Poor beginnings

Poor beginnings

Simply by growing up in a certain part of England, a child under five is more likely to have poor health that will impact the rest of their lives. That’s the conclusion of a new report by the National Children’s Bureau which looks at four key measures of health and well-being, including accidental injury.

Variation in four key outcomes for the early years

The first five years of a child’s life are critical to their future development. Poor beginnings uses the latest published data to analyse variation in four key outcomes for children’s health and development in the early years across England. It makes comparisons across English local authorities and regions, and uses the Indices of Multiple Deprivation to assess the link between the extent of deprivation in an area and early years’ outcomes.

The report shows how growing up in different areas of the country has a dramatic effect on young children’s lives. It points to startling variations in young children’s outcomes at regional and local authority level. And it shows how young children growing up in deprived areas tend to do worse than those living in less deprived areas.

However, significantly, the report shows that it is not inevitable that children in poor areas fare worse than those in more prosperous areas.

Childhood injuries

The report highlights how severe injury in childhood is linked to a range of health and psychosocial problems in the short and long term. Key findings include:

  •      If the North West had the same early childhood outcomes as the South East, it would have 31% fewer children under five admitted to hospital with an injury, equivalent to over 2,500 fewer cases a year.

  •       The proportion of young children who suffer an injury serious enough to be admitted to hospital ranges from 67.6 per 10,000 in Westminster to 316.4 per 10,000 on the Isle of Wight. This means that a young child on the Isle of Wight is over four times more likely to be admitted to hospital than one of their peers in Westminster.
  •       Comparing the most deprived local authorities with the least deprived local authorities shows a significant difference in key health outcomes for children under five. Outcomes for children in the more deprived areas are much worse, with higher levels of injuries.
  •       Of the 30 most deprived local authorities, 12 areas are in the worst fifth for injuries, with hospital admission rates of over 180 over 10,000 each year. This contrasts with the 30 most affluent local authorities, where none are in the worst fifth for injuries.
  •       If all local authority areas had the same outcomes as the least deprived fifth, across England there would be an 11% reduction in the number of children under the age of five admitted to hospital with an injury. This is the equivalent of over 5,000 fewer cases of early childhood injury.
  •      Although poor health outcomes clearly correlate with growing up in a disadvantaged area, there is also variation among the most disadvantaged areas. For example, in 2013-14 there were 100 cases (per 10,000) of a child under five being admitted to hospital due to an injury in Haringey compared to 241 in Middlesbrough, despite both having the same level of deprivation.

Opportunities to improve

The report concludes that local authorities taking responsibility for young children’s public health provides an opportunity for areas to improve young children’s lives, whatever their socio-economic context. It highlights how the development of effective local integrated systems and approaches are key for improving outcomes for young children, and local authorities and their partners need to take action together.

It calls on local authorities and their local health and well-being boards to use local data to identify where their outcomes for children’s health and development in the first five years are poor compared to other areas of the country, and to put in place long-term strategies for improving outcomes.

It also recommends that local areas ensure they use the transfer of public health for under-fives in October 2015 to integrate commissioning of services such as children’s centres, parenting support and health visiting.

Support from CAPT

CAPT offers local authorities evidence-based support for effective action. This includes an opportunity to talk through local injury data, compare outcomes to other areas and explore local prevention opportunities. To find out more, contact Kevin Lowe on 020 7608 7363.

More information

Download Poor beginnings

Read NCB’s area summaries document to explore the stories of deprived areas where young children's health and development is as good as, or better than, the national average.

Download NCB’s data on outcomes in local authorities as a spreadsheet.

View NCB’s interactive map http://www.ncb.org.uk/poorbeginnings

Updated September 2015