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State of Child Health Report 2017

‘A vital and productive society with a prosperous and sustainable future is built on a foundation of healthy child development.’ Centre for the Developing Child, Harvard.

High income countries, including the UK, have seen extraordinary improvements in child and adolescent health over the past 100 years. At the beginning of the 20th century, one in six infants did not live until their first birthday in the UK (the infant mortality rate was around 150 to 160 per 1,000 live births). Today, infant mortality in the UK is 3.9 per 1,000 – meaning that only one in 256 infants do not reach their first birthday. Similar gains in mortality, morbidity and general health have been seen across childhood and also into adolescence. These improvements have continued over the past 30 years, albeit at a slower pace.

Advances in child health have particularly come from the control of infectious diseases, history's great killer of children, but also from preventing injuries and better management of common conditions such as asthma and diabetes. Much of this improvement is the result of the UK’s strong public health system and child health workforce, as well as continued advances in clinical medicine for children, underpinned by research.

Tracking progress

The UK was one of the world leaders in improving children's health through the 20th century, and our public health system, our NHS and the research undertaken within them are the envy of many across the world.

Yet there are concerning signs that not all is right and that the UK fares poorly in some child health comparisons with other wealthy countries. Mortality is the most concerning, with data showing that child deaths are higher than in comparable countries. There are also worrying signals from conditions such as diabetes, from public health issues such as obesity and in our children's overall wellbeing.

The RCPCH therefore decided to put together the first snapshot of infant, children and young people’s health across the UK. It covers physical and mental health and some of the main determinants of health, showing where our children are doing well but also where we must improve and how we can achieve this.

The report has been guided by the issues children and young people have told the RCPCH are important to their health and wellbeing (the next section outlines what they told us). This gives it a credibility and authority that complement the scientific work done in identifying, analysing and checking each indicator. The selection of indicators and collation of data were then overseen by a steering group of paediatricians and other child health experts. The report also focuses on the social determinants of health, examining how we as a society create the optimal environment for children to survive and thrive.

Perspective across the four nations

A key element of this report is that it is focused on the four nations of the UK. We have only included indicators where data are available from two or more countries (with a few exceptions). This has meant that some important data available only in one country could not be included. However, we felt it important to ensure this was a UK-wide perspective. In most indicators we see similar trends across countries, but those where there are differences provide us with opportunities to see how things could be better.

One issue highlighted by taking this approach is the lack of data on many of the included indicators for Northern Ireland.

Data shine a light on what we are doing and allow us to improve. Visibility in data is a key part of driving improvement, and we do a disservice to those who are not visible in our data systems.