Widening inequalities for children in the North of England cost billions, increase poverty and cost children’s lives

A MAJOR new report out today paints a stark picture of inequality for children growing up in the North of England post-pandemic compared to those in the rest of the country.

The considerable costs to society and the UK’s economy of rising inequality are outlined in The Child of the North: Building a fairer future after COVID-19 report, produced by the Northern Health Science Alliance (NHSA) and N8 Research Partnership (N8), and written by over 40 leading academics from across the North of England.

The report looks at a wide range of factors, from child poverty to children in care, to build up a picture of The Child of the North. It sets out 18 clear recommendations that can be put in place to tackle the widening gap between the North and the rest of England.

It shows that:

• Children in the North of England’s loss of learning, experienced over the course of the pandemic, will cost an estimated £24.6 billion in lost wages over lifetime earnings.
• Children in the North are more likely to be obese than a child elsewhere in England. At Year 6 (age 11): 22.6% in the North compared to 20.5% in the rest of England.
• Children in the North have a 27% chance of living in poverty compared to 20% in the rest of England.
• They have a 58% chance of living in a local authority with above average levels of low-income families, compared to 19% in the rest of England.
• Compared to children in England as a whole, they are more likely to die under the age of one.
• They missed more schooling in lockdown than their peers elsewhere in England. Only 14% received four or more pieces of offline schoolwork per day, compared with 20% country-wide.
• The mental health conditions that children in the North developed during the pandemic could cost an estimated £13.2 billion in lost wages over their working lives.
• Children in the North are significantly more likely to be in care than those in the rest of England. Of the local authorities with more than 100 children per 10,000 in care, 21 of 26 are in the North.
• Pupils in the North East and Yorkshire and Humber lost 4-5 times more learning in primary maths compared to areas in the South (4.0 and 5.3 months’ learning loss respectively, compared to less than a month in the South West and London).
• During the pandemic children in the North were lonelier than children in the rest of England. 23% of parents in the North reported that their child was ‘often’ lonely compared to 15% in the rest of the country.
• Their parents and carers were also more likely to have often been lonely during the first lockdown: 23% in the North compared to 13% in the rest of England.
• Prior to the pandemic, the North saw much larger cuts to spending on Sure Start children’s centres. On average, spending was cut by £412 per eligible child in the North, compared to only £283 in the rest of England.
• More than one in five children in the North are from an ethnic minority. These children are more likely to live in a deprived area than children from an ethnic minority in the rest of England.

Professor of Epidemiology at the University of York and co-lead author of the report Kate Pickett said: “Levelling up for the North must be as much about building resilience and opportunities for the Covid generation and for future children as it is about building roads, railways and bridges. But the positive message of this report is that investment in children creates high returns and benefits for society as a whole.”

Professor of Public Health and Policy at the University of Liverpool and co-lead author of the report David Taylor Robinson said: “Children growing up in the North of England get a bad deal. Due to poverty and lack of investment, their outcomes are worse across the board - from risk of death in childhood, to obesity, mental health, and education, and the pandemic has made the situation worse. The stark inequalities exposed in our report are preventable and unfair. Levelling up must begin with better policies for children.”

Hannah Davies, Health Inequalities lead for the Northern Health Science Alliance and report co-author, said: “This new report illustrates in no uncertain terms that without significant, properly-funded measures to tackle the entrenched inequalities experienced by children in the North of England, from birth, there will be no levelling up in the country.”

Stephen Parkinson, of the N8 Research Partnership and report co-author, said: “If we fail to focus on children in the recovery, we risk burdening them with some of the most enduring consequences of the pandemic. As this report sets out, children growing up in the North have in many ways been disproportionately impacted, and we invite government at all levels to engage with our recommendations to secure the best possible future for them.”

Lemn Sissay OBE, Poet, Author and Chancellor of the University of Manchester, who wrote the foreword for The Child of the North report, said: “Inequality has been shown to be one of the most damaging things to society. The Child of the North report is a call to government, to educators, to all of us who are participants in this society, of our duty to gift our children equality, no matter where they are born.”

