Yet another wake-up call on declining child health
Readers respond to a warning from the Royal College of Paediatrics and Child Health on a ‘national embarrassment’
We were pleased to see your report (UK children will be one of unhealthiest generations in decades, doctors say, 14 July) on the deteriorating health of UK children, based on a study by the Royal College of Paediatrics and Child Health. However, it was disappointing to see no mention of the shrinking health visitor workforce and the impact that this has on the health and wellbeing of young children and their families.
Health visitors are described by Unicef UK as the “backbone of the early years … the safety net around all families”. A long-established and trusted profession, health visitors are specialist public health nurses who work with families to improve health and reduce inequalities. They provide the only universal service that sees babies and children in their own homes
All of the big-ticket health concerns that have been flagged in this damning report fall within the remit of health visitors, who can contribute significantly to improving birth outcomes and child health, tackling falling immunisation rates, and supporting strong foundations for health and development across the life course – alongside their work in safeguarding, parenting support and addressing the wider social determinants of health. They must continue to be at the forefront of community-based efforts to improve child health and wellbeing.
Yet the profession is in crisis. With 45% fewer health visitors than in 2015, preventive support for families has been eroded over years of underinvestment. Rebuilding the workforce must be a priority. If we are serious about improving child health and reducing inequalities, investment in health visiting is key.Barbara StilwellPresident,International Collaboration on Community Health Nursing Research,Alison MortonCEO,Institute of Health Visiting, Sally KendallProfessor of community nursing and public health,University of Kent,Gina HigginbothamEmeritus professorof ethnicity and community health,University of Nottingham,Pam SmithProfessor of nursing,University of Edinburgh
The Royal College of Paediatrics and Child Health is right to describe the state of children’s health in the UK as a “national embarrassment”. While greater investment in health services is essential, the roots of poor child health lie far beyond the NHS. The most striking finding of the RCPCH study is not worsening child health alone, but the deep inequalities that drive it. Children from poorer communities face higher rates of infant mortality, obesity, poor mental health and other adverse health outcomes.
Children’s health is shaped long before they enter a clinic or hospital. It is shaped by whether families can afford nutritious food, live in warm homes, access secure housing, enjoy green spaces, attend well-funded schools and grow up free from the chronic stress of poverty
After years of austerity, local government cuts, reductions in preventive services, the cost of living crisis and rising child poverty, it should surprise no one that health outcomes have stagnated. The consequences extend far beyond childhood: as healthy life expectancy stalls, more people face lives shaped by ill health. Poverty does not simply affect children’s health; it drives inequalities that persist throughout life.
The widening gap between rich and poor children is the result of political choices. Tackling poverty, inequality, insecure housing and the erosion of public services would do more to improve children’s health than any number of new clinical targets. The healthiest societies are those that create the conditions in which good health can flourish
As Sarah Woolnough of the King’s Fund said, this report is a wake-up call. The question is: how many wake-up calls do we need before governments act?DrLouise LawsonLecturer in social policy, University of Glasgow
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