Health and poverty
February 2000

Children's health and poverty
Mortality
Morbidity
Health-related behaviour
Mental health
Nutrition

Since the 1970s there has been a substantial widening of health inequalities. The table below shows the extent of the health inequalities in the early 1990s for men aged 20-64. If all men in this age group had the same death rates as those in classes I and II, it is estimated that there would have been 17,000 fewer deaths each year from 1991 to 1993.

Table: Estimates of the number of deaths and working years lost per year due to social class, inequalities in mortality, selected causes, men aged 20-64, 1991-1993, England and Wales [footnote 1]

Over this period there has also been a marked increase in poverty and income inequality, so that these variations affect ever-growing numbers. The latest figures show that 1in 4 (14 million people live in poverty compared with 1 in 10 in 1979. Families with children are over represented at the bottom end of the income distribution. 1 in 3 children are in poverty (4.4million). [footnote 2] There is increasing evidence of the effects of a child's socio-economic status on their health.

Children's health and poverty

Mortality
There are significant differences between social classes in stillbirth, perinatal and infant mortality rates. Overall infant and childhood death rates have fallen steadily in the UK. In 1986 in England and Wales they were 9.6 per 1,000, in 1996 it was 5.9.[footnote 3] However, it is still the highest of the developed countries of Europe.

Children, whose fathers are unskilled, have death rates double their counterparts in professional classes. The differential is particularly pronounced for death rates from injury and poisoning, which has increased from a threefold difference of classes IV/V over classes I/II to a five-fold difference. Children from social class V are four times as likely to die in accidents as those from social class I. The UK's death rate from accidents is 75 per cent higher than Sweden. [footnote 4]

Morbidity
Mean birth-weight is lower for babies whose fathers are in manual social classes. Mean birth-weight is even lower for babies whose birth is registered solely by the mother. Britain has the highest rate of low birth weight in the EU.[footnote 5] Birthweight is determined by the mother's weight and height. A healthy diet in pregnancy may have substantial beneficial effects on the child's health. Many mothers on state benefits are unable to afford a healthy diet.

Children in manual classes are twice as likely to suffer from chronic sickness than children in non-manual classes, although this difference is receding. Children living in social housing are more likely to consult their GP, particularly for a serious condition than those living in owner-occupied housing.[footnote 6] Asthma is the most common chronic illness with 1.3 million sufferers.[footnote 7] Children from ethnic minority groups are, as a result of poverty, substantially more likely to be unhealthy than their white counterparts.[footnote 8]

Health-related behaviour
Mothers with partners in manual classes are more likely to smoke during pregnancy than those in non-manual classes. This difference has increased in the past ten years, despite a fall in the rates of maternal smoking. Babies of fathers from social class I are more likely to be breastfeed (81 per cent) than those in social class V (44 per cent). Continued breastfeeding is also less common.[footnote 9]

Mental health
A recent Mental Health Foundation report found that at any one time up to 20 per cent of the child population of the UK is suffering from psychological problems. Diagnosable anxiety disorders affect 12 per cent of children, disruptive disorders about 10 per cent, attention deficit disorders around 5 per cent and psychotic and pervasive disorders around 1 per cent. 10 per cent of children will experience mental health problems severe enough to require professional help. Socio-economic disadvantage is a significant risk factor in the probability of a child developing a mental health problem.[footnote 10]

Nutrition
Children's eating habits are related to social class and household income. The diet of children from manual background has less fruit and cereals and more inappropriate weaning foods such as crisps, sweets and soft drinks.[footnote 11] Control on the advertising of these products would help address this problem.

The Acheson report also identified socio-economic differences in food consumption. People in lower socio–economic groups tend to eat less fruit and vegetables, and less food rich in dietary fibre. This means a lower intake of anti-oxidants and other vitamins and some minerals, particularly in relation to higher socio-economic groups. There is evidence that these inequalities have increased over the past 15 years. The report recommended increased benefits for expectant mothers and families with young children.

Food poverty is also experienced by many in low-income groups. The diets of those in lower social classes are more likely to lack choice and variety. There is evidence that some mothers go without food due to lack of money.[footnote 12]

Footnotes

1. Independent Inquiry into Inequalities in Health, 1998 Report of the independent Inquiry into Inequalities in Health (Acheson Report), London: the Stationery Office. Page 14.[back to text]
2.Households below Average Income: a statistical analysis 1994-1998/9, Leeds: Department of Social Security [back to text]
3. Social Trends 29 1999 Office of National Statistics London: Stationery Office [back to text]
4. Growing Up in Britain, 1999 London:BMA [back to text]
5. Growing Up in Britain, 1999 London:BMA [back to text]
6. Mother, fetus, infant and child & family: socio-economic inequalities, C.Law in Inequalities in Health, the evidence 1999 Bristol: Policy Press [back to text]
7. Health survey for England: The Health of Young people '95-97, 1998 London: Department of Health [back to text]
8. Health of Britain's Ethnic Minorities 1997. London:Policy Studies Institute [back to text]
9. Mother, fetus, infant and child & family: socio-economic inequalities C.Law in Inequalities in Health, the evidence 1999 Bristol: Policy Press [back to text]
10. The Fundamental Facts, 1999 London:Mental Health Foundation [back to text]
11. Health survey for England: The Health of Young people '95-97, 1998 London: Department of Health [back to text]
12. Independent Inquiry into Inequalities in Health, 1998 Report of the independent Inquiry into Inequalities in Health (Acheson Report), London: the Stationery Office [back to text]

February 2000