Last reviewed 20 December 2021

Progress in improving the health of children aged under five has stalled in recent years, according to a new report by the Nuffield Foundation.

The report reveals that in some measures, particularly infant mortality and obesity, children’s health is actually getting worse. Although under-fives are healthier today than 20 years ago, health inequalities between disadvantaged and advantaged children are increasing, with inequalities also evident between different regions and countries of the UK and different ethnic groups.

Poverty is a significant driver of poorer health outcomes across all seven indicators reviewed and has been rising particularly steeply for families with a child aged under five years old. Increasing levels of poor parental mental health also pose a risk for children’s health and wellbeing.

The report says that these health inequalities are being compounded by the pandemic, which has led to a spike in rates of obesity in children under five, worsening parental and child mental health and reduced health services for children, including a drastic drop in health visiting and community paediatric services.

The review highlights a number of key trends as follows.

  • The last five years have seen small but unprecedented increases in rates of infant mortality. The UK’s infant mortality rate is 30% higher than the median rate across EU countries.

  • Until the Covid-19 pandemic, rates of obesity in four and five-year-olds had remained broadly static since 2005 but they have soared in the last year.

  • Vaccination uptake rates have increased in the last 20 years but have been falling since 2014.

  • There have been improvements in the proportion of mothers who breastfeed immediately after birth, but rates for those who continue to exclusively breastfeed remain far below recommended levels and are among the lowest in high income countries.

  • Improvement in dental decay has slowed since 2014–15.

  • Evidence suggests respiratory health is worsening among children. Respiratory conditions are three of the top five reasons children are admitted to hospital.

The review concludes that the health of young children, which is vital to the future health and wellbeing of adults and our society, is at a critical point. It recommends action on the following four fronts.

  1. !eassessment of whether young children are receiving adequate universal healthcare services.

  2. Further development of integrated services that meet both the health and non-health needs of young children and their families.

  3. Action to address child poverty.

  4. Research to explore how the associations between poor health and place, ethnicity, and level of deprivation intersect, compound and accumulate.

Carey Oppenheim, early childhood lead at the Nuffield Foundation, said:

 “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.

“Our evidence shows that targeted interventions and integrated services can make a positive difference in specific areas of children’s health but the worsening picture on infant mortality, low birth weight and obesity is a major concern, with long-term consequences for health and wellbeing into adulthood.

“There is such a clear link to levels of poverty and deprivation that action to tackle child poverty also needs to be a policy priority if substantial progress is to be made.”