The authors have put forward a set of recommendations to tackle the inequalities suffered by children over the course of the pandemic. They include:

1. Increase government investment in welfare, health and social care systems that support children’s health, particularly in deprived areas and areas most affected by the COVID-19 pandemic.
2. Tackle the negative impacts of the pandemic in the North through rapid, focussed investment in early years services, such as the Health Improvement Fund. This should include health visiting, family hubs and children’s centres - as supported in the Leadsom review - but with investment proportional to need and area-level deprivation adequately accounted for.
3. Commissioners of maternity and early years services must consider the impact of pandemic-related service changes on inequalities in families and children’s experiences and outcomes. This must shape service delivery during the recovery.
4. Take immediate measures to tackle child poverty. Increase child benefit by £10 per child per week. Increase the child element in Universal Credit and increase child tax credits.
5. We must feed our children. Introduce universal free school meals, make the Holiday Activities and Food Programme scheme permanent, and extend it to support all low-income families. Promote the provision of Healthy Start vouchers to all children under five and make current government food standards mandatory in all early years settings.
6. Government should prioritise support to deprived localities by increasing the spending available to schools serving the most disadvantaged pupils in England. This requires a reversal of the current approach to resource allocation: the new national funding formula will deliver 3–4 percentage points less funding to schools in poorer areas relative to those in more affluent areas.
7. Support educational settings to initiate earlier interventions. Teachers and early years professionals see many of the first indicators of children’s risk and vulnerabilities. Prioritising strong pupil and staff relationships and collaboration with parents/carers will ensure a firm foundation for meeting children’s needs, and for a return to learning.
8. NHS England and the Office for Health Improvement and Disparities should adopt a public mental health approach that includes a focus on mental ill health prevention early in the life-course, recognising the importance of early detection and prompt access to professional treatment.
9. Government should invest in and develop a place-based monitoring system for understanding the longer-term mental health impacts of the COVID-19 pandemic on children and parents. Targeted support should then flow to families where needed, including outreach services more closely tailored to the needs of vulnerable parents.
10. Area-level measures of children’s physical and mental health should be developed to better understand place-based inequalities.
11. More National Institute of Health Research (NIHR) research should be undertaken into the relationship between child health and economic performance, in particular in understanding the likely causal pathways between these in order to identify entry points for policy.
12. Government should reinvest in services that tackle domestic abuse, recognising the part domestic abuse plays, not only in children entering care, but also in high conflict divorce and separation cases, which also feature disproportionately in the North.
13. Address the uneven geographic distribution of children’s residential care, including secure provision, in order to reduce the disproportionate burden on the North.

An impact assessment of the disproportionate costs to a range of services in the North due to the number of children with complex care and support needs, is needed and long overdue.

14. Embed Equity Impact Assessments in all COVID-19 recovery and other policy processes relating to socioeconomic deprivation at national, regional and local levels.
15. Use Children’s Rights Impact Assessments to anticipate and evaluate the specific impact of COVID-19 recovery strategies on children and young people. Collect, disaggregate and publish relevant data so that the impact of the pandemic on children can be routinely evaluated.
16. Promote and expand the Race Disparity Audit, sharpening the focus on children and drawing on disaggregated data by region. Ethnicity should be included in all national public health data collection systems, including child and maternal health datasets.
17. Increase the representation of ethnic minority staff within public services and in decision-making processes with specific recruitment targets, recruitment campaigns and greater transparency on the percentage of ethnic minority staff. This should be particularly in leadership positions, in order to reflect the populations served.
18. Local COVID-19 recovery strategies must be grounded in internationally recognised human rights-based values and principles, notably those contained in the United Nations Convention on the Rights of the Child 1989.

A full embargoed copy of the report can be found here.

ENDS

MEDIA CONTACT 
For more interviews, comment etc. contact Ruth Boston, NHSA Communications Manager: ruth.boston@theNHSA.co.uk / 07952980545. 

