This review by the Nuffield Foundation explores the significant developments in young children’s health over the last 20 years, focusing on seven fundamental indicators. While the review identifies improvements across these indicators, progress has recently stalled—and in some cases the situation has deteriorated.
Overall, young children are healthier than they were 20 years ago and more children are receiving a better start in life. Infant mortality rates have fallen. Vaccination uptake rates have increased. Breastfeeding has increased. Tooth decay has declined.
But this progress has stalled in the last five years and we are now seeing a reversal of some of these long-term improvements. Infant mortality rates increased three years in a row in England and Wales between 2015 and 2017. Vaccination uptake rates have started to decline, with only Scotland and Wales meeting the 95% coverage recommended by the World Health Organisation for herd immunity (for the 6-in-1 vaccine for one-year-olds). Obesity rates have soared during the pandemic, with over one quarter of four and five-year-olds now overweight or obese.
Health inequalities between disadvantaged and advantaged children have increased and inequalities are also evident between children from different geographical areas 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 under five since 2013/14. In 2018 the infant mortality rate in the most deprived areas of England was almost twice the rate of those from the least deprived areas.
While data has not historically been collected on young children’s mental health, parental mental health has worsened over time, which in some cases can negatively affect young children, including their own mental health. Perinatal mental health problems affect up to 20% of mothers, only about half of whom are identified and even fewer receive adequate treatment. In England, an estimated 11.5% of children under five live in a household with a parent suffering from a severe mental health problem.