UK progress on child health ‘stalled’ or ‘in reverse,’ concludes report

Author: Caroline White

UK progress on many measures of child health and wellbeing has stalled or gone into reverse ─ something that is rarely seen in high-income countries concludes a report* from the Royal College of Paediatrics and Child Health (RCPCH), published today.

The report, which includes the largest ever compilation of data on the health of babies, children, and young people across all four UK nations, shows that for most indicators, health outcomes are worse for children who live in deprived areas.

Inequalities in some outcomes have widened since the last report was published in 2017. Progress has also been seriously affected by deep cuts to local authority budgets, used to finance public health initiatives and community services.

Despite some notable improvements in children’s health, the UK is often lagging far behind other countries, says the report. For example, despite a fall in the number of emergency asthma admission, the UK still has one of the highest death rates in Europe for children and young people with asthma.

The UK is fifth from bottom among 27 European countries for infant mortality, which in England stalled between 2013 and 2018 at 3.9/1000 livebirths.

Dr Ronny Cheung, RCPCH clinical lead and co-author of the report, said: “Two weeks ago, the Marmot Review presented a stark picture about life expectancy in England. Now, our own report shows troubling signs for children and young people across the UK.

“The harsh reality is that, in terms of health and wellbeing, children born in the UK are often worse off than those born in other comparably wealthy countries. This is especially true if the child is from a less well-off background.”

He continued: “Infant mortality is a globally-recognised sign of how well a country is looking after the health of its citizens. Throughout the world, the number of babies dying in their first year has been steadily falling for decades, as incomes rise and mothers and children receive better healthcare.

“Yet UK infant mortality rates have stalled, and in England, they actually got worse between 2016 and 2017. For a high-income nation such as ours that should be a major wake up call.” 

This latest report brings together 28 measures of health outcomes, ranging from conditions, such as asthma, epilepsy, and mental health problems, to risk factors for poor health, such as poverty, low rates of breastfeeding, and obesity.

Community paediatrician and co-author, Dr Rakhee Shah, commented: “Investment in preventative health services must now be prioritised by the new UK government. England has seen a huge decline in spending on local services and I see the results of that every day of my working life, especially for my most disadvantaged patients. The cuts to services also have an impact on our NHS – people have fewer places to go to get advice, support, and stay well.”

The authors make a raft of policy recommendations for each nation. For England, these include the introduction of a cross-departmental National Child Health and Wellbeing Strategy to address and monitor child poverty and health inequalities; and the restoration of the £1 billion of real-terms cuts to the public health grant for Local Authorities.

RCPCH president, Professor Russell Viner, said: “We’ve got a lot of work ahead of us if we’re to get a grip on the state of child health in the UK. This report is the only one of its kind to zoom out and look at the full picture, and it’s not a pretty sight. On many vital measures we risk lagging behind other European countries.”

There were some positive signs, he said, citing the fall in teenage pregnancies, the reduction in youth violence in Scotland, and advances in the treatment of conditions like diabetes.

“In many areas of healthcare, we’ve led the rest of the world. But we’re in danger of failing a generation if we don’t turn this situation around,” he said.

Responding to the findings, a Local Government Association spokesperson, said: “The government’s announcement of a real-terms increase in public health funding this year will help, but this report reinforces our call for long-term investment in councils’ public health and early intervention services if we are to protect children’s health, and it reaffirms the widening health inequalities we are seeing across the country.

“We have long argued that previous reductions to the public health grant have been a false economy, which only compound acute pressures for NHS and social care services further down the line.”

The spokesperson added: “We would like to see a workforce strategy, which, in addition to ensuring we have a sufficient supply of specialist public health nurses, recognises the benefits of having a diverse range of health visiting, school nursing, children’s centre and other early years staff in children’s and health services.”

*State of Child Health 2020. A report prepared by the Royal College of Paediatrics and Child Health, 2020.