Yet another wake-up call on declining child health

We were happy to see your report about the worsening health of UK children, which was based on a study by the Royal College of Paediatrics and Child Health. However, it was disappointing that the report did not mention the shrinking number of health visitors and how this affects the health and wellbeing of young children and their families.

Health visitors are described by Unicef UK as the main support for early years, acting as a safety net for all families. They are a well-established and trusted profession. Health visitors are specialist nurses who focus on public health. They work with families to improve health and reduce differences in health outcomes between different groups. They provide the only service that is available to all families, checking on babies and children in their own homes.

All the major health issues highlighted in this critical report are within the area of responsibility of health visitors. They can significantly help to improve birth outcomes and child health, address falling immunisation rates, and support strong foundations for health and development throughout life. They also play a role in safeguarding children, supporting parents, and addressing broader social factors that affect health. They must continue to be central to community efforts aimed at improving child health and wellbeing.

Yet, the profession is facing a serious crisis. With 45% fewer health visitors than in 2015, the preventive support for families has been weakened due to years of insufficient investment. Rebuilding the workforce must be a top priority. If we are serious about improving child health and reducing inequalities, investing in health visiting is essential.

The Royal College of Paediatrics and Child Health is correct to call the state of children’s health in the UK a national embarrassment. While more investment in health services is crucial, the reasons for poor child health go far beyond the NHS. The most significant finding of the RCPCH study is not just worsening child health, but the profound inequalities that cause it. Children from poorer communities experience higher rates of infant mortality, obesity, poor mental health, and other negative health outcomes.

Children’s health is influenced long before they ever visit a doctor or hospital. It is affected by whether families can afford healthy food, live in warm homes, have secure housing, access green spaces, attend schools with good funding, and grow up without the constant stress of poverty. After years of budget cuts, reductions in preventive services, the high cost of living, and increasing child poverty, it is not surprising that health outcomes have remained stagnant.

The consequences of this extend beyond childhood. As the number of years people live in good health stops increasing, more individuals face lives affected by illness. Poverty does not only impact children’s health; it creates inequalities that continue throughout their lives. The growing difference between rich and poor children is the result of political decisions. Addressing poverty, inequality, insecure housing, and the decline of public services would do more to improve children’s health than any new targets for healthcare services. The healthiest societies are those that create the conditions where good health can thrive.

As Sarah Woolnough from the King’s Fund stated, this report is a wake-up call. The question remains: how many more wake-up calls are needed before governments take action?