Child Health Inequalities by Alison Burton

The UK is 16th out of 29 in the UNICEF league table of child well-being in the world’s rich countries. This is an improvement since the data was first compiled in 2007 when UK was the lowest ranking country, but it also highlights that we must do better. The picture of children’s wellbeing in England by age 5 years is still one of significant inequalities. There is continuing variation in England in important child health outcomes resulting from disadvantage and poverty. For example, child obesity at age 4-5 yrs. among the most deprived 10% population is approximately twice that among the least deprived 10% (12% vs 6.6%) and half of children in areas of social disadvantage have significant language delays.

Recent data from the Department of Education shows that around 60% of children have reached a good level of development by the end of the Foundation year which means that 40% of children are starting their school journey at a disadvantage. Across the country the reality is that in some areas fewer than half of children are “school ready” compared to over three quarters of children in others (range 41.2% - 75.3%).

The most important influence on children’s outcomes in the early years is parenting. However we know that many parents are struggling with difficulties such as lack of money, poor housing, mental illness or domestic violence which can impact on their ability to do many of the things that we take from granted - such as being able to spend time playing, cuddling and reading with their babies and children and that we know are so important in helping children to develop good cognitive, social and emotional wellbeing.

In October last year Public Health England committed to leading improvements in the public’s health in seven key areas including giving every child the “Best Start in Life”. Success will depend on a shared commitment across the system at all levels from national government departments to local communities and across organisational boundaries and budgets. We are in the process of holding a series of national “conversations” with as many partners as we can in the early years, health and local government sector and later in the year we will be holding some local events across the country. The aim of these conversations is to understand the opportunities and challenges in the environment we find ourselves living and working in, to learn from the people with the knowledge and experience of supporting families and young children and to co-produce a shared plan of actions that all partners can sign up to begin to close the gap in child inequalities over the next 5 years. We will talk and listen to what families think as well.

The transfer of public health commissioning for 0 – 5 year olds to local government is an opportunity to improve how we work together. For example, to integrate commissioning and delivery of universal health services with support for the wider determinants of health and wellbeing such as housing, transport, education and employment which we should not waste. Health visitors in particular are uniquely placed to identify needs at individual and community level, to get alongside people they serve in lobbying decision makers and empowering families and communities to articulate their needs and develop their own solutions.

We are interested in hearing what you think – get in touch!


Alison Burton is Maternity and Early Years Lead at Public Health England

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  1. Comment by Anne-Marie Martin posted on

    Hi. I work in the early years sector and would love to have conversations about physical activity in the under 5s.


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