Breaking the link between poverty and poor health outcomes


The work schools undertake to promote the health and wellbeing of students is far-reaching, the whole system must work harder to break the link between disadvantaged children and poor health outcomes. Dr Hilary Emery explains.

Helping children to be healthy and encouraging them to make healthy lifestyle choices is a fundamental concern of schools across the country. 

Teachers are reminded of the importance of their role by the chief medical officer’s (CMO) annual report. It makes a compelling case for early intervention and preventative work on child health, exactly the type of initiatives that take place within schools. The report makes far-reaching recommendations and includes suggestions for how schools can play their part in the inter-agency approach required to improve child health.

Aptly titled Our Children Deserve Better, the report finds that the lives of five children every day could be saved if we could match the achievements of countries like Sweden. 

It makes a strong case for doing more to address health issues sooner rather later. For example, if the rate of obesity in children and young people was reduced by just one per cent, it could save the NHS nearly £1 billion a year on the cost of treating adult patients with long-term conditions due to overweight.

Schools are already doing great work to intervene early and ensure that children get a healthy start in life. The CMO praises the work of school nurses who provide a variety of important services (such as health and sex education, developmental screening, immunisation).

Similarly, many schools will be engaging with the School Food Plan that aims to continue the improvement of the quality of school meals, while encouraging children to eat healthy foods and teaching them how to cook healthy meals. 

Many schools continue to follow the Healthy Schools guidance. Its “plan, do, review” model helps schools identify the needs of pupils and devise interventions that match these needs. Interventions range from adopting a healthy diet, to improving behaviour and attendance through initiatives to encourage emotional wellbeing. Crucial work to reduce risky behaviours will also take place in PSHE classes.

But how do we make sure such positive work is reaching those most at risk of poor outcomes? To give an example, the CMO calls on local authorities, schools and Public Health England to develop innovative approaches to widening access to sports facilities in order to allow children to exercise more easily.

The report also calls for more to be done to build resilience in young people. The CMO is keen that Public Health England works with others to ensure schools that wish to adopt this approach are supported.

Perhaps most importantly, the CMO underlines how health and the environments in which children grow up are closely inter-related. The report finds that a higher percentage of children and young people are in, or at risk of, poverty or social exclusion compared to the overall population. 

We know from other research, including our own Greater Expectations report in August, that these poorer children suffer worse outcomes in practically every area of life, including health. Boys living in deprived areas, for example, are three times more likely to be obese than boys in affluent areas.

Solving these problems requires concerted efforts across education, public health, and the NHS, but also wider measures to tackle the cycle of deprivation and poor health outcomes which are so unfair on children. Education is undeniably an important part of improving child health, but only part of the answer. The up-front costs of addressing social inequality may be unappealing to government, but the alternatives are far worse. 

  • Dr Hilary Emery is chief executive of the National Children’s Bureau.

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