Interviews are available with the report authors on request: 

Professor Kate Pickett: Professor of Epidemiology and Deputy Director of the Centre for Future Health at the University of York.  She is a Fellow of the RSA and a Fellow of the UK Faculty of Public Health. Her research focuses on the social determinants of health and health inequalities. She works closely with Born in Bradford and leads the Healthy Livelihoods theme for ActEarly. Within the Yorkshire & Humber Applied Research Collaboration she co-leads the Early Years and Prevention theme. 

Professor David Taylor-Robinson: Professor of Public Health and Policy at the University of Liverpool, and Professor of Child Public Health at the University of Copenhagen. He works clinically as a Consultant in Public Health at Alder Hey Children’s Hospital in Liverpool.  David’s research aims to improve child health and reduce inequalities. He co-leads the Health Inequalities Policy Research Group (HIPR) at the University of Liverpool. 

Dr Luke Munford: Senior Lecturer in Health Economics, University of Manchester. He co-leads the health in a wider context theme within the School of Health Sciences as well as the economic sustainability theme within the NIHR ARC Greater Manchester. 

Dr Sophie Wickham: Wellcome Trust Research Fellow at the University of Liverpool. Sophie is part of a team that researches the effects of welfare reform and poverty on different aspects of health and health inequalities, and has produced extensive research on health inequalities in the UK and on the health consequences of poverty. Sophie’s fellowship has focused on the impact of policies that aim to reduce child poverty on child and maternal mental health and health inequalities – with recent work focusing on the mental health impact of universal credit.

Professor Clare Bambra: Professor of Public Health, Newcastle University. She leads the health and care inequalities theme for the NIHR Applied Research Collaborations and is a Senior Investigator in the NIHR ARC North East and North Cumbria. 

Hannah Davies: is Health Inequalities lead for the NHSA. She has developed its health inequalities programme, launching the 2018 Health for Wealth report and co-authoring its ‘COVID-19 In the Northern Powerhouse’ and ‘A Year of COVID-19 in the North’ reports. She helped launch the Northern Universities Public Health Alliance and leads the NHSA’s health inequalities work with the NIHR ARCs. 

Professor Carolyn Summerbell: A dietitian and Professor of Nutrition at Durham University. Her research focuses on the collation of evidence for the prevention of obesity in children, and the dissemination and translation of this evidence into policy and practice, in addition to the development and evaluation of interventions to prevent childhood obesity. The need to assess and reduce health inequalities underpins this programme of work. Carolyn is Deputy Director of Fuse, which is a member of the National Institute for Health Research (NIHR) funded School for Public Health Research.

Professor Jonathan Bradshaw CBE, FBA: Emeritus Professor of Social Policy at the University of York.

Professor Caroline Bond: Professor of Educational Psychology at the University of Manchester, and a practitioner educational psychologist. She is an experienced researcher and has undertaken a number of funded projects, particularly in the areas of developmental difference and educational psychology practice.

Professor Helen Stalford: Professor of Law and founding director of the European Children’s Rights Unit, School of Law and Social Justice, University of Liverpool. She has researched and published extensively on children’s access to and enforcement of their rights in an international, European and domestic context.

Professor Uta Papen: Professor of Literacy Studies and Co-Director of the Lancaster Literacy Research Centre. She has researched widely on the teaching of reading and writing in primary schools, critically examining current policy and how it is implemented by teachers in schools. She is particularly interested in the role of a broad and inclusive literacy curriculum that engages all children.

Jason Halford: Head of the School of Psychology at the University of Leeds, President of the European Association of Obesity (EASO), and former Chair of the UK Association for the Study of Obesity (ASO). He is a Chartered Health Psychologist. Over the past 10 years his research has focused on drug-induced weight gain, the effects of nutrients and fibre on appetite and hormone release, the effects of stress on eating behaviour, the effect of marketing on children, and on lean-obese differences in the expression of appetite.

Professor Sarah Salway: Professor of Public Health in the Department of Sociological Studies, University of Sheffield. Sarah’s work lies at the intersection of sociology, social policy and public health, with the aim of understanding and addressing the social and political determinants of health and wellbeing. Her work has particularly focused on health inequalities linked to migration, ethnicity and gender, and the processes of identification and in/exclusion operating at policy, practice and community levels that shape health-related experiences and outcomes.

