a A decade of austerity combined with other factors, including the pandemic, has contributed to a deterioration in public health in Britain. The National Health Service in the four countries is not equipped to meet current demand, putting particular pressure on mental health services. The burden of chronic diseases continues to increase. Britain has the third highest level of obesity in Europe.
The contours of this increasingly dire situation are widely accepted. On Monday, Rishi Sunak admitted his government has failed to cut waiting lists as he promised. However, there is less agreement on how to tackle this enormous backlog. While health and care services urgently need new funding, there are also calls to tackle the problems caused by poor housing, nutrition and air quality.
a new report from the Academy of Medical Sciences shows how the general deterioration in the country’s health has affected one part of the population in particular: the under-fives. While themes such as obesity, tooth decay and the effects of poverty are not new, it brings them together to form a powerful case for change. One of the shocking details that emerges is the increase in infant mortality between 2014 and 2017, especially in the poorest areas.
As the architects of New Labour’s Sure Start program knew, the effects of economic deprivation on children’s health begin to be felt before birth. Household income is a robust predictor of maternal prenatal mental health, which in turn is closely linked to later problems. Children born into the poorest fifth of families in Britain are 12 times more likely to have health and education problems than affluent peers. More than 34% of children in the most deprived areas have cavities, compared to 14% in the least deprived areas.
There is evidence that these patterns can persist for long periods of time. Obese children are five times more likely to become obese in adulthood than others. But on the other hand, and as this report indicates, children respond more readily than adults to environmental changes. Because this developmental plasticity decreases over time, they can also be considered among the easiest people to help.
Deep-seated problems with housing supply and inadequate benefits will not be easily resolved – even if a future Labor government proves more willing to invest than seems likely. But doing too little will prove costly. From promoting breastfeeding to tackling air quality, the precise effects of different interventions will vary. But there is no doubt that the early years are crucial and that deficits are difficult to make up. With that in mind, rebuilding the health visitor workforce would be sensible, and consistent with the expansion of the family hubs that were set up in place of Sure Start. Home visits, such as health visitors, provide invaluable support.
Beyond that, and as other reports have argued, there is an overwhelming argument for a more joined-up and cross-government approach to young lives. Given what we know about how a child’s progress is determined by their overall situation, it makes sense to take a holistic approach. But such reallocations are not a substitute for resources. With the restoration of family centers, ministers have recognized the existing need. But much more will be needed to undo the damage caused by ten years of austerity.