has the second highest proportion of children in households where no adult is working.

RCPCH president Dr Russell Viner, who pointed out in his BMJ editorial today that money invested in child health brings clear and substantial returns, added: “We want to see the UK government develop a comprehensive cross-departmental child health strategy, which includes a ‘health in all policies’ approach to policy making. It’s also crucial that some of the biggest threats to child health are tackled boldly; for example, tighter restrictions on junk food advertising to tackle obesity, the reinstatement of child poverty reduction targets and crucially the reversal of damaging public health cuts.”

1. International comparison of health and wellbeing in early childhood. A report prepared by Nuffield Trust in association with Royal College of Paediatrics and Child Health, March 2018.
2. Life expectancy, low birth weight, breastfeeding rates, obesity, vaccine uptake, income poverty, parental education, parental employment, stillbirth, infant mortality, neonatal mortality, early childhood mortality, childhood cancer survival, congenital heart disease incidence, neural tube defects incidence and death due to unintentional injury.
3. Australia, Belgium, Canada, France, Germany, Greece, Ireland, Italy, the Netherlands, New Zealand, Portugal, Spain, Sweden and the United States.

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