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4 - Giving children the best start in life?
- Edited by Adrian Bonner, University of Stirling
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- Book:
- COVID-19 and Social Determinants of Health
- Published by:
- Bristol University Press
- Published online:
- 18 January 2024
- Print publication:
- 20 January 2023, pp 70-82
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- Chapter
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Summary
Introduction
It is universally accepted that giving children the best start in life should be one of the top priorities for any health and wellbeing system. A number of reports reinforce the need for evidence-based approaches to tackle health inequalities, highlighting that interventions focusing on early years are most effective, cost-effective and lead to improved individual and population health outcomes (Marmot et al, 2010; Marmot, 2020). An increasing number of reports have drawn attention to the importance of ensuring that efforts to recover from the COVID-19 pandemic not only ‘build back better’, but also ‘build back fairer’ (Marmot, 2020). For children and young people (CYP) together with their families this means addressing the significant challenges that existed before the pandemic, mitigating the negative impacts of the pandemic and also ensuring the future of our younger generation is safeguarded.
The size of the challenge before the COVID-19 pandemic
In England, over the last 15 years, social care spending on reactive services for children (including child protection and services for looked after children) has increased exponentially, with nearly two-thirds of councils reporting their 2018/2019 children’s social care budget was insufficient to meet actual levels of demand and spending (LGA, 2019). In order to meet these financial pressures, many local authorities have had no option but to cut non-statutory preventative and early intervention services. This has led to massive reductions in critical infrastructure, services and programmes that support the growth and development of CYP. A few examples have been the closure of Sure Start centres, cuts to public health grants and the resultant reduction in preventative programmes, including health visitors and school nursing and the decommissioning of Family Nurse Partnerships. Even before the COVID-19 pandemic, aligning the best start in life rhetoric with the reality was a significant challenge.
Before the pandemic hit, concerns had already been raised about the health and wellbeing of CYP living in the UK. In 2020, the Royal College of Paediatrics launched their ‘State of Child Health’ in the UK report, raising concerns over increasing numbers of children living in poverty, the stalling of progress in infant mortality and the widening inequality in a range of health indicators (RCPCH, 2020).
7 - Inequalities in Health and Wellbeing Across the Uk: A Local North-East Perspective
- Edited by Adrian Bonner, University of Stirling
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- Book:
- Local Authorities and the Social Determinants of Health
- Published by:
- Bristol University Press
- Published online:
- 25 March 2021
- Print publication:
- 14 October 2020, pp 121-148
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Summary
A City by the Sea
Yes I come from a city by the Sea
And its shores and its water have become a part of me
And when I die it's where I want to be
In a grave in that city by the Sea
I was born, I was raised upon the tide
And the salt, and the sea, yeah, it warms me up inside
Upon the sand, there is no place to hide
From the view where the ocean meets the sky
Yes it's cold and it's hard where I come from
And you do what your dad did or you don't quite belong
Forget all that ‘cause we’ll do as we please
There is life in my city by the Sea
Martin Longstaff, 2012Introduction
Chapter 2 of this book, by the Association of Directors of Public Health, provides a review of the system changes of public health, moving from the National Health Service (NHS) back to management by local authorities. The authors of that chapter also point to the major concerns about the limited potential for delivery upstream of health prevention and promotion that was due to reductions in funding from central government to local authorities. The Association of Directors of Public Health has long championed taking a whole-system and long-term view about how we create, enable and sustain the health and wellbeing of everyone in society.
This chapter will identify the challenges facing the North-East from a population health perspective, and the implications for the area of the contemporary context of the reductions in funding that widen health inequalities and create challenges in the labour market. It will consider the potential benefits of building new approaches that address these challenges using community assets, place-based, targeted, collaborative approaches and are based heavily on community ownership, participation and voice.
The chapter will review the responses of local authorities (LAs) in the North-East to reduced central government funding, examine key issues such as supporting vulnerable groups (children/young people, older people, homeless, unemployed and so on), then highlight LA and community responses and innovation approaches to supporting people via health and wellbeing strategies.