UK lagging behind peers on child health, new research reveals

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, and we are lagging behind most other high-income countries on mortality, breastfeeding and obesity rates.

That’s according to the first ever international analysis looking at UK child health measures over time and across 14 other comparable countries, published today by the Nuffield Trust and Royal College of Paediatrics and Child Health (RCPCH).

The report, written by paediatrician and Nuffield Trust Visiting Fellow Dr Ronny Cheung, is based on analysis of 16 child health measures in 14 OECD countries between the early 2000s and the last year for which data are comparable. The indicators examined present a broad look at child health outcomes - spanning life expectancy, nutrition, immunisations, and deaths in early childhood.

The report concludes that despite some impressive progress in recent decades, the UK remains a long way short of its stated ambition to be an international leader in fostering a healthy start for children. To tackle this, the Nuffield Trust and RCPCH say that Governments in the UK must do more to improve maternal and antenatal health promotion, address health and socioeconomic inequalities, and protect public health budgets.

Key findings from the report include:

· Child health outcomes have improved across nine of the 16 areas examined over the past decade, including reductions in the rate of infant deaths, increases in cancer survival, and a rise in the rate of immunisation. For example the proportion of children in the UK receiving two doses of the measles vaccine has grown by almost fifth over ten years and the infant mortality rate has reduced by nearly a quarter.

· Yet 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 all comparable countries. Improvements in life expectancy have stalled since 2011.

· The UK still lags behind countries like Sweden, Spain, Germany and the Netherlands on the uptake of measles vaccinations. Uptake of vaccines for illnesses like whooping cough and meningitis have all dropped in the past year.

· 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.

· The UK has considerably more overweight or obese children than the average amongst high-income countries and in 2013 it had one of the highest proportions of overweight girls aged 2-19, at 29% - second only to the US.

· The UK has the second highest prevalence of babies born with neural tube defects – something that can be prevented by taking folic acid.

The report also looks at social determinants of health. It finds that while the UK has a comparatively low rate of child income poverty using an OECD definition, the proportion of children in relative income poverty is now back to levels last seen in 2009/10. The UK also has the second highest proportion of children in households where no adult is working.

Commenting on the findings, report author Dr Ronny Cheung said:

“While international comparisons of health outcomes should be handled with care, 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.”

Nigel Edwards, Chief Executive of the Nuffield Trust said:

“It is a truism to say that looking after our youngest members of society reaps rewards in the future. And yet, 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.”

Dr Russell Viner, President of the RCPCH said:

“Given that children and young people make up a quarter of the UK population, it’s a real failure of the system that child health gets so little political attention. Investing in child health makes both moral and economic sense – for every £1 you put in, you get an average of £10 back in terms of future productivity.

“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. It’s also crucial that some of the biggest threats to child health are tackled boldly; for example tighter restrictions on junk food advertising to tackle obesity, the reinstatement of child poverty reduction targets and crucially the reversal of damaging public health cuts.”

NOTES TO EDITORS

· The 14 countries selected for their comparability with the UK are: Australia, Belgium, Canada, France, Germany, Greece, Ireland, Italy, the Netherlands, New Zealand, Portugal, Spain, Sweden and the United States.

· The 16 areas of comparison are: 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 and death due to unintentional injury.

· The Nuffield Trust is an independent health think tank. We aim to improve the quality of health care in the UK by providing evidence-based research and policy analysis and informing and generating debate.

· The Royal College of Paediatrics and Child Health (RCPCH) is responsible for training and examining paediatricians in the UK. The College has over 17,500 members in the UK and internationally, and sets standards for professional and postgraduate medical education. We work to transform child health through knowledge, innovation and expertise, ultimately ensuring a healthier future for children and young people across the world.