The situation for children is getting worse: for the first time in more than 17 years, child poverty in the UK has increased in absolute terms. While the poorest areas are being hit hardest by current austerity measures, it’s children’s services that are being disproportionately affected, with early years budgets facing significant cuts.
The Policy Exchange think-tank estimates that between 2010 and 2013, spending on children’s centres fell by 28%, with 580 children’s centres closing as a result of local authority cuts. Between 2009 and 2011 local government spending on family support, including early childhood development programmes, fell by £28 per person. And in Liverpool, due to the devastating centrally imposed budget cuts, the city council has recently announced proposals to cut the children’s centre budget by a huge 70%, leading to a likely reduction in children’s centres from 27 down to four. Other councils have put similar proposals forward.
Taking away this investment in the early years of life is a public health disaster. What happens to children in their earliest years is the litmus test of a society, and determines how well things turn out, or don’t, in adult life.
There are striking differences in the life chances of children based on the lottery of their place of birth. For example, there is a difference of more than 10 years in both male and female life expectancy at birth between a child born in Kensington in Liverpool (life expectancy of 74.8 years for men, 79.2 for women) and a child born in Kensington and Chelsea in London (life expectancy of 85.1 years for men, 89.8 for women). Within areas of Liverpool there are differences in life expectancy of more than 10 years between the least to the most deprived areas.
These differences in life expectancy are not “natural”, or biologically pre-determined, and largely result from exposure to adverse living conditions starting in early life. And there is a large body of evidence/research to show that early disadvantage tracks forward, to influence health and development trajectories in later life; the children who start behind tend to stay behind.
The first years
Children living in poverty in the UK are more likely to die in the first year of life; be born small; be bottle fed; be exposed to second-hand smoke; become overweight; perform poorly at school; die in an accident; become a young parent; and to die earlier. Disadvantage in early life means that children will be less likely to be in work, to live in a decent home, to earn a decent wage, and to report good health and well-being as adult.
Children who have grown up in adverse conditions are more likely to face recurring disadvantage that is harmful to their health as adults. This accumulation of health-damaging exposures over the course of people’s lives is likely to explain the close relationship between levels of child poverty, and life expectancy at birth in Liverpool.
The first years of life are crucial for brain development and provide the foundations for children’s capacities to learn. Consequently, getting it right in early life leads to better development and is less costly than trying to fix things later.
The benefits of investing in the early years are well demonstrated and large numbers of children stand to benefit. Investing in the early years will lead to overall benefits for population health, a reduction in health inequalities and clear net economic benefits.
For instance, the cost of treating behavioural problems in children in the UK is on average 10 times that of preventing them. A New Economics Foundation report further estimated that for every £1 invested in a children’s centre, a forecast social return to society of £4.60 can be expected.
But the arguments are not just about evidence, but also that investing in children is morally and legally the right thing to do. Children are often not in a position to speak out for themselves and for this reason are offered special protection under the UN charter on human rights.
A commitment to early years support is a critical, and cost-effective investment and these services should be protected. There has been some announcements about investment but it’s this is more complex than it first seems. The announcement by the government of additional support with childcare costs is to be welcomed, but it is unlikely to mitigate loss of key early years services. The expansion of childcare support for people on Universal Credit is going to be funded by cuts to Universal Credit so the overall gains may be limited. The expanded system of tax free child care will benefit more affluent families the most and due to rapidly rising costs won’t make childcare more affordable.
The healthy development of all children benefits all of society by providing a solid foundation for future health, learning, economic productivity and responsible citizenship. In the US for example, there is a “President’s Commitment” to “make sure no children start the race of life already behind”. Why can’t we commit to do the same?
A focus on early child development will improve the health of all children, not just in Liverpool but in other cities where rich and poor rub shoulders but who have very different life chances. It has the potential to improve the health of the most disadvantaged most quickly and so reduce health inequalities. This is the basis upon which strong communities and thriving cities are built.