Startling variations reveal postcode lottery of child health in South East England

The health and development of children under five varies dramatically between different parts of England, finds a report published today, with young children in the South East enjoying the lowest rates of obesity, tooth decay and poor development in early childhood, and below average rates of injuries.

Nevertheless, in the South East over 8,000 children aged four to five are obese (8%), over 18,000 five year-olds have tooth decay (18%), and each year over 7,000 under-fives are admitted to hospital with an injury. Over a third of children in reception class do not reach a good level of development.

The analysis by the National Children's Bureau looks at important indicators of health and development in early childhood and reveals startling variations, with a five-year old in Slough around twice as likely to be obese, or to be suffering from tooth decay, as a child of the same age in West Berkshire.

West Berkshire, Bracknell Forest, Wokingham, Surrey, Windsor and Maidenhead, Brighton and Hove, and Buckinghamshire all rank among the ten local authority areas nationally with the lowest rates of early childhood obesity.

West Sussex, Brighton and Hove, Medway, Kent, Wokingham and Hampshire are among the ten local authority areas with the lowest rates of five-year olds with tooth decay.

Wokingham is one of the ten areas with the lowest rates of hospital admissions for children under five due to injury, while the Isle of Wight has the highest rate in England.

The report confirms that the health and development of children under five is closely linked to the affluence of the area they grow up in, with those living in deprived areas far more likely to suffer poor health.

Comparing the 30 most deprived local authorities in England with the 30 best-off, the report finds that children under five in poor areas are significantly more prone to obesity, tooth decay, accidental injuries and lower educational development. While only 18.4% of children living in the 30 richest areas suffer from tooth decay, this rises substantially to 31.6% of four to five-year-olds in the 30 most deprived areas.

However, the data shows that poor early health is not inevitable for children growing up in deprived areas. Several areas with high levels of deprivation buck the trend and achieve better than expected results, suggesting that more work is needed to understand how local strategies and programmes can make a difference.

Poor Beginnings is published as responsibility for public health services aimed at under-fives, including health visitors and family nurse partnerships, is transferred from central government to local authorities in October.

Anna Feuchtwang, Chief Executive of the National Children's Bureau 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 school. Government must make it a national mission over the next five years to ensure that the heath and development of the first five years of a child's life is improved.'

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 off 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 calls on the government to set out a renewed strategy to improve the health and development of children and families in the early years, and further investigate the variations uncovered in the report and how they relate to local health initiatives.

Poor Beginnings: health inequalities among young children across England is available from www.ncb.org.uk/poorbeginnings where there are also interactive maps detailing local authority and regional data.