Marmot Review warns of ill health for children


Health experts have warned that almost half the children in England are failing to reach a good level of development by the age of five, a measure which is used as an indicator of future health prospects.

The Marmot Review, led by Sir Michael Marmot, director of the International Institute for Society and Health at University College London, sets out the most effective ways of reducing health inequalities in England from 2010 by looking at five key indicators that are used to predict future health.

These are life expectancy, disability-free life expectancy, child development at five, young people out of work and households on means-tested benefits.

Although life expectancy has improved dramatically over the last 10 years, with men in the bottom quarter of society seeing their life expectancy increase by almost three years, there are still people in England who are living with ill-heath.

The difference in life expectancy in men between the poorest and the wealthiest is more than nine years for roughly half of the authorities in England, and six years for women.

The assessment of children's development at the age of five found that 44% of all five-year-olds in England are not considered by their teachers to have reached a level where they should be able to share, self-motivate, co-operate and concentrate at school.

Experts agree that reading to children every day has a positive impact on their development, but research shows poorer families are less likely to engage in reading activities.

British Medical Association president, Sir Michael Marmot, told BBC Radio 4's Today programme: "There are cohort studies that follow children from birth right through life to adulthood, and you can see that the circumstances in early childhood affect and health and health inequalities in adult life.

"There is no question that inequalities in society are, in large measure, responsible for inequalities in early child development.

"Now, a big part of that is parenting. If parents can't parent properly because they are poor, depressed, pressed in by circumstances ... then we need to be there to support those parents.

"I suspect that a simple intervention like reading to children every day is something that, if parents can't do it, others could step in and help. It can make a huge difference."

"There are data from Canada that suggest half the deficit in readiness for school associated with low income can be reversed by reading to children daily.

"It's been put to me that these sort of recommendations we are making in straitened economic circumstances are going to be difficult, but reading to children is not an expensive intervention."

Dr John Middleton, vice-president of the Faculty of Public Health, said:"The challenge is now for local authorities, working together with public health colleagues and supported by national government initiatives, to invest money and expertise in addressing  inequalities."

A spokeswoman for the Department for Education said the Government was determined to tackle the divide between children from the richest and poorest households.

She said: "To do this, we will put in place a pupil premium to support the most disadvantaged children, introduce a reading progress check for six-year-olds to identify those falling behind before it's too late, and raise standards in education across the board through our schools reforms."

The review, which was commissioned by the Secretary of State for Health, makes six key recommendations which focus on giving children the best start in life, enabling all children, young people and adults to maximise their capabilities, creating fair employment and good work for all, ensuring a healthy standard of living for all, developing healthy and sustainable places and communities and strengthening the role and impact of health prevention.

February 2011