‘Five for the under-fives’: Preventing serious accidents for children under five

Public Health England (PHE) recommends that local authorities and their partners develop child accident prevention strategies and programmes. Here we set out the scale and nature of the problem, outline the five key injury issues for children under five (choking, suffocation and strangulation; falls; poisoning; burns and scalds; and drowning) and describe what organisations can do.

A significant problem

Unintentional injuries are a leading cause of preventable death for children under five and a major cause of ill health and serious disability. A new resource from Public Health England (PDF, 1.4MB) reveals that, each year, across England:

  • 62 children under five die following accidents
  • 40,000 under-fives are admitted to hospital
  • around 450,000 under-fives attend A&E. 

In addition to the devastating impact of childhood death, acquired disability and serious injury on families, there are significant costs for the NHS and for local authority social care services.

PHE identifies unintentional injuries as a major health inequality. For the under-fives, the emergency hospital admission rate for unintentional injuries is 45% higher for children from the most deprived areas compared with children from the least deprived areas.

What injury causes should we focus on?

Children under five experience many different kinds of accidents. This can make it hard for organisations to focus their work for maximum impact. What types of injuries are the most serious? And which are most easily prevented?

PHE commissioned CAPT to analyse the data on deaths and hospital admissions for the five years from 2008-12. This analysis shows that, when the main causes are considered carefully, five injury types deserve priority for the under-fives – and all occur in and around the home. 

Five key issues for the under-fives

The five main causes of serious unintentional injury for the under-fives in England are:

Each article looks in more detail at the scale and nature of the issue, links with child development, and specific opportunities for action by authorities and their partners.

Action by local authorities and their partners

PHE makes a strong argument for local authorities to focus on tackling the leading, preventable causes of death and serious long-term harm for children under five. It highlights the importance of providing leadership, mobilising existing services, working in partnership, focusing on what works and addressing inequalities. 

Other hazards

While PHE has prioritised five principal causes of serious injuries to children under five, other causes should not be ignored. For example, exposure to smoke, fire and flames results in a high proportion of deaths among the under-fives in the home, but a relatively low level of hospital admissions. 

More information

  1. Reducing unintentional injuries among children and young people – a suite of resources from Public Health England.
  2. Reducing unintentional injuries for under 5s poster (PDF, 193kb)
Updated September 2014