Income inequality 'puts children at risk of premature death'

Published on Thursday, 01 May 2014 09:30
Written by Govtoday staff

UK children are at a higher risk of premature death than their western European counterparts due to the growing gap between rich and poor and a lack of targeted public health policies to reduce child deaths, finds a new report from the Royal College of Paediatrics and Child Health (RCPCH) and the National Children's Bureau (NCB), launched today.

Every year, an estimated 2,000 additional children - that's five a day - die in the UK compared to the best performing country, Sweden.

The report, Why Children Die, written by Dr Ingrid Wolfe and other leading child health experts, including Michael Marmot, finds that many of the causes of child death - including perinatal deaths and suicides, disproportionally affect the most disadvantaged in society, and says that many child deaths could be prevented through a combination of societal changes, political engagement and improved training for children's healthcare professionals.

Why Children Die reviewed existing UK evidence on child deaths and their causes, and found that:

  • In 2012 over 3,000 babies died before age one and over 2,000 children and young people died between the ages of one and 19.
  • Over half of deaths in childhood occur during the first year of a child's life, and are strongly influenced by pre-term delivery and low birth weight; with risk factors including maternal age, smoking and disadvantaged circumstances.
  • Suicide remains a leading cause of death in young people in the UK, and the number of deaths due to intentional injuries and self-harm have not declined in 30 years.
  • After the age of one, injury is the most frequent cause of death; over three quarters of deaths due to injury in the age bracket of 10-18 year olds are related to traffic incidents.

The report highlights the importance of access to high quality healthcare for children and young people, calling for a reduction in preventable deaths through better training of healthcare professionals to enable confident, competent, early identification and treatment of illness, and better use of tools such as epilepsy passports, asthma plans and coordinated care between hospitals and schools.

Dr Hilary Cass, president of the Royal College of Paediatrics and Child Health, said: "We know there are things that all healthcare professionals can be doing better to help reduce avoidable child deaths - whether that's early detection of problems, safe prescribing or using effective tools such as asthma plans to manage conditions."

"But if we're to make real in roads into reducing these tragic mortality figures, we cannot do it alone. It's time that political parties of all colours took health inequalities seriously. At the moment, policies to reduce child mortality are too piecemeal, not targeted and fail to address the underlying causes."

Dr Ingrid Wolfe, lead author of the report and child public health expert, said: "Social and economic inequalities are matters of life and death for children. Countries that spend more on social protection have lower child mortality rates. The messages are stark and crucial. Poverty kills children. Equity saves lives. Social protection is life-saving medicine for the population."

Many of the causes associated with preventable child deaths affect the poorest families. For example smoking in pregnancy is one of the most important preventable factors associated with adverse pregnancy outcomes - attributed to around 2,200 preterm births, 5,000 miscarriages and 300 perinatal deaths ever year in the UK. And mothers who smoke during pregnancy are much more likely to be from poorer families.

Dr Hilary Emery, chief executive of the National Children's Bureau, said: "There are currently 3.5 million children living in poverty across the UK, that's 1 in 4; twice that of many industrialised nations. This report clearly illustrates the direct impact persistent inequality in our society has on the life chances of the most disadvantaged children and young people."

"Government needs to bring forward a revised child poverty strategy that has tackling health inequality as a central focus to prevent the disproportionate number of deaths amongst children in low income families. Equally important is enhancing the wellbeing and resilience of our children through education, and ensuring that every child grows up in a place that is healthy and safe."

"Now is the time to act, to ensure that all our children have the opportunity to fulfil their potential and live long and healthy lives, regardless of their circumstances."

RCPCH and NCBhave made specific recommendations on some of the most preventable causes of death highlighted in Why Children Die - including deaths from injuries, poisoning, road traffic accidents, poor mental health and neonatal deaths caused by risky behaviours during pregnancy. These include:

Taking action to reduce poverty and inequality:

  • Withdrawing the new cap on welfare spending and implementing a safety net so that the risks of rising living costs do not hit families with the lowest incomes.

Implementing measures to promote healthy pregnancy including:

  • High quality PSHE and SRE lessons in schools
  • Action across the health system to promote smoking cessation in pregnancy.

Creating healthy, safe communities and environments:

  • Introducing minimum unit pricing for alcohol.
  • Reducing the national speed limit in built up areas to 20mph.
  • introducing Graduated Licensing Schemes for novice drivers of all ages.

Creating an action plan for improving child and adolescent mental health services:

  • Department of Health should commission a regular survey to identify the prevalence ofmental health problems among children and young people.
  • Ofsted's inspection framework for early years settings, schools and colleges should include consideration of the extent to which these settings provide an environment that promotes children and young people'ssocial and emotional wellbeing.

Better training for healthcare staff:

  • All frontline health professionals involved in the acute assessment of children and young people should utilise resources such as the 'Spotting the sick child' web resource and complete relevant professional development so they are confident and competent to recognise a sick child.
  • Clinical teams looking after children and young people with known medical conditions make maximum use of tools to support improved communication and clarity around ongoing management, for example: introduction of epilepsy passports or asthma management plans where appropriate; cooperating with schools to meet their duty to support pupils with medical conditions.

The report also calls for a national child mortality database to ensure data can be compared and analysed across the UK.

Source: NCB

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