Professor Karen Broadhurst: Professor in the Department of Sociology at Lancaster University and Co-Director of the University’s Data Science Institute. Karen also founded and directs the Centre for Child and Family Justice Research. Karen's team produced the first estimate of women's repeat appearances in the family courts, drawing attention to the impact of "repeat removals" of children on birth mothers, their partners and wider family networks. Subsequently, Karen's work has also evidenced the considerable regional disparities in rates of children appearing before the family courts in England and Wales, but also access to justice.

Professor Mark Mon-Williams: Holds a Chair in Cognitive Psychology at the University of Leeds, is Professor of Psychology at the Bradford Institute of Health Research, Professor of Vision Science at The Norwegian Centre for Vision and a Turing Fellow at The Alan Turing Institute. He is the University of Leeds Academic Director for the Wolfson Centre for Applied Health Research and Director of Impact for Medicine and Health at the University of Leeds. He is also the Founder Director of the Centre of Applied Education Research. He leads the NHS Yorkshire and Humber Applied Research Collaboration group responsible for ‘Healthy Schools, and is an executive member of the Born in Bradford project.

EDITORS NOTES 
The NHSA ltd is a partnership established by the leading Universities and NHS Hospital Trusts in the North of England to improve the health and wealth of the region by creating an internationally recognised life science and healthcare system. It links ten universities and ten research-intensive NHS Teaching Trusts with four Academic Health Science Networks (AHSNs covering a population of over 16 million). 

The NHSA’s members include: Newcastle University, Durham University, University of York, University of Liverpool, University of Manchester, Lancaster University, University of Central Lancashire, University of Sheffield, Sheffield Hallam University, University of Leeds, The Newcastle Upon Tyne Hospitals NHS Trust, South Tees Hospitals NHS Trust, Leeds Teaching Hospitals, Sheffield Teaching Hospitals, Rotherham, Doncaster and South Humber NHS Foundation Trust, Manchester University NHS Foundation Trust, Liverpool University Hospitals NHS Foundation Trust, Hull and East Yorkshire Hospitals, Lancashire Teaching Hospitals, Tees, Esk and Wear Valleys Foundation NHS Trust, Innovation Agency, Yorkshire and Humber AHSN, AHSN North East North Cumbria, Health Innovation Manchester. 

For more information on the NHSA visit www.theNHSA.co.uk 

The NHSA, in partnership with MedCity, received funding from Research England for a three-year project to improve the visibility of UK life sciences expertise on the international stage, which began in early 2020. Funding is being provided from the Research England Development (RED) Fund which supports strategic projects aiming to implement innovations in research and knowledge exchange.  

Research England shapes healthy, dynamic research and knowledge exchange in English universities. It distributes over £2.2bn to universities in England every year; works to understand their strategies, capabilities and capacity; and supports and challenges universities to create new knowledge, strengthen the economy, and enrich society. Research England is part of UK Research and Innovation alongside the seven Research Councils and Innovate UK. www.ukri.org/re, @ResEngland 

The N8 Research Partnership is a strategic collaboration between the universities of Durham, Lancaster, Leeds, Liverpool, Manchester, Newcastle, Sheffield, and York, and aims to maximise the impact of this research base to enable business innovation and societal transformation.

The N8 universities receive around 80% of competitively awarded research funding in the North of England, or around £1.2bn annually, and employ more than 18,000 academic staff, forming the largest research-pooling partnership in the UK.

N8 creates programmes involving a critical mass of world class academics, which form networks of innovation excellence with partners in other sectors, to drive investment and economic growth.

For more information on the N8 visit www.n8research.org.uk.

The mission of the National Institute for Health Research (NIHR) is to improve the health and wealth of the nation through research. We do this by:

• Funding high quality, timely research that benefits the NHS, public health and social care;
• Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services;
• Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research;
• Attracting, training and supporting the best researchers to tackle complex health and social care challenges;
• Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system;
• Funding applied global health research and training to meet the needs of the poorest people in low and middle income countries.

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