Dramatic variations in children's health by location revealed

The findings have been published ahead of next month's transfer of responsibility for public health services aimed at the under-fives, from Government to local authorities.

According to the National Children's Bureau's (NCB) report, children who grow up in deprived areas are more likely to have poor health and educational outcomes than those from more affluent parts of the country.

For example, the latest data shows 31.6 per cent of four- to five-year-olds in the most deprived areas of the country suffer from tooth decay, as opposed to 18.4 per cent in the most affluent areas (see infographic below).

The report, which compares the 30 most deprived local authorities with the 30 most affluent, uses data on four key outcomes for children's health and development in the early years: obesity, tooth decay, hospital admissions due to injury, and children achieving a good level of development by the end of Reception.

However, the Poor Beginnings report also shows that poor early health is not inevitable for children growing up in deprived areas, with some local authorities achieving better than expected results.

For instance, five of the most deprived areas are in the top two-fifths for children achieving a good level of development by the end of Reception.

The report also reveals variations in outcomes between areas that have similar levels of deprivation, for example in Salford 9.6 per cent of children are obese, compared to 12.8 per cent in Halton in the North West.

Regional differences

The South East has the best overall outcomes for early childhood obesity, tooth decay, injury and development. In contrast, the North West has consistently poor results.

However, the charity found that some regions perform very differently across the four outcomes. For example, London has a smaller number of hospital admissions due to injury compared to other regions and relatively high rates of children achieving a good level of development, but high levels of tooth decay and obesity.

The NCB says that if the North West enjoyed the same health and development as that in the South East, more than 15,000 cases of ill heath could be prevented, resulting in:

• 43 per cent fewer five-year-olds with tooth decay - more than 11, 000 children per year
• 31 per cent fewer under-fives admitted to hospital with an injury - equivalent to more than 2, 500 cases a year
• 12 per cent fewer obese four to five-year-olds - more than 1,600 children a year
• 11 per cent more children achieving a good level of development by the end of Reception class - or about 5,500 children per year.

Local authorities

The report shows even greater outcome variations when broken down by local authority. A child in Reception class in Barking and Dagenham is over two-and-a-half times more likely to be obese than a child of the same age in Richmond upon Thames, just 18 miles away. In Leicester, a five-year-old is over five times more likely to have tooth decay than a child in West Sussex.

The NCB says its findings suggest that more work is needed to understand how local strategies and programmes can make a difference given the variations in outcomes.

It goes on to call on the Government to set out a renewed strategy to improve the health and development of children and families in the early years, as well as further investigate the variations it has uncovered and how they relate to local health initiatives.

The charity also recommends the Government reviews plans to replace the Early Years Foundation Stage Profile with the new baseline assessment, as the assessment will not provide information on children's social and emotional development.

Chief executive of the NCB Anna Feuchtwang said, 'As these variations are closely linked to poverty, 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.'

Dr Carol Ewing, vice president for health policy at the Royal College of Paediatrics and Child Health (RCPCH), said, 'This report provides further evidence that children born to low-income families are at most risk of poor health.  In a country which describes itself as having one of the best health systems in the world, this type of health inequality cannot and should not exist.

'There is an overwhelming body of evidence showing that prevention and early intervention works.  We know that if children and families from the most vulnerable families are not supported in their early years, they are much more likely to suffer from ill health throughout their lives.

'But we have to challenge the idea that this is irretrievable – that if a child is born into a low-income family, they are automatically on a pathway to ill health. This simply isn’t the case.  Areas such as Hartlepool and Islington are addressing the trend and demonstrating that with targeted support and concerted effort, every child, no matter where they live or their family background,  has the potential to be healthy.  We urge Government to develop and implement a new child health strategy which takes a joined up approach to health, education and social care as this will help to tackle the root causes of health inequalities.'

Lambeth Early Action Partnership project

The NCB's Lambeth Early Action Partnership (LEAP) aims to transform the lives of babies, young children and their families living in the London borough. It is funded by the Big Lottery as part of its A Better Start initiative.

Still in the planning stages, LEAP will provide a wide range of programmes to support parents, particularly those from hard-to-reach communities, from conception until their child is four. The majority of programmes will be run from children's centres. It will also train 'parent champions' to support other parents.

One programme will aim to tackle Lambeth's higher than average levels of childhood obesity by providing support and information to families. According to Poor Beginnings, 12 per cent of fourto five-year-olds in Lambeth are obese, compared to a national average of 9.5 per cent.

Laura McFarlane, Lambeth Early Action Partnership project director, said parents and practitioners in Lambeth will co-design a universal community nutrition programme. The content will vary slightly across different communities depending on their needs, and may include food growing sessions and cook-and-eat sessions.

A similar initiative will be introduced for overweight and obese pregnant women.

In the next couple of months, LEAP plans to start rolling out its Watch, Wait and Wonder programme, to support parents of children under two with attachment issues.

• Read the NCB's area summaries here
• Link to interactive map - search your area