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UK ‘lagging’ on health outcomes for babies and young children

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After many years of progress, health outcomes for babies and young children in the UK are now stalling in several key areas like infant mortality and immunisation levels, a report has warned.

The country is also lagging behind most other high-income countries on mortality, breastfeeding and obesity rates, according to the Nuffield Trust and Royal College of Paediatrics and Child Health.

“We must do much better for our children and young people”

Ronny Cheung

The think-tank and the college have published the first ever international analysis looking at UK child health measures over time and across 14 other comparable countries.

It is based on analysis of 16 child health measures in 14 Organisation for Economic Co-operation and Development (OECD) countries. The indicators examined present a “broad look” at outcomes – covering life expectancy, nutrition, immunisations and deaths in early childhood – said the two organisations.

Their report – International comparisons of health and wellbeing in early childhood – concluded that, despite some impressive progress in recent decades, the UK remained a long way short of its stated ambition to be an international leader in fostering a healthy start in life.

The two organisations said the UK governments must do more to improve maternal and antenatal health promotion, address health and socioeconomic inequalities, and protect public health budgets.

“It’s a real failure of the system that child health gets so little political attention”

Russell Viner

Key findings included that outcomes have improved across nine of the 16 areas examined over the past decade, including infant death rates, cancer survival, and the rate of immunisation.

For example, the proportion of children in the UK receiving two doses of the measles vaccine has grown by almost a fifth over 10 years and the infant mortality rate has reduced by nearly a quarter.

However, the analysis revealed that the rates of deaths for babies under a year old and tiny babies under 28 days have “plateaued” since 2013. In 2014, the UK had the fourth highest infant mortality rate among comparable countries and improvements in life expectancy have “stalled” since 2011, said the report.

The UK also still lags behind countries like Sweden, Spain and the Netherlands on uptake of measles immunisation, while vaccine uptake for illnesses like diphtheria, tetanus and whooping cough and pneumococcal vaccines have all dropped in the past year.

In addition, rates of breastfeeding are among the lowest in the world, with just 34% of babies in the UK receiving any breast milk at six months in 2010 compared with 62.5% in Sweden.

“School nurses and health visitors see at first-hand the effects of child health inequalities”

Fiona Smith

Meanwhile, the UK has considerably more overweight or obese children than average among high-income countries and in 2013 had one of the highest proportions of overweight girls aged two to 19, at 29% – second only to the US.

The UK also has the second highest prevalence of babies born with neural tube defects – something that the report authors noted could be prevented by taking folic acid.

Report author Dr Ronny Cheung, paediatrician and Nuffield Trust visiting fellow, said: “This research has an unequivocal message: we must do much better for our children and young people.

“The recent changes to the UK’s trajectory on life expectancy, premature deaths and immunisation should set alarm bells ringing for policymakers about the effects of cuts to public health and early years services,” he said.

Nigel Edwards

Nigel Edwards

Nigel Edwards

Nigel Edwards, chief executive of the Nuffield Trust, said: “With some honourable exceptions, child health is notably absent from much policy thinking at the moment and we are now falling behind our peers when it comes to several vital measures.

“It’s time for policymakers to take child health seriously before our somewhat mediocre international standing becomes even worse,” he said.

RCPCH president Dr Russell Viner said: “It’s a real failure of the system that child health gets so little political attention. We want to see the UK government develop a comprehensive cross-departmental child health strategy, which includes a ‘health in all policies’ approach to policy making.”

He added that it was also crucial that some of the biggest threats to child health were “tackled boldly”, with tighter restrictions on junk food advertising and the reversal of public health cuts.

The 14 countries selected for their comparability with the UK were:

  • Australia
  • Belgium
  • Canada
  • France
  • Germany
  • Greece
  • Ireland
  • Italy
  • The Netherlands
  • New Zealand
  • Portugal
  • Spain
  • Sweden
  • US

Meanwhile, the 16 areas of comparison were:

  • Life expectancy
  • Low birth weight
  • Breastfeeding rates
  • Obesity
  • Vaccine uptake
  • Income poverty
  • Parental education
  • Parental employment
  • Stillbirth
  • Infant mortality
  • Neonatal mortality
  • Early childhood mortality
  • Childhood cancer survival
  • Congenital heart disease incidence
  • Neural tube defects incidence
  • Death due to unintentional injury

Fiona Smith, professional lead for children and young people at the RCN, said: “This report highlights the serious health challenges facing children and young people in the UK.

“It’s unacceptable that the UK is lagging behind so many countries when it comes to their care and key health indicators such as obesity, breastfeeding and immunisation,” she said.

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Fiona Smith

Ms Smith highlighted that the number of children in relative income poverty was “deeply troubling”. “School nurses and health visitors see at first-hand the effects of child health inequalities and play a pivotal role in their mitigation,” she said.

“Yet their numbers are dwindling at an alarming rate and cuts to services across the UK mean that many children are not able to access the care they need,” she noted.

“If we continue on this trajectory, we are jeopardising the future of our children and young people,” she said. “The government must properly invest in children’s services.”

A spokesman for the Department of Health and Social Care said: “This government is committed to ensuring children get the best start in life – that’s why we have introduced mandatory health visitor checks, a world-leading vaccination programme and robust plans to tackle childhood obesity.

“Childhood mortality is at an all-time low, and we will continue to do everything we can to reduce the number of families who go through the tragedy of losing a child,” he added.

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