Leading children’s charity Barnardo’s, the UCL Institute of Health Equity (IHE), and three Integrated Care Systems (ICSs) across England are today launching Born Unequal: Tackling the Root Causes of Health Inequity in Childhood, a groundbreaking new report which lays bare the deep and widening inequalities facing children across England – and demonstrates the vital role that the healthcare system and partners can play in addressing health inequalities.
“England is failing its children,” says Professor Sir Michael Marmot, Director of the UCL Institute of Health Equity (IHE) and co-chair of the Child Health Equity Board.
“Too many children are growing up in cold, overcrowded homes, breathing polluted air, experiencing food insecurity, and lacking nurturing activities fundamental to healthy development. These are the social determinants of health - and they shape not only childhood, but health and life chances across the whole life course.”
Children in England now face some of the poorest health outcomes in Europe, with inequalities continuing to widen and growing concern about the long-term impact on the next generation. Infants in England’s most deprived communities are twice as likely to die in their first year of life as those in the least deprived, while children living in poverty are 72% more likely to be diagnosed with a long-term illness. Children in the poorest 20% of households are four times more likely to develop a mental health disorder than those in the wealthiest.
Over 300 children and young people from across the UK were consulted at the start of the initiative about what health means to them.
“We kept saying the same thing: our health isn’t just about hospitals,” said 17-year-old Aisha Warsame. “It’s about feeling safe, having space to play, breathing clean air, and being able to learn. If leaders want things to change, they need to start where we actually live our lives.”
The report, which launches today at a joint event with the King’s Fund, comes at the end of three successful pilot programmes, each delivered in areas identified as having high levels of child health inequity.
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Birmingham & Solihull used corporate social responsibility and social value in procurement to direct meaningful support from businesses to children and families in deprived communities.
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In Cheshire & Merseyside, Tell Me a Story, Liverpool helped teenage parents build an emotional bond with their children, develop their early language skills and get them ready to start school by providing monthly picture books and specialist storytelling support.
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In South Yorkshire, the Friday Fun Club in Rotherham offered safe, nurturing after-school sessions that strengthened children’s emotional wellbeing, confidence, and engagement in learning.
Collectively, the report outlines how these pilots, informed by the voices of children and young people alongside system collaboration across health, local authority and Voluntary, Community and Faith Sector (VCFS), have demonstrated that preventative, community-based approaches can help improve children’s health and wellbeing to reduce inequality.
Launching alongside the report is the Child Health Equity Monitoring Framework; a powerful new resource to help local health systems understand and tackle the social determinants shaping children’s lives – from housing and education to safety, connection, and community.
Barnardo’s is now calling on the government to adopt a cross-government Child Health Action Plan, guided by the new Framework, to deliver on its ambition to raise the healthiest generation of children in the country’s history.
16-year-old Victor Agbontean, who took part in the programme, said: “Being part of this project showed me that young people’s voices can change things. But we need adults in power to keep going – not just for a year, but for the long term.”
Rukshana Kapasi, Director of Health, Quality and Inclusion at Barnardo’s and co-chair of the Child Health Equity Board, said: “Every day across Barnardo’s services, we see children who are full of potential but held back by circumstances they cannot control. Poverty, unsafe housing and unequal access to support mean these children are missing out on a good childhood and are more likely to have poor health and fewer chances in life. We simply don’t think that’s fair. Our report and findings released today show that change is possible. Now we need national leadership to scale that change, so that every child has the opportunity to thrive.”
Sir Michael added: “Action in our three areas, and in the around 60 health equity ‘Marmot’ places across the UK, is inspiring. But we need much more. It is the responsibility of central government to produce the transformational changes that reduce poverty of income and life chances. Such action will give all children the opportunity to lead flourishing lives.”