Action needed to close the gap in children’s health between different socio-economic groups
Government efforts to narrow the gap on health inequalities amongst children from different socioeconomic groups across England during the past 10 years have failed and may even have got wider, indicates research published online in the Archives of Disease in Childhood.
Researchers from London have said concerted efforts are now needed to change this trend especially as a rise in child poverty is anticipated in coming years as a consequence of the current financial climate.
Health inequalities, defined as the gap in health outcomes between different groups in society, exist such as those gaps between people at different ends of the socio-economic spectrum – wealthier and less affluent.
Between 1999 and 2010, the English government pursued a programme to reduce health inequalities which was described as being more developed, better resourced, and more stringently implemented and monitored than anywhere else in Europe.
The programme included increases to benefit payments, higher spending on health, education and housing, and a number of specific initiatives such as policies to reduce smoking and establish Sure Start centres for low-income families.
Previous research has shown that the gap between affluent and more deprived groups increased between 2003 and 2008 for multiple adult health risks such as smoking, poor diet and lack of physical exercise.
However, much of the extra money in England was spent on children’s services, and inequality did decrease for infant mortality and some other child health indicators over this period, including child road accidents, and teenage pregnancies.
Nevertheless, improvements were small and the programme targets were not met and previous studies have provided little information on many health inequalities that matter most for children, young people and their families outside of infancy.
Researchers from University College London’s Institute of Child Health and Imperial College NHS Trust, London, set out to investigate inequality trends between 1999 and 2009 among English children and young people.
They studied health outcomes identified as important by children and young people themselves and analysed data on two measures of current health (general health and presence of a long standing illness), as well as two leading risk factors for future ill health – smoking and obesity.
Nationally-representative data were used from four years of the Health Survey for England published in 1999, 2004, 2006, and 2009.
These represent the start, middle and finish of the main lifetime of the government’s strategy, supplemented by 2006 in which a boost sample of participants under 16 was surveyed.
The researchers analysed findings for children, adolescents and young adults aged from birth up to 24 years old.
Analysis of the results showed that there was no reduction of inequality in health status and key risk factors in children and young people between 1999 and 2009; in fact, there was some evidence of increased inequality.
All four outcomes – self/parent-reported general health; presence of a long-standing illness; obesity; and smoking – showed a significant increase in inequality at some point during the strategy, although absolute inequality in smoking among children aged 8-15 increased between 1999 and 2004 before decreasing again by 2009.
The authors praised the government’s attempts to change health inequalities, saying the gaps could have been even wider without the efforts made, but stressed that this was a long-term problem that should keep being tackled.
They concluded: “We propose that expected increases in child poverty may exacerbate the challenge of reducing child health inequalities in the future and we call for a concerted policy response.”
“Inequality trends in health and future health risk among English children and young people, 1999-2009”,
Dougal S Hargreaves et al.
Arch Dis Child 2013;00:1–6. doi:10.1136/archdischild-2012-303403