Pandemic effect on deprived children's health could last into adulthood

Progress has stalled in efforts to improve young children’s health, an in-depth analysis of the past two decades has revealed.

Nuffield Foundation researchers found that while children under five are healthier today overall than 20 years ago, the health gap between disadvantaged youth and their well-off peers is growing – and was turbocharged by the pandemic.

By 2017, the infant mortality rate in the most deprived parts of England was nearly double the rate seen in the wealthiest areas – at 6.0 per 1,000 live births compared to 3.1 – and the disparity is increasing. 

The gap is even wider between ethnic groups, with 7.3 deaths per 1,000 live births of babies from Pakistani backgrounds compared to 3.2 for those from white British backgrounds. Researchers found a “small but unprecedented” increase in infant mortality over the past five years.

“There is such a clear link to levels of poverty and deprivation,” said Carey Oppenheim, early childhood lead at the Nuffield Foundation. Tackling child poverty must be made a policy priority if “substantial progress” is to be made, she added.

“It is very worrying that after two decades of improvement in young children’s health, progress on some key indicators has stalled or gone into reverse.”

The study showed an increase in children admitted to hospital with respiratory illnesses, the same year campaigners pushed for legislation to protect young people from air pollution.

Researchers found a worsening picture on low birthweight and obesity as well as infant mortality, with disadvantaged children most affected.

“Poverty is a significant driver of poorer health outcomes,” the report stated, “and has been rising particularly steeply for families with a child under five.”

Babies born into families on low incomes were more likely to have a low birthweight, according to the study, which is closely tied to prematurity and infant death as well as impacting a child’s development.

The gap between deprived and wealthy families narrowed between 2005 and 2011, the report said, but began increasing among low-income households after 2012 and eventually returned to 2005 levels.

Young children’s mental health has deteriorated, the research suggests. Around six per cent of two-to-four-year-olds are thought to have a mental health disorder – but this is higher among children whose parents rely on benefits to make ends meet.

The study was published as a health and social care committee report warned the demand for mental health services among children is pushing the NHS to “breaking point”.

“Our children’s futures can’t be put at risk because the government continues to ignore the rising demand for mental health services,” said Dr Rosena Allin-Khan, Labour’s shadow cabinet minister for mental health.

“Throughout the pandemic, we have been warning of the mental health impact of Covid on our children and young people.

“Urgent action is needed now.”

The Covid-19 crisis had a dramatic knock-on effect on the physical health of children in poverty too, the Nuffield Foundation study showed. By 2021, a fifth (20 per cent) of youngsters aged four and five living in the most deprived areas were obese, compared to eight per cent of kids in well-off regions.

Existing health inequalities were exacerbated by the pandemic’s impact on both parental and child mental health, researchers said, as well as the dramatic reduction in health services for children.

Urgent action to address the issue is “vital to the future health of our society,” they concluded, recommending a review of how healthcare serves young children and integrated services which support families in terms of both health and social wellbeing.

The researchers also called for an investigation into how poor health and poverty, ethnicity and location intersect and drive down quality of life for youngsters.

The “concerning trends” revealed by the research “reflect a failure to put the needs of babies and young children first,” said Dr Dougal Hargreaves, co-author of the report and reader in paediatrics and population health at Imperial